Music has never been more present in our lives than it is today. Technology, the ability to record and edit and streaming services have made music a common feature of our daily lives.
Just look at people walking on the streets, at bus terminals or train stations. With a quick glance you can already see many of them with headphones hanging.
Shops, restaurants and even elevators use background music to make the atmosphere more pleasant.
This simple availability and accessibility may have made us so accommodated that we didn’t even pay as much attention to music as we used to, when people were forced to go to theaters to be able to enjoy a piece of music.
We reflect little on this art, which has become a gigantic consumer industry, and many of us never stop to think about the effects that music can have on our lives.
So little that the therapeutic potential of music is unknown and has not even been considered by many. That’s where music therapy lives, a therapeutic technique that can help people with communication difficulties, depression and even memory problems!
For, as Rubem Alves (1933-2014) would say, a Brazilian educator, psychoanalyst, theologian and writer:
“There are songs that contain memories of lived moments. They bring us back to the past. We remember places, objects, faces, gestures, feelings. (…) But there are songs that make us return to a past that never happened. ” – Excerpt from the book “Na Morada das Palavras” (Papirus Editora, 2003).
Music therapy is a therapeutic technique that uses music to treat its patients. It is a hybrid between art and health and serves to promote communication, expression and learning. In addition, it seeks to facilitate the organization and relationship of its patients.
It can be used in any area that is in demand, whether promoting health, rehabilitating or acting as a preventive measure or simply to improve the quality of life.
In addition, there is community or social music therapy, which aims to empower groups and enable the engagement and organization necessary for individuals in the group to have full capacities to face the common challenges of life in society.
According to the World Music Therapy Federation, “music therapy aims to develop potentials and restore the individual’s functions so that he / she can achieve better intra and interpersonal integration and, consequently, a better quality of life” .
In order for us to definitively understand how music acts in our brain, we need to understand a little about the anatomy of this organ.
Because it is a very complex device, we will stick to regions of the brain that are directly influenced by music.
Whether we are playing an instrument or when we are passive, just listening to music, several areas of the brain activate and start to function.
Check the image and the explanatory topics below:
Callous body (in orange)
The corpus callosum is a brain structure that connects the two cerebral hemispheres, right and left. Its function is to transfer information from one hemisphere to the other. When under the influence of music, this area is activated more than normal.
Sensory cortex (in red)
The sensory cortex is responsible for processing sensory information, such as touch, vision and hearing. It consists of a series of sensory neurons that translate the information collected into our brain.
When under the influence of music, this area of the brain not only processes part of the auditory information but also controls the tactile response when playing instruments or when dancing.
Auditory cortex (in blue)
The auditory cortex is the one who “listens” to sounds and processes them in our mind. It is the person who perceives the variations of tone, rhythm and melody.
Motor cortex (in yellow)
The motor cortex is also immensely involved in the entire tactile response process when we dance and play instruments.
Pre-frontal cortex (in green)
The prefrontal cortex is the anterior part of the frontal lobe of the brain and is related to planning complex behaviors and thoughts, personality expression, decision making and modulations of social behavior.
Music strongly activates this area of the brain and, as many researchers indicate a link between a person’s personality and the prefrontal cortex, it is possible to speculate with some scientific support about the influence of music on personality.
Visual cortex (in purple)
The visual cortex, as its name leads us to deduce, is responsible for the processing of visual information. It is a very active area when under the influence of music. This can be verified not only through studies with magnetic resonance machines, but also by ourselves, at home. After all, who was it that never heard a song and visualized a scene in their own head, right?
Cerebellum (in pink)
The cerebellum is the part of the brain responsible for maintaining balance, controlling muscle tone, voluntary movements and motor learning processes.
It is to be expected that this area of the brain is quite active when we are under the influence of music, whether dancing, singing or playing an instrument, given that all these acts require the use of our motor functions.
Hippocampus (in gray)
The hippocampus is a structure located in the temporal lobes of the human brain. It is the main seat of memory, being an important component of the limbic system and of fundamental relevance for space navigation.
The influence of music on the hippocampus is another thing that can easily be seen by any of us. The songs, because they are intimately linked to emotions, often awaken deep memories.
Who has never heard that song that reminded you of your ex partner and being hit by an intense feeling of melancholy, that throws the first stone.
Amigdala (in brown)
Tonsils are a group of neurons that together form the temporal pole of the cerebral hemisphere. This region of the brain is part of the limbic system and is an important regulator of sexual behavior, aggressive behavior, emotional responses and reactivity to biological stimuli.
