The motion of the stars and celestial bodies result in inaudible sounds, reflecting the mathematical harmony of the macrocosm. In the animal kingdom, we see that music emerged long before humans did. Archaeologists have uncovered what they think were ancient flutes as old as 43,000 years and musical notations as old as 4,000 years. Music has always played a part in humankind’s development (Andrews 2018). There is not one place in the world that does not have some kind of musical culture. This scheme of cosmic music suggests that music is a universal language. However, many have questioned why, “as neither the enjoyment nor capacity of producing music notes are faculties of the least use to man… they must be ranked among the most mysterious with which he is endowed (Darwin 1871).”

Why is it that whale and human music have so much in common? How is it that music reaches deeper, past our auditory cortex, to activate our limbic system, which our emotions are connected to? One can thus ponder the biological purpose of music since it does not contribute directly towards our survival. Some people, such as Dr. Steven Pinker, suggest that music is merely “auditory cheesecake,” a by-product of our motivational systems that give us pleasure and release dopamine; “as far as biological cause and effect are concerned, music is useless … it could vanish from our species and the rest of our lifestyle would be virtually unchanged” (Leutwyler 2001).

Looking back at history allows us to see that music was implemented as a healing tool for centuries. Hippocrates played music to treat mental health patients as early as 400 BC. In the Bible, David played the harp to heal King Saul of a bad spirit. Physicians such as Al-Farabi (Alpharabius), Al-Razi (Rhazes), and Ibn Sina (Avicenna) passed on their ideas of music therapy that Ottoman physicians developed further into therapeutic systems. Muslim scientists traced ancient musical theories of the Hellenistic sources (borrowed mainly from Sumerian, Babylonian, and Egyptian concepts and perspectives) as well as the Chinese and Indian sources, and melded western and far eastern ideas to introduce a new and innovative approach. Patients suffering from a certain physical or psychological illness were expected to be influenced by certain makams, or specific musical modes, and were prescribed these makams for therapeutic purposes. These effects were systematically applied as preventative and curative means. For example, sciatica (a type of back pain) was expected to be treated with the neva makam, which also brings a person pleasure and contentment and is most effective in the evening. Hüseyni makam, most effective at dawn, was used to treat fever; zengule and irak were for meningitis (referred to as sersam) (Sari 2009). Native American communities still practice religious healing ceremonies consisting of prayer, dance, and chanting to help members of their tribe heal and find harmony. The earliest proponents of music therapy, whether they be from the East or West, engaged in scientific debate with each other, curious as to why they observed improvements in their patients with music therapy. One theory was that music, humans, and cosmology were in harmony with the physical elements of water, air, fire, and soil. Others approached sound from a physicist's point of view and discussed the nature of sound, its subdivisions, and the process of perceiving sound. They also debated what these therapies could be used for, some argued they were only suitable for treating mental disorders, whereas others supported its expansion for other physical ailments.

It has long been argued whether or not music therapy is only useful for regulating emotions or if it can also be used to aid the treatment of physical ailments. It has also long been observed in psychology and biology that specific emotions result in well-known physiological responses. For example, when you feel sad, your skin’s conductivity usually decreases and heart’s pulse slows down, while blood pressure and body temperature rise. Fear often results in an increased heart rate, and happiness tends to make us breathe faster. We see that music can directly trigger these emotions: music with a quick tempo and major (wider interval, more open sound) key bring about the physical changes associated with happiness, whereas a slow tempo and minor (narrow interval) key result in those associated with sadness. However, newer research (Jolij & Meurs 2011) suggests that music does not only affect our moods but that it can affect our worldviews and can even change our perceptions of the world. Since emotions elicit physiological responses, music therapy may have the capacity to prevent or treat physical illnesses, in addition to emotional and psychological ones.

These debates still continue, but with the technologies of today and the evidence we record in patients, we see the potential for music therapy more than ever. Maybe the more important question isn’t how, but why this information is important and how we can properly utilize it. If music is so universal and so essential, what effects does it have on what makes us, us: our soul and body? Music therapy tries to answer this question. In western tradition, the Latin phrase “Mens sana in corpore san,” which means “a healthy mind in a healthy body” is supported with the current psychological understanding that there is a clear connection between body and psyche and how both processes react to each other. As functional MRIs allow us to see the living brain dance as individuals listen to, imagine, and even compose music, we are finding many answers and also asking new questions. We see there is no single center within the brain that responds to musical activity and that different parts of the brain light up for different people. Many current studies explore the positive effects of music therapy, meditation, and other holistic treatment options for pain management. In 1944, Michigan State University established the first academic program in music therapy and the Certification Board for Music Therapists was incorporated in 1983 to assure the competency of credentialed music therapists. Currently, in the United States, music therapy is an established profession that uses music as a therapeutic tool to address physical, emotional, cognitive, and social needs of individuals. Since 1998, the American Music Therapy Association has been the intellectual home of music therapists and has published two research journals that promote music therapy through social media streams in addition to podcasts, scholarships, and newsletters.

Contemporary music therapy comes in two forms: active and receptive. In active therapy the therapist and patient make music together, with their voice, instruments, or other objects, allowing the patient to express his or her creativity. Receptive therapy, on the other hand, is very similar to what we observed with historical musical therapists where a therapist plays music for the patient to listen to. It is used in a variety of fields, for example, individuals with special needs focus on developmental work, such as communication or motor skills. In the physical rehabilitation of stroke victims, practices include processing and relaxing via rhythmic entertainment. Alcohol and drug recovery programs, correctional facilities, medical hospitals, psychiatric hospitals, and cancer centers have also utilized music therapy in various forms. Current music therapists work with older adults to lessen dementia symptoms, children with autism to improve communication capabilities, and with premature infants to improve sleep patterns and increase weight gain.

