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.
So music that has the same tempo as the walking speed.
The gait of a Parkinson's patient 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.
Hey guys, how you doing?
Hope you're having a good week so far.
My name is Dr. Rangan Chatterjee, and this is my podcast, Feel Better, Live More.
Today's conversation is a meeting of two key areas in my life, music and medicine.
Music has always been hugely meaningful to me.
I've sung and played multiple instruments since I was a young boy and honestly, some of my happiest moments have been performing on stage or simply losing myself in music.
Now, even if you don't play yourself and after hearing this episode that might change most of us know intuitively that music just does something to us.
The right track at the right time can soothe you, energize you or transport you back to another time.
But here's where it gets even more interesting.
In all my years as a clinician, music was never really discussed as a therapeutic tool.
Drugs, nutrition, exercise, sure, but never music.
Yet the more I've learned about and experienced its effects, the more I've come to realize that we could be missing out on a powerful and beautiful form of healing.
Music is medicine.
It makes sense, doesn't it?
And it's the title of a fascinating book by today's guest, who first appeared on my podcast back in 2020.
Dr Daniel Levitin is a neuroscientist, cognitive psychologist, former record producer and musician, who's combined all those titles to become a scientific advocate for the primal therapeutic benefits of music.
And his work is genuinely influencing public health policies around the world.
So sit back, relax and listen as we uncover the science behind that instinct.
You've always felt that music is far more than simply entertainment or distraction.
It can actually be one of the most powerful forms of medicine.
Many of us will know that certain pieces of music can make us feel better.
But one of the key messages I got from your book is that music can be considered a powerful form of medicine.
Could you just sort of make that top line case?
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.
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 best way to unpack this conceptually is to take the case that you mentioned first, which is Parkinson's.
So in Parkinsonism what happens is the disease degrades circuits in a region of the brain called the basal ganglia.
And those circuits use dopamine to help them process the timing of what we call voluntary movements.
So an involuntary movement is coughing or swallowing or hiccuping. startle reflects.
But a voluntary movement is almost everything else we do.
We feed ourselves, we walk, 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.
Because, 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 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 20 minutes a day for a couple of weeks and then they don't even need the music anymore because they've built supplementary circuits to help them walk.
Yeah, 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 stopped, the car's in the drive.
And I found this with my kids sometimes that maybe five or 10 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?
Very much so.
And this question we call is 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 memory for timing is exquisite.
And 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 and the satellite radio can no longer reach right.
Terrestrial radio still can reach, but the satellite doesn't.
So when I emerge from the end of the tunnel, almost always I'm at the same part of the song that the satellite radio is.
And that's not just me.
This is a common phenomenon because we have timing circuits in the brain that govern everything from the release of hormones and digestive fluids, and melatonin at night to help you sleep, and Rexit in the morning to help you wake up, and all of these kinds of things.
The timing circuits are millions of years old evolutionarily.
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?
Well, to be fair, this is a controversial notion.
Steven Pinker famously would claim that music is tricking 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.
The parts of the brain that process music exclusively are phylogenetically older.
They're evolutionarily older.
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 or a tumor or a stroke.
Music remains intact.
And that's just some of the evidence that music was around first.
And yeah, what that means is 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 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.
Music has that power for emotional communication and that's reflected in a bunch of neurochemical systems that are selectively responsive to music.
Dopaminergic, serotonergic.
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.
Yeah, which really goes back to the opening point, doesn't it about music being medicine?
We know through that lens of endogenous opioids, people will talk about the runners 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 perhaps your hope when writing this book, is that you know that might be something you can change.
Absolutely.
I mean, that's the reason I wrote the book.
Uh, I read about 4000 peer reviewed articles and synthesize the information and 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 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 to develop a music as medicine grant program.
And they gave away $40 million in research funds.
And then I began working with the White House Science Office under the Biden administration, 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 remarkable.
One is that the in in the us, the state of new jersey, blue cross and blue shield private insurers there now cover music therapy.
The state of massachusetts, 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 announced an initiative on music as medicine and i spoke there to help kick it off.
So things are coming together.
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.
Is that fair, would you say?
I would, and just to get back to this notion that you raised, that music may have preceded language in 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 of daily life, for rituals, for ceremonies mothers singing to infants, work songs, and It seems as though we assume that hunter-gatherers that have been isolated from the West are living the way we were 40000 or 60000 years ago.
And so we assume, anthropologists, archaeologists assume that that's the way things were.
We always had music.
And in our own recent history, my grandparents – were children before there was electricity.
So there was no radio.
If you wanted to hear music, you had to play it yourself.
And most people played an instrument in their generation.
And nobody cared about whether they were any good or not, not good enough.
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 all night long.
And you go back to hunter-gatherers.
They tend to have their sleep divided, where they'll sleep when it first gets dark, but they wake from midnight to three and they sing around a fire to ward off predators with the strength of their voices.
So this music being part of our lives in a rich way 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, where we created a class of performers on a stage and a class of listeners.
And pretty soon over the intervening years, it became, oh, well, I'm not good enough.
I'm never going to be an Ella Fitzgerald or an Adele, so I won't bother to sing.
But it's peculiar.
Nobody says, I'm never going to be a professional soccer player, so why should I even play?
Or I'm never going to be a Winston Churchill, so why should I ever talk?
But with music, we say, if I'm not going to be an expert at it, I don't want to do it.
I don't want to learn the instrument.
It seems like a waste of time.
Which is, I think, a ridiculous argument.
It's enriching.
Yeah.
I love 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.
And 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 we all know that it does something to us that you can't always explain with words, can you?
You know, if music just made you want to dance or be social, 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, various – 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 talk in the book that you and I last spoke about, The Changing Mind.