It is mainly that region of the brain that is most affected when we listen to music that touches us deeply.
Music evokes intense emotions and acts on the brain activating all of these regions mentioned in the previous topic.
A study published in 2014 in the journal PLoS One looked at how the brain works when under the influence of music.
In that study, the researchers put jazz musicians to play their instruments while doing an MRI scan of the brain. This practice served to ascertain which parts of the brain would light up when the musicians were playing.
In addition to verifying that all those regions were in fact activated, the researchers asked the musicians to improvise together. This made it possible to verify that the brain, when we are improvising a song together, works in a very similar way to when we are talking orally with another person.
This discovery supports music therapy and its benefits for communicative processes, since the same areas of communication light up both when we are talking and when we are playing an instrument with someone else.
In addition, music activates various regions of the brain responsible for memory, such as the hippocampus. This means that it can be used therapeutically in patients suffering from neurodegenerative diseases, such as Alzheimer’s. See more in the topic “Instituto Music & Memory”.
It is quite difficult to describe what happens in a music therapy session, as there are several treatment approaches.
It can be performed with the passive patient, just listening to the music therapist playing, or active, that is, participating and making music with the therapist.
These therapy sessions are very useful in helping to develop communication and self-expression skills.
It is also possible for music therapy to be used in groups, in which all members play an instrument together and participate in the performance of a song. According to the case studies, the sessions help patients to loosen up more and express their emotions more easily.
For children with autism
The Autism is a condition that greatly impedes the child’s communication processes. It is to treat this problem that music therapy has its value.
In a session with an autistic child, music therapists usually decide to play instruments with the child, to encourage him to express himself through music. Thereafter, therapists can choose to either music the sounds the child makes or simply leave them free to play the way they want.
An improvement in the child is noted throughout the session. In the beginning, she tends to play notes, melodies and rhythms without much musical logical sense, but, as the therapists get closer to the child, at the end of the session, she may be playing similar notes or playing at the same rhythm.
This is an impressive form of communication. When playing together with other people, the activated areas of the brain are the same as in a conversation. Therefore, the therapeutic potential of music in these cases becomes almost undeniable.
There are several benefits that can be provided by music therapy. We list here the main scientifically proven ones:
According to a review published by the Cochrane Library , a non-profit research partner of the World Health Organization (WHO), the simple act of listening to music can improve heart and respiratory rates, as well as blood pressure in patients with Coronary Artery Disease ( DAC).
More studies are still needed to prove the real efficiency and applicability of music therapy for patients with CAD, but the research indicates that music helps to reduce blood pressure, improve heart rate and decrease stress levels , being it a piece by Mozart or an Exaltasamba show.
Although music therapy has already been used persistently to treat various psychological problems, it was only in the 1980s that empirical research (based on experiments) began to be carried out in this field.
Since then, several studies in the area have been developed, taking into account several pathologies. Until today, music therapy has been shown to be more effective in treating negative symptoms, such as anxiety and isolation.
Music acts on several reasons in the brain, which is why it is so effective in treating stroke victims. This is because music is capable of arousing emotions and stimulating social interactions, helping the patient to recover.
It is precisely because it activates so many areas of the brain and in such an intense way that music serves as a therapeutic route to treat symptoms such as dementia, so common in diseases such as Alzheimer’s disease and other neurodegenerative diseases.
When listening to music, the patient activates several neuronal patterns (synapses) that have not been stimulated for a long time, causing the person suffering from dementia to “wake up”, in a way.
This type of therapy has been widely used in the United States and has been gaining a lot of popularity in recent years.
Some symptoms of amnesia have been mitigated through several interactions with music, either when the patient plays an instrument, or when he is passive, just listening to a song.
A famous case of an amnesic patient who benefits from music to this day is that of musicologist, conductor and tenor Clive Wearing, which we will see in more detail in the topic “Oliver Sacks – ‘I think of us as being a musical species’” .
There is a technique used by music therapists and speech therapists called Melodic Tone Therapy , which serves to help people with communication disorders caused by damage to the left brain.
The technique seeks to involve singing skills, encouraging the undamaged regions of the right hemisphere to “learn” to speak. In this technique, common phrases are transformed into melodic phrases.
At the beginning, the patient speaks almost singing and gradually learns the typical intonation and the common rhythmic patterns of everyday speech.
Autism, also known as Autism Spectrum Disorder, is a disorder that causes problems in language development, communication processes, interaction and social behavior in children.