Neurologist Dr. Oliver Sacks has done incredible research on the power of music therapy for the treatment of dementia. His curiosity was sparked in 1966 when he first saw the profound effects music had on long drifted Parkinson’s patients which he described in the book, Awakenings. With music, he saw his patients awaken, their dyskinesias diminishing, and their memories coming back into view. What may seem magical to some is simple neuroscience to others: Parkinson’s is a dysfunction of dopaminergic neurons in the brain, and the memory of music we love gives us a rush of dopamine. He also applied what he observed with his Alzheimer’s patients who couldn’t remember their own names (Sacks 2008). After being immersed in a “brain bath” of music from the patient’s past, they could now have a conversation and talk about their childhood memories. “Even if they can't recognize loved ones and they've stopped speaking, they hear music and they come alive.”

In other neurological conditions such as strokes, aphasias (difficulties with expressive language due to head trauma or brain tumors), autism, and psychiatric illnesses, there is growing evidence of the difference music therapy can have on long-term outcomes. Stroke patients who choose to add music therapy, in addition to other treatments, have an overall better quality of life and are better able to regulate their emotions and communicate with fewer occurrences of depression and anxiety while also having a greater increase in muscle strength. Melodic intonation therapy (MIT) is an active therapy technique that is used to help treat communication disorders (aphasias) that were caused by brain damage (Norton 2009). It encourages patients to sing and hum in order to engage the language-capable regions of their brains. Sometimes this humming can be accompanied by physical movements such as tapping of the hand or drumming. Along with these neural activations, visual stimuli of the word to be relearned will be shown. With many repetitions, patients can eventually remember words without the musical and physical cues. With the connections that have been illustrated between music, emotion, and communication, it’s not difficult to see how music could also help patients who are autistic and having difficulty with social interactions.  Research has illustrated the usefulness of music therapy in autism treatment approaches, and how it promotes healthy neurodevelopment along with honing socio-communication, interaction, speech production, language acquisition, attention, and motor skills. There is also much evidence that supports music therapy as supplemental treatment in patients suffering from psychiatric ailments such as schizophrenia, major depressive disorders, anxiety disorders, and post-traumatic stress disorder (PTSD).

We are also starting to see the emergence of music therapy research that concerns non-neurological conditions such as heart disease, cancer, and autoimmune diseases including arthritis or lupus. It is easier to wrap one's mind around how music therapy may help someone with heart disease, but more difficult to understand how it could have any effect on autoimmune diseases, which are already a mystery for modern medicine to treat. As mentioned above, music and emotions go hand in hand; when we feel happy or relaxed our heart beats in a different way than when we feel angry or stressed. These long-term effects can reduce blood pressure and provide a healthy environment for our hearts.

Emerging research shows that listening to music can actually alter our genetic material on a molecular level. Scientists at the University of Helsinki found that music directly affects human RNA, which is the very core of one’s biological being (Kanduri 2015). A similar research project is also underway at Kyoto University. Another approach, if we remember our historical physicians’ debates, is high-intensity focused ultrasound (HIFU), which harnesses the actual physical property of sound waves and targets them toward cancer cells, which is already being used as an FDA-approved treatment to cure prostate cancer (FDA 2015).

The sensation of perceiving music is on a spectrum; it changes from anhedonia (almost no dopamine response) to synthesis (increased dopamine response). But even when we take away the dopamine rush and the element of enjoyment, there is still a benefit of music/sound waves from a purely physical point of view, as in the ultrasound treatment of cancer or in the rewriting of our DNA with post-transcriptional regulation. 

As can be seen with the historical and current explorations, there is much potential in music therapy. There is still much to be uncovered about the power of sound and music, but this will require a multi-pronged, interdisciplinary approach from budding STEM enthusiasts.

References

• Andrews, Evan. 2018. “What is the oldest known piece of music?” https://www.history.com/news/what-is-the-oldest-known-piece-of-music
• Darwin, Charles. 1871. The Descent of Man, and Selection in Relation to Sex, UK: John Murray.
• Leutwyler, Kristin. 2001. “Exploring the Musical Brain,” Scientific American. http://www.scientificamerican.com/article/exploring-the-musical-bra/
• Sacks, Oliver. 2008. Musicophilia: Tales of Music and the Brain, Vintage.
• “Alive Inside: A Story of Music & Memory Featurette” (https://www.youtube.com/watch?v=8HLEr-zP3fc)
• Sari, Nil. 2009. “Ottoman Music Therapy” http://www.muslimheritage.com/article/ottoman-music-therapy#sec_2
• Norton, Andrea. 2009. Melodic Intonation Therapy: Shared Insights on How it is Done and Why it Might Help
• Kanduri, Chakravarthi, et al. 2015. “The Effect of Listening to Music on Human Transcriptome,” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4362302/
• Jolij, Jacob. 2011. “Music Alters Visual Perception,” https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0018861
• De Novo Classification Request for Sonablate 450. 2015. https://www.accessdata.fda.gov/cdrh_docs/reviews/DEN150011.pdf