I relate the story of an experience I had with the Dalai Lama whose picture is on the wall here behind me, 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.
She had a lot of problems.
Her family was sick.
And he helped her to meditate on the notion that there is no, in the grand scheme of things, in the Tibetan Buddhist tradition.
There is no I.
We are all connected.
Now, we talk about this a lot.
Few of us ever feel that unless we have a moment of awe or a hallucinogenic reverie or something.
But here, he talked her through a meditation practice that she knew.
And she was hysterically crying and weeping.
And he gets her to meditate for about 45 seconds.
And she bursts out in laughter.
Her ego dissolved.
She felt a sense of awe, awe at being with him, perhaps, but awe at the wonder of the universe.
And she was healed.
It was like those old, you know Southern Baptist things, you know you couldn't walk, and then you get up out of your chair.
It was extraordinary.
Music can have that same effect on us if we let it, and art can in general.
I think the one epidemic that we're experiencing is we're all so productivity-oriented, perhaps over-caffeinated, as a society, that we feel if we were to take five minutes off to just sit and stare our work, and so I've made it a point to put art where I can't miss it, and I make it a point to experience it.
I'm going to turn the camera around here just to show you the office, my home office.
This is a painting I have of the Quebec countryside yeah, and it's right across from my desk.
So when I'm stuck writing or something, I
I can just look at it, and it transports me.
You can't tell from the camera view, but when I stare at it I get a sense of motion from those flowers in front and motion in the hills.
It feels like the grass is in the wind.
And then I have this Keith Haring right here, which is just this delightful, whimsical love kind of a thing out of a hand.
So...
And with music.
I got one of these wireless sound systems by Sonos where I can have music playing as I walk from the kitchen to the office or the bathroom and things like that.
And I make it a point to make playlists.
I tell the story in the book about the singer-songwriter Joni Mitchell having a stroke and needing music to bring her back.
And fortunately, she had effectively created a playlist of her 16 favorite songs.
And it makes me think that I'm gonna come up with a playlist and attach it to my advanced medical directive so that if I'm in a coma, people will know what to play me.
Well, the funny thing is you're joking about that, but I'm hearing it going.
That's actually a damn good idea.
I mean, we know, don't we, that music can take us back to a different place.
We know that, that you can hear a song and suddenly be transported 30 years back or whatever it might be.
I mean, you know, in the UK, when you start university, we call it Freshers Week.
And the Freshers Week song, which is by a band called Supergrass, came on the radio the other day.
I hadn't heard it in years.
But I was literally taken back to the first week of uni.
I can almost remember the weather and how I felt and what friends I was making and all that kind of stuff just from hearing a song.
It totally seems really reasonable that actually, as well as trying to put your affairs in order and things, if something was to happen to me well, maybe this playlist is going to rehabilitate me.
You know, music literally is medicine.
And of course, we know, don't we, with Alzheimer's sufferers, sometimes music can be very powerful.
Why don't you talk a little bit about the relationship between music and Alzheimer's?
Beautiful segue there, because my mind was going there too.
Uh, and the great minds think alike department.
Um the um uh, the case with Alzheimer's is that um often, and not just Alzheimer's but other forms of cognitive decline uh, other forms of dementia uh uh, at some point a patient may no longer recognize loved ones.
We've seen this happen a lot.
You've seen it in clinic, I'm sure.
Or they don't even recognize themselves in a mirror.
They don't recognize the caregivers who have been coming in three times a day.
They don't recognize the surroundings or how they got there.
Everything is unfamiliar.
And patients tend to have one of two responses to this.
They either become very agitated because nothing makes sense, Or they fold in on themselves and kind of collapse and become almost catatonic because nothing makes sense in this world they're seeing.
But if we play the music from their youth, the oldest stuff in your memory is the last stuff to go.
So if you play music from their youth, from sort of the heyday of their listening life, let's say ages 11 to 18 – they immediately get back in touch with that part of themselves they had lost.
And they can become verbal again.
When they were not verbal, they can become activated.
And that can last for a day or two, just from a few songs.
Yeah.
It's amazing, isn't it, to hear that.
It's interesting Dan, as we're having this conversation.
I would say about two months ago I had Jon Bon Jovi on my podcast.
He was in London and we went to a music studio and had a beautiful conversation and a little bit of perspective.
Jon was my childhood hero.
And you know, I was a mega fan for many years.
I've seen him in concert over 30 times, like a proper, proper mega fan.
I remember in the preparation for that conversation I started re-listening to those albums of my youth Slippery When Wet, New Jersey, Keep the Faith These Days, all that stuff that I used to idolize and dream about when I was a kid.
And I think in so many ways, it just made me younger.
I felt, again, like I used to be like, I can take on the world.
I can do whatever I want.
I thought, this is amazing.
Just listening to music from my youth, which had a very powerful effect on me, literally had a profound impact on my state of being.
Now, I don't really struggle with low mood or anything like that.
I'm pretty balanced and calm a lot of the time, but I did feel that that music gave me a lift.
So what is it do you think that's so powerful about that time period?
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Well, it is a property of human memory that, first of all, the things that we remember best in our lives are the things that delivered an emotional wallop.
The most emotional experiences are what we remember most vividly.
And the reason is that, if we were emotional about it, it's an evolutionary signal that maybe this is something I need to pay attention to.
I almost fell off the roof.
I better be more careful.
Uh, i was really thirsty and i found this spring.
You know, i need to remember where the spring is in case i get lost again.
Uh, so emotional stuff gets in there and it's recorded more vividly, and then all the contextual information gets separate neurochemical tags for a memory.
So um, you're 16 years old, you're driving in the summer, Maybe you're driving out to the beach.
There's a certain song playing on the radio.
There's a certain somebody sitting in the seat next to you.
There's some rain.
All those details are encoded both as a package, but also as separately.
So you can access them.
You can say, when's the last time I drove to the beach?
And all your beach memories come up.
Or when's the last time What was I doing when I was 16?
What was my first experience with a car?
All these are what we call retrieval cues.
But once you activate one node in this memory network, all the other nodes start to light up.
And so if there was a time in your life when you were particularly challenged or depressed and you overcame it, music that was around then can help you relive that experience, if you choose to relive it.
If that sense that so many of us had as teenagers that i can do anything, my life is all ahead of me yeah, the most exciting parts are yet to come.
I can be a doctor, or i can be a lawyer, or i can be a truck driver.
If i want, i can do anything i want to do.
That sense of boundless optimism uh, existed alongside a musical soundtrack for most of us, and the music can evoke that again.
Could it also be, if I think about what it's doing in, let's say, an Alzheimer's patient.
If music is something really mysterious that clearly can go beyond just mere language and words, It can stir things deep inside of us.
It can take us to different parts of our life.
Could it be that in Alzheimer's quite literally, let's say you're 82 years old you feel stuck, your memory's going, you're maybe not recognising people.
Your sense of who you are is different from how it was in the past. very simplistically.
If you go back to the music of your youth, or even your 20s or your 30s, is it that that music is literally taking a part of you back, so you then experience the world kind of in a state in which you were back at that time?
I mean, that seems overly simplistic to me, but on one level it seems.
Well, maybe that's exactly what is happening.
Well, I think that's fair to say to different degrees and different people.
And it's got some commonalities with dreaming.
I mean, I assume I'm average and no different from anybody else.
And um, i have these dreams where i'm suddenly back in high school and i didn't bring a number two pencil to the exam and i forgot to study, and my whole grade is writing on this.
Or, you know, i show up late for an exam and in uni, i imagine you have those dreams too.
These are these are connecting with a former self.
There is this odd aspect that appears to be uniquely human, And Mike Azaniga has written about this, as have other neuroscientists.
Dan Dennett, the philosopher, wrote about it as well.
We stitch together a narrative of our lives without consciously trying to do so.
That creates continuity.
Oh, yeah, I'm that same person.
But we really are different people.
Our brain chemistry is changing.
Our experiences have changed us.
Our brain connectivity has changed.
We are very different people than we were 10 or 20 or 30 or 40 years ago.
And so these thinkers would say it's all an illusion that we think we're the same person, because we're not.
But because we're these hyper-analytic beings, many of us find comfort in being able to stitch it together and go back, read old journal entries or meet old friends and create that sense of continuity.
I'm now 68 years old and I find it especially valuable that I have friends that I knew when I was 13.
Not because they're my closest friends necessarily now we've changed and you'll follow different paths but because we knew the people we were back then and we liked those people and we like each other now.
And it's just this wonderful sense of, you know, what a ride this has been.
Yeah.
What's the relationship between music and trauma?
Music can certainly...
Along the lines we're talking about.
If there was a piece of music playing around the time of a tragedy or a traumatic a personally traumatic event, that can trigger a kind of post-traumatic stress in the listener right.
If you saw something horrific a car crash, somebody you knew was in the car, you saw a family member die a violent death there was music going on.
Even not at that moment, but in that period, that song can really trigger you and it can take a lot of therapy to get over that.
Um, but on the flip side, we've seen that people who have severe trauma, particularly soldiers uh, in Iraq and Afghanistan, coming back having seen just the most horrifying things the bodies of friends being blown apart, you know um, trying to carry them back out of a war zone.
Veterans with post-traumatic stress disorder often are debilitated, and they're hypervigilant.
The slightest sound in the environment sends them into a panic.
And there's a program here in the US called Songwriting with Soldiers, where professional songwriters are paired with soldiers and they write a song about the traumatic event.
And what that does for the soldier is it gets the song outside and into the world so they can be more objective about it.
And there's something healing in the same way that journaling can be healing.
But now the song is an entity, a living, breathing entity.
And it's out there, not in here.
And many of them find it very therapeutic.
Do you think it's unique to songwriting?
Because as you say, it almost sounds like a form of journaling.
Journaling is a way, of course, to get our thoughts down out of our mind and onto paper, which can be incredibly beneficial.
But writing a song, of course, can do that as well.
Do you think there's something unique about the song?
Because of course there's the words but also the melody, whereas with journaling it's just the words.
Well, the thing is a song is something you can memorize.
It's more highly structured than a journal entry.
It's got a rhyme scheme, typically.
It's got a rhythm.
It's got a certain number of syllables per line.
And if you're lucky, the melody and the words reinforce one another.
And so it's precisely – it's like you were saying when you and your kids get home and the car is in the drive and then you're in the kitchen, there's still a song playing in your head.
Songs play in our heads.
And most of my friends these days, those who are not neuroscientists, are songwriters.
And almost –
Every one of them is writing songs about some emotional experience that they're trying, and often a sad experience, a breakup, a loss, a loss of friends, a loss of confidence, a loss of health.
And those songs become therapeutic for them in the way they do for the soldiers.
Yeah.
You mentioned that soldiers who have experienced PTSD have been teamed up with songwriters to write these songs, which they found healing.
Some people listening, Dan, might be thinking, well, I'm not a songwriter.
Going back to what you said before about, you know, I'm not a musician, you know, I'm no good.
You know, maybe I was told at school I wasn't good.
You know, I never got picked for orchestra or choir or whatever.
So you have this negative view of yourself in music that A lot of people will also say Dan yeah, songwriting sounds great, but I'm not a songwriter.
I mean, maybe I can get my head around journaling, but I can't get my head around songwriting.
What would you say to that person?
Well, there are a number of ways to do it.
I started writing songs when I was 16.
I didn't know what I was doing.
The Beatles had to write 100 songs, they said before they got a good one.
Um, so you just have to keep doing it.
And now there are online songwriting courses on youtube and you know but um if, if all you can do is say the words and and warble out a melody, and you don't even know how to play an instrument or write chords, you can upload that to suno and it'll turn it into a country song or a classic rock song or a hip-hop song, and you can iterate it until you get the the features you like.
I'm not recommending AI music as something that will be fulfilling.
I'm recommending it as a kind of a kickstart as a you know what I've done as a songwriter, and as I spent a lot of my career as a record producer working with songwriters, is They'd write a song and then we'd run it through different iterations.
We'd get different musicians in, or we'd do different styles.
Let's try it as a calypso.
Let's try it as a heavy metal.
Let's see what works.
And you're using your ears and you're in real time not to see necessarily what you think is going to sell the most records.
That never works.
But to see what feels truest to the artistic vision.
So AI software can help there a little bit.
And in the same way that people now use AI to write, I would never publish anything or put out to the world something that was AI written.
But I like it when AI will give me some suggestions and maybe out of 500 words that it writes, there's one word in there that I could use that I wouldn't have thought of otherwise.
But I think the more, I mean, that's for people who, that's an option.
But another option is just to collaborate with somebody who plays an instrument and doesn't know how to write or want to write.
In the section on songwriting in the book, there were a couple of things I noted down.
You mentioned a quote from Nick Cave.
The thing about writing a song is that it tells you something about yourself that you didn't know.
And then you specifically say, Dan, about you, I don't write after I've understood something.
I write to help myself better understand it and to better explore my emotions.
And just to make sure this is really, really applicable to everyone, I honestly believe that That's what journaling does for so many people as well.
I do accept songwriting is different, but for people who maybe are a bit intimidated by the thought of writing a song or don't have a friend who they can collaborate with journaling kind of can do a very similar thing.
You can find parts of yourself that you didn't know were in there.
Just from starting to write your thoughts down on a page, can't you?
Absolutely.
And this is the the not well-known secret of all writers of either fiction or nonfiction is that most writers don't go into the article or the book knowing exactly what they're going to say or, if they think they do, it changes along the way.
There's something about the words staring back at you on the page and you realize, oh well, that That's what I thought I wanted to say, but it's not very clear.
And it leaves a bunch of unanswered questions.
And I don't know the answers to those.
I have to figure them out.
That comes in professional writing like you do.
It comes in amateur writing, for lack of a better word, when we journal or, you know, jot down our thoughts on paper or speak them into voice memos.
It's It's an act of discovery, not an act of dictation.
Yeah.
I've heard you once say that sad songs can be medicine when you're feeling depressed.
Why is it?
Do you think that when we're feeling low, we also want to listen to songs that talk about feeling low, as opposed to upbeat happy ones?
I think because most of the time when we're feeling low, it's because in some sense, we feel misunderstood by another person or by the world, or we misunderstood ourselves and did something we didn't want to do or think we could do or should do.
And that feeling of being misunderstood.
If I put on you're sad, you're low, I put on happy music.
That's just a bunch of people who don't understand you either.
But if I put on the right sad song, there's this glint of recognition.
Oh my God, that's, they're talking about me.
That's how I feel.
And, you know, I'm no longer sitting at the edge of the cliff, staring into the abyss.
By myself, there's somebody here next to me who's put this whole experience to music.
And they came out the other side and turned it into a great work of art.
That's uplifting.
I feel understood now.
Yeah.
Musical tastes are quite unique, aren't they?
I mean what you may enjoy listening to and you will connect with may be different from what I might enjoy listening to or connect with.
And so, thinking about this idea as music, as medicine, I really like this idea that, let's say, someone has depression or has been diagnosed with depression.
We can't really prescribe this song for you to help you feel better, because it may be that that song doesn't resonate with you.
I guess the point I'm trying to make is that if we're going to use music in a healing way for ourselves, whether it be to lift our mood or lower stress or just know that there's other people out there in the world who feel the same way in which we do it's highly personal, isn't it?
So could it be that one particular song someone finds calming, whereas at the same time that same song could trigger anxiety, for example in someone else?
Oh, absolutely.
We see that all the time.
I did a massive study of 20000 listeners in Europe back when UK was in Europe.
They were included in the study.
And we asked people all kinds of questions 200 questions and one of them was what music do you listen to to relax?
And at the time, relaxing music was Enya, or Bach, maybe slow ballads by John Coltrane.
But then there was this cluster of people in Sweden who were listening to metal to relax.
And we got farther down the questionnaire, what do you use to help yourself get out of bed in the morning or get through an exercise workout?
And the Swedes were listening to, like you know, swedish speed metal to get them going, and so regular old metal seemed relaxing to them.
By comparison, acdc van halen very tame compared to swedish speed metal.
So it is very subjective.
There is no one song everybody likes.
There's no one song everybody hates, and even if you have a set of favorite songs, those may change throughout your lifetime.
You may get bored of them.
Um, may just not.
They may not hit you right, but you know, since we're talking about this as music, as medicine, and since you are a medical doctor um, just for so our listeners will know, if you go to your doctor and you complain to depression, it's a lot of trial and error.
Uh, i mean, even setting aside the 20 different forms of talk therapy that might be recommended um, the The medicinal side is okay.
Well, let's try Prozac, and it'll take three months or so to see whether it's working.
And if it's not, we can raise the dose.
And then, you know, well, that doesn't work.
And six months in, you say, well, we'll move to Zoloft.
Well, we'll move to Wellbutrin.
Well, we'll move to, you know, I mean, it's constantly chasing the right concoction.
And music is somewhat like that.
You've got to do some trial and error.
Fortunately, you don't have to wait three months to see with whether the song's going to work.
You only have to wait three minutes and you can go through a bunch of things.
And many people have a strong intuition about what they like and don't like, and they can immediately home in on it.
But there is a profession called music therapist.
It's a certification that is separate from being a therapist.
And um.
There are music therapists all over Europe and the UK and the US and Canada and the Commonwealth and they can help you to find music that will help you achieve your therapeutic goals, whatever they are.
Just as you were talking about, there may be 18 or 20 different forms of therapy.
And of course there's research on the various merits of certain types of therapy.
But There's a lot of research out there supporting that the most important thing is not the therapy but the therapist.
I'm glad you went there with that.
That's absolutely true.
It doesn't matter from the research.
It doesn't matter what school they were trained in, if they were Freudian or Jungian or Gestalt or Adlerian or cognitive behavior.
What really matters is your relationship with the therapist.
And therefore we can apply that to the song.
What really matters is our relationship to the song, not someone else's relationship.
As you just said, these things are totally individual.
Yeah, the.
The other thing that matters is not just your personal relationship with the song, but your relationship with the artist.
So you know you may find something appealing out of a an unearthed Bon Jovi song, because that voice and band is so familiar sounding to you that you're you're predisposed to it.
For me, it wouldn't be Bon Jovi.
It would be Robert Smith and the cure, but you know, it's, to each his own.
I have a friend who's a comedian named Dan Peraro.
He writes a syndicated comic strip called Bizarro that's been in newspapers all over the world for 30 years.
And he says as part of his standup routine I always hate it when I overhear somebody at the table next to me at the restaurant.
Ask the waiter what do you recommend?
He says, I don't have the same mouth and taste buds as the waiter.
What he likes has nothing to do with what I like.
Yeah, I love it.
It's so true.
And I've been thinking recently, did you observe what happened with Oasis this summer?
You know, they're one of the biggest British rock bands of all time.
Right, right.
And they reformed and They were probably the hottest tickets not of the year, off the decade or arguably, off the millennium, so far.
I mean, it was like Goldust.
I think one and a half million people across the UK went to one of their concerts, and I didn't.
I've seen them many times before, but I was away in the summer.
And the reason I'm bringing this up is you write in a book about what actually happens when we listen to music with other people.
In your final chapter, you write that music is that phenomenal experience.
Music is rather unique in that it can be a communal experience and at the same time be very personal.
And the video footage of Oasis was really quite phenomenal.
People who went.
I've got really good friends who went.
They said wrong and it was like nothing else we've ever been to.
Everyone was happy.
Everyone was hugging each other.
There was no negativity.
It was just pure joy.
And at the end of the night when they played Champagne Supernova, one of their biggest hits.
With all the lights, it's a dark British summer evening.
Everyone's singing.
It would have been like a spiritual experience.
And I genuinely believe that a lot of people were having a nostalgia for a different time of their life.
You know, in the 90s, when life seemed a bit simpler, there was no smartphones or social media, we weren't as busy and as stressed out as we are today.
And I genuinely believe that maybe the Oasis concerts did more for the collective wellbeing of the UK than maybe anything else that year.
And I don't believe there's any drug on the planet or a prescribed drug on the planet that could probably do to people what they experience when they experience that collective effervescence in an arena with songs that they love and 80000 other people around them also love.
That is healing, isn't it?
Yeah, and just on the neurochemical side, that experience releases oxytocin, which is neurochemical, that helps you to feel more trustful and bonded.
It's the same chemical that's released when two people are together and share an orgasm.
It bonds them together.
It was evolution's way of tricking the man to stick around, is the way some biologists look at it.
And you get that sense of warm, attachment from sharing music with others.
We don't know why, but we talked earlier in the broadcast about how different neurochemical systems evolve to support different aspects of music.
And one of them is this social bonding.
Uh, probably owing to the I mean, it was all evolutionary, you know descent with modification um, and The adaptations that confer the greatest chance of survival are the ones that get passed on.
So those of our ancient ancestors who found pleasure in singing around a campfire and therefore successfully warded off predators or neighboring tribes that might attack them while they were asleep, They're the ones that lived.
The others all died out.
And so we are the legacy of people who liked hearing music collectively.
And I mean not to put too fine a point on it, but none of us is descended from an ancestor who failed to reproduce.
They succeeded in reproducing because of a number of qualities they had.
And one of them clearly was the ability to enjoy music together.
Your lab, I believe, has studied goosebumps before and what actually causes goosebumps.
And I think it would be interesting to talk about that here because I do think that you know, I appreciate.
You may not be an Oasis fan, but anyone who is into their music will know the song Champagne Supernova.
It's this magnificent song that, in the right setting, in a stadium, would feel rather mystical and magical.
I imagine some people who heard that in that collective setting had goosebumps at the same time.
So what are goosebumps and what do we know about them so far?
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That feeling of the hair on the back of your neck standing up or that little shiver you get down your spine.
It's related to a sense of awe.
It's also related to surprise.
Whether you know it or not, and whether you're a musician or not, when you're listening to music, there are parts of your brain, particularly in the prefrontal cortex, that are trying to track and predict.
Track the music that's going on and has gone on and then predict what will come next.
If your brain is nothing else, the human brain is a giant prediction machine.
It tries to figure out what's going to happen next.
And to do that, it looks for patterns, which is why, on a cloudy day, if you lie on your back and you look at the clouds, you might see a rabbit.
Or why, when the ancient Greeks looked at the stars, they saw Orion the hunter, and Ursa Major the big bear.
Orion the Hunter doesn't really exist in the stars.
It's the human brain imposing order on something that's disordered.
And so that predictive device, particularly in a region called Broadman, Area 47, is trying to figure out what's going to happen next in the music.
The composer's job and the performer's job.
So is to reward your expectations.
Enough of the time that you feel that there's a conversation going on.
It's almost like you're completing each other's sentences, you and the composer.
But if you're completing each other's sentences too much, you get bored.
And so the composer and performer's job is to surprise you every once in a while, to not fulfill your prediction, And if they can surprise you in a way that's extraordinarily pleasing, that can lead to goosebumps.
And it will work even with a song you've heard a thousand times, because schematically that song is different than the tens of thousands of songs you've heard before it.
And so, even though the surprise in that particular song is anticipated, it's still surprising compared to all the other songs.
You mentioned before that perhaps something has changed in modern society where, because we're busier or we feel the pressure to perform and get through our email inbox and our to-do list, that those opportunities for art that used to exist have in many ways been eroded in many of our lives.
One thing I've observed since the COVID pandemic is this collective inertia that's set in across society.
I really don't think we've fully recovered yet.
We've not gone back to doing the things that we did beforehand.
We've lost so much from not going back to these collective type of experiences, whether it be yoga or concerts or watching a musical or whatever it might be.
Is there something unique about doing this or listening to music with other people that we don't get from listening to music by ourselves?
And I guess the follow-up to that is in a world of YouTube now where, whatever concert you might want to go to, someone's taken a high definition video recorder in and has uploaded it to YouTube right.
So the second part of that question is is there a difference, do you think, of watching a live experience of a concert on YouTube versus actually being in the concert hall yourself?
We don't have any research on this, but I think the marketplace has decided for us.
As you note, being able to listen to music at home through AirPods or whatever, or to watch a YouTube video is always more convenient than going out somewhere.
And yet, concert venues sell out.
Part of it is being with others and feeling part of something larger than you, because there are another thousand or ten thousand or forty thousand people there with you.
The same reason we go to see sporting events live uh, is to be with other people.
It's even if you're watching at home.
People often have uh, football parties yeah uh, i know people with listening parties uh, that seems not to have caught on in the same way.
But the other element is that in a live performance, anything could happen.
Certainly true at a sporting event as well as at a music event.
You know, they're not going to play it exactly the same way as you heard it on the record.
And that can be exciting.
But I think if it was just the collective experience of being with others and not also the live element of anything can happen.
Some entrepreneur would have figured out that they can sell tickets to the O2 and just play records.
Yeah.
But nobody wants to do that.
So there is something about live music that's different.
And I like to think it's that we feel some connection to the artist.
The artist is there.
They showed up for us.
Yeah.
Earlier on we spoke about Alzheimer's, and in your book you write about Glen Campbell, and I'd love you to talk to us a little bit about Glen, and what do you think his story tells us about the brain.
So Glen Campbell is, in America anyway, one of the most famous musicians.
He um, he began as a member of what we call the wrecking crew, which was a set of studio musicians that included him and Hal Blaine and Carol Kay and others, who he was a guitarist.
And they played on a bunch of records by sixties groups that had the songwriting ability and singing, but not necessarily the musicianship, to make great records.
So I'm talking about records by the Birds and the Association, the Turtles, the Mamas and the Papas, a lot of the Phil Spector recordings.
This was kind of a house studio band.
Glenn was the guitarist.
He played for the Monkees and other groups.
And then he developed into a songwriter and solo artist, had a TV series.
And had a number of massive hits on the country charts here in the US.
So he's somebody that's as well known here as, say, Adele or Oasis is known in the UK.
And he developed Alzheimer's and decided that he wanted to do one last tour.
He loves performing.
And that they could send a film crew out with him to document it.
Um, i've seen the family got in touch with me around this time because of my research work and i saw the brain scans and when he was in the middle of the tour, i would say half his brain was offline at that point and you, there were vestiges of this apparent to an audience.
Um, He would sometimes forget that he had just finished a song and maybe play it three times in a row.
He often didn't know what city he was in.
He'd say, you know, good evening, Philadelphia, when he was in St.
Louis, that sort of thing.
He had a teleprompter, but many artists his age use teleprompters.
Mick Jagger's using a prompter, as far as I know, as is Bono, so that's all right.
Can't remember all the lyrics to the 500 songs you do?
Yeah, um.
But and then, off stage, he didn't know where he was or what time of day it was, and he didn't recognize people that he had known for decades.
But once the song started, he played as brilliant as ever.
Wow, with have his brain missing.
He might still have been the best guitarist on the planet.
What that tells us about him is that he had spent a lifetime building up what you and I would call cognitive reserve.
Excess capacity, excess redundant neural circuits, in the same way that an athlete builds up muscle reserves.
So I like working out at the gym.
There's a guy there who can bench press 500 pounds.
I can't do that.
I can't even do 250.
But on a bad day, the guy who can do 500 can still do 250.
So on a bad day, Glen Campbell could still play better than anybody else.
Tony Bennett went through the same thing as a singer when he had Alzheimer's.
This is well known.
The thing that we've practiced the most is something that can stay preserved.
And the take-home message for, I think, all our listeners here is if you don't play an instrument now, it's never too late to start.
I know a lot of people in their 70s and 80s who started to play.
And if you do play an instrument or used to, keep up with it.
Not because it's necessarily going to be that you're going out on tour, but playing an instrument builds up cognitive reserve and motor reserve in ways that are helpful.
It builds up eye-hand coordination.
It builds up feedback loops where you're anticipating a sound.
You have to listen to it, you have to adjust the sound.
It does all these things that are neuroprotective for memory and for attention.
And you can't.
You can't prevent Alzheimer's, but you can mask the symptoms of it for many years if you've got cognitive reserve.
Yeah, I love that.
That real take home for us to think about learning to play an instrument if we don't currently do, or if we do, just make sure we stay consistent with that and keep playing.
That's very practical, Dan.
What about...
As a music listener.
Let's say, there's someone who's come across this conversation who doesn't really listen to music much anymore.
Maybe they did as a teenager, but for whatever reason, they don't now.
They listen to the news or to podcasts about health or, you know, they're not listening to music anymore.
Why do you think they might benefit from bringing more music into their lives?
Well, I think through music I mean the big picture as I write about in the second to the last chapter.
The big picture is through engagement with the arts in general and music in particular.
We often can imagine the world different than it is.
That's what art does, is it paints a picture of... Somebody wanted to join the interview.
That's okay.
Doesn't like not being the center of attention.
Art can paint a picture of other lives, of other ways of seeing things.
And through imagining a different world, that act of imagination, we can imagine a better world.
And it's only by imagining a better world that we can build it.
So I would say what's at stake here is the future of the society that you want.
If you're not engaged with the arts, you're not going to have the imaginative strength to think about making things different.
And things can always be made better.
It's so thought-provoking what you've just said.
If we just continue with these super busy, rational lives where we get through our emails, do our job, do our errands, make sure the shopping's in, or whatever it might be, that's going to be one type of existence.
And, of course, for some people that they've got really tough lives and they're doing the best they can to make ends meet and to keep a roof over themselves and their family.
I understand that, at the same time, even if you can bring in some of the arts and, of course, through this conversation music, into your life, it does help you imagine, it does take you out of your own existence and connect you to the world around you.
People sometimes do that through meditation, right?
Or through loving kindness meditation, they might try and connect themselves to the world around them.
But music is also a powerful way of doing that.
And in your book you have all kinds of luminaries from the past talking about the benefits and the essential nature of music, including Nietzsche, who says life without music would be a mistake, which I think says it all.
Dan, I just want to talk about the song Fast Car by Tracy Chapman.
In your section on trauma, You wrote quite a lot about this song.
It's, of course, a phenomenal song that stood the test of time.
What is it that you like so much about this song and why did you include it in your book?
It's a powerful expression of a person's emotional life.
Whether it's autobiographical or not is not the point.
But I like songs that are little novellas, little short stories that capture something very real.
And so Tracy is writing about a person may or may not be her who's in a dead end job in a small town and faced with a decision about whether to care for her alcoholic father or care for herself.
And she doesn't see any way out.
And somebody with a fast car we could be a man or a woman, we don't know shows up and they dream of going to the city and getting better jobs and having a life there.
And they get there and whoever it was she went with is spending all his or her time at the bar, not helping to raise the kids.
Doesn't have any money.
And she finally says you know effectively, I wish you had just taken your fast car and kept on driving.
But what's so seductive about the song is the chorus.
I listened to that song for decades and I just liked the melody and I liked the words and I didn't really the story didn't really register with me because the chorus is so bouncy.
You know I remember when I was in your arms.
You know we were driving and Speed so fast as if I was drunk.
You know just yeah, that feel good sort of, you're just escaping.
Yeah, and it just sounds bouncy and intoxicatingly wonderful, until you realize the darkness that's beneath it.
And so any great piece of art has these layers and these levels, right?
And it's a funny thing, the bounciness of a melody and a rhythm can distract us and in some way make the darker message more palatable.
One of the most famous songs of the last hundred years is Mack the Knife, which most people will be familiar with.
It was a big hit for Bobby Darin and Louis Armstrong and Ella Fitzgerald.
But it's about a serial killer in the way that Maxwell's Silver Hammer by the Beatles, a much-loved song of theirs is about a serial killer.
So it's a funny thing.
We allow ourselves to surrender to the music and the lyrics kind of seep in.
I just saw an Instagram post that was really funny, that during the 1969, the year the Beatles were breaking up Paul McCartney.
The caption was you know, Some therapists should have intervened and taken care of, helped take care of Paul McCartney's psyche, because in that same year he wrote this song about obsession, Oh Darling.
A song about legal problems and a breakup with two of us.
A song about desolation with the long and winding road.
And then a song about a serial killer in Maxwell's Silver Hammer.
The lyrics were telling you everything you needed to know about his emotional state, but none of us noticed the cries for help.
Yeah.
It's interesting what you're saying about Fast Car.
I was talking to my wife this morning about it.
We're both big Tracy Chapman fans.
And I said, hey, Vid, what do you like about the song?
And she said, well, first of all, I love the story.
I love Tracy's voice, the emotion in her voice as she's singing it.
And I said, what do you know about the story?
You know, what do you remember?
She goes well, you know, and she basically said accurately how it all starts and then how it changes at the end.
You know it's almost the punchline to the song, when you know she says take that fast car and just keep on driving right.
I like you, Dan.
I don't think I fully registered the story.
I just loved it for years.
Whereas my wife hears lyrics more than I do.
I hear tunes and beats and she hears words.
So that's really interesting as well, isn't it?
That we can have the same piece of music and take different things from it.
We all take different things from, from songs.
Um, One of my, my two of my favorite lyricists are Walter Becker and Donald Fagan of Steely Dan.
And they write their lyrics intentionally to be obtuse, because they want people to read into it whatever they want.
Dylan said in his autobiography, he tried to write out of both sides of his mouth.
He tried to write messages that were contradictory so that people could find in it their own truth.
He's not precious.
Dylan's not precious about insisting that people interpret the song the way he intended.
The opposite case is Joni Mitchell, who is indignant if you interpret the song differently than she did.
She had a very particular thing in mind.
And I mean I think I recognize her right and respect – her right as an artist to say no.
The song doesn't mean that.
But on the other hand, I think the beauty of songs is that people can find their own meaning in them.
The as as we do in poetry, or as we do in paintings or film or dance the um.
We can project our lives on it, or or we can allow a blank screen in our minds and hearts to have that song projected on it.
And it can mean what it means to us.
And that meaning can change.
I think that's, that's part of the power of it.
And, you know, Joni may have had something in mind, writing autobiographically, and that's why she wrote it, but it doesn't mean that my experience is going to be the same, just because, you know, getting back to the waiter and the patron at the restaurant, we don't have the same sense organs.
You know the same mouth.
I want to finish off dan, talking about something that we touched upon at various times throughout this conversation.
You know what is music, at its core, what is it really?
And in the final chapter of your book, You quote the German philosopher Arthur Schopenhauer, and you said that he viewed music as not merely a representation of the world, but as an expression of the very will that drives everything in our corporeal and metaphysical worlds.
And then you say this distinction elevates music to a plane where it becomes not a mirror but a window into the deepest recesses of existence.
I love that.
It's so evocative.
But with that in mind, is it reasonable that we can use science to study music?
Well, let's do it as a counterfactual.
If you can't study music, music scientifically you can't study consciousness scientifically, or emotions or feelings of awe or the origins of the universe.
I mean, all these things are probably more complex and marvelous than we know and we probably understand one or two percent of it, but that one or two percent we've understood has helped us to do things that were valuable to us, like the discovery of the germ theory of disease by Semmelweis, the discovery of penicillin by Alexander Fleming.
That's one or two percent of the equation, but it's an important one or two percent.
Now I don't know that we've benefited in practical ways from trying to understand the origins of the universe and the Big Bang, but that you know the work that has come out of modern physics is helping us to better meet our energy demands as, as a culture, uh and better uh, better engineering and things like that have come about.
So that you know, it seems silly, but cars are safer now than they were 50 years ago because of physics and engineering, and you know.
The space program, which seemed purely exploratory, gave us things like Kevlar and fire retardant materials.
So the nature of science, as Einstein said, is you don't know what you're going to find until you start looking for it.
It's not engineering.
That's what distinguishes science from engineering.
Engineers.
They build a bridge, and it darn better be – exactly as they thought it would be at the end when they started it.
But with scientific research.
If you think you know what it is going into it, then it's engineering, not science.
Yeah.
Perhaps it's not that we shouldn't use science to study music, but we should understand the limitations of what we find.
Perhaps that is another way of looking at it.
Would you say Dan, having studied music?
You are a musician yourself, but you have studied music this topic, for many, many years now.
Has your research in any way changed the way you utilize music in your own life?
It has.
Thank you for asking.
I am now more likely to write music or play music when I'm feeling off kilter, because I feel like Before I studied the science, it felt untested or frivolous or self-indulgent.
Now I've got the rational basis for knowing how it works.
And so I allow myself to spend more time doing something that's not writing books, or doing research, or cleaning the house.
And the other thing that I learned I learned it from Joni Mitchell mentoring me in songwriting and from my friendship with Sting which is that the discipline required to do music is much more than I acknowledged and it makes practice much more pleasurable for me, knowing how hard they work at their craft.
Yeah.
I love that, Dan.
I love talking to you.
I think the book is absolutely phenomenal.
It's such a wonderful and original read.
I've thoroughly enjoyed making my way through and I think I'll keep coming back to it over the coming years.
To finish off Dan, if there was someone who is listening to us right now and they're struggling in their life.
They are struggling with meaning, with purpose.
Maybe they feel a bit stuck, maybe they struggle with low mood some of the time and they're keen to bring music into their life, but perhaps they never ever learned an instrument before.
What would you say to them?
Well, I mean certainly it's easy enough to.
Pianos are probably the easiest and keyboards are the easiest instrument to play.
I mean, you're a guitarist and you know you have to build up calluses and It's hard to visualize the scale on a fingerboard because the strings are tuned to different pitches.
But on a piano, a novice can make a sound.
You can play a middle C as well as Arthur Rubinstein or as well as Elton John.
Stringing the notes together is much easier to learn.
And there's so many videos now on YouTube about how to play the piano.
And there's a glut of pianos.
People buy them, electronic keyboards.
On Facebook Marketplace or various neighborhood websites.
People are often giving them away or selling them for five cents on the dollar because they don't play them anymore or don't want them anymore.
And so the cost barrier to entry is very low, and YouTube videos are very, very helpful.
There was a song I wanted to play on the piano and I couldn't quite figure it out because the official sheet music for it is wrong, which is often the case.
And it's buried in an arrangement so that I couldn't hear what the pianist was doing.
And the song I learned was Martha, My Dear by the Beatles, a Paul McCartney song.
And I take so much pleasure playing it now.
And it was a YouTube video that taught me.
So you would say, to that person, maybe start learning an instrument.
And if that feels like a step too far, would you encourage them to start listening to more music?
Or singing, you know, start singing along.
You don't have to have a great voice.
Leonard Cohen and Bruce Springsteen and Bob Dylan showed us that.
Just, you know, sing more, sing along with the music you like.
Yeah.
Even if in the shower.
Even if you're in the shower, let music be thy medicine.
Dan, it's been a real pleasure to talk to you.
Thank you for making time.
Thank you for writing such a wonderful book.
And I hope we get to do this again sometime in person.
I do too.
Thank you again for your hospitality.
Really hope you enjoyed that conversation.
Do think about one thing that you can take away and apply into your own life.
And also have a think about one thing from this conversation that you can teach to somebody else.
Remember, when you teach someone, it not only helps them, it also helps you learn and retain the information.
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