According to the World Health Organization (WHO), approximately 70 million people worldwide have some degree of autism, and this number, in Brazil alone, exceeds 2 million.
Although there is no cure and its causes are uncertain, children with autism can benefit greatly from music therapy, as the use of instruments can serve as an important tool to encourage communication and self-expression, bringing quality of life to the person with the condition. .
Music therapy stimulates the creative potential and the communicative capacity, mobilizing psychological, biological and cultural aspects. That’s where community or social music therapy comes in.
This type of music therapy seeks to empower groups and enable engagements, exchange of experiences between patients, so that they can organize themselves and carry out all the confrontations necessary for a healthier social life.
Music therapy is widely used in Brazil. As it is a hybrid between art and health, professionals in the field, music therapists, graduate from higher education courses offered at art schools, given that, to practice the profession, it is necessary to have an advanced mastery of musical instruments such as the piano and the guitar.
Music therapists work in clinics, psychiatric hospitals, rehabilitation facilities, outpatient clinics, day care centers, agencies that assist people with developmental problems, mental health centers, elderly centers, correctional facilities, schools and many other places.
In addition, music therapy has been offered free of charge by SUS (Unified Health System) since January 2017. The adoption of the technique aims to offer a more humanized treatment, and the Ministry of Health has also started to offer art therapy, meditation, chiropractic and other alternative techniques.
Oliver Sacks (1933-2015) is a British neurologist and author of several best sellers . He served as a neurologist in New York City from the 1960s and it is his patients ‘stories that inspired him to write most of his books, largely clinical accounts of his patients’ lives.
In addition, it played a very important role in the creation and scientific foundation of the Institute for Music and Neurological Functions (in free translation, from the English “ Institute for Music and Neurologic Function ”).
To give an idea of who Oliver Sacks is, see the video below, in which the doctor explains a little about the importance of music in his personal and professional life and reports the case of one of his patients with Parkinson’s disease.
Attention! Activate the subtitles: click on the “settings” icon (its symbol is a gear) and then on subtitles “Portuguese – PORT-BR”.
Or case of Clive Wearing
Clive Wearing was an American musicologist, conductor and tenor who developed a severe case of amnesia, acquired after contracting encephalitis caused by a herpes virus that attacked his Central Nervous System (CNS).
The disease that affected him was both anterograde and retrograde. This means that he has lost access to memories of the past and that he is also unable to form recent memory.
According to family members, it is as if Wearing was always thinking that he just woke up from a coma, as he does not understand the time jump that has occurred since the last memory to which he had access.
It is as if he spent his days “waking up” every 20 seconds, “restarting” his consciousness, since the time span of his short-term memory is about 30 seconds.
The interesting thing about Wearing, however, is the fact that he can play piano and other instruments without problems, no matter how much amnesia attacks him. Clive does not remember his entire musical education process, but he still plays his instruments and would be able to conduct an orchestra very well.
For Dr. Sacks, his patient continues to have the skills to play instruments because his procedural memory has not been damaged by the virus.
Although the memories of events simply disappear, memories like the muscular one remain intact, which makes Wearing even able to learn new songs, forget that he learned them, and play them on the piano later.
Dr. P, the character who gives title to Oliver Sacks’ most famous book, “The man who mistook his wife for a hat” (1985), was a university professor, cultured and with extensive musical knowledge.
Overnight, Dr. P started not to recognize other people’s faces and to perceive faces where none existed. Still, he worked normally, recognizing his students by the voice or the way they played.
This led to some embarrassing situations, such as stroking a fire hydrant, thinking it was a child’s head.
It was only when the diabetes he suffered from began to worsen that he thought he was having a vision problem and went to the ophthalmologist. The doctor said his vision was perfect and that he might be experiencing a neurological problem, sending Dr. P to see Oliver Sacks.
Sacks was impressed by the case. Dr. P could not recognize mouth, nose, facial expression.
The neurologist, then, after the consultation, asked him to put on his shoe and Dr. P complied. After some time, when Sacks returned to the room, Dr. P had not yet put on his shoe and, when asked why, he said that he thought he had already put it on.
Sacks found that Dr. P mistook his own foot for the shoe and the suspicion became true when, at the end of an appointment, the patient took his wife by the head and pulled her up, thinking it was a hat.
To continue the diagnosis, Sacks went to the patient’s home for dinner, where he found that he was unable to recognize family members in family photos, unless they had very characteristic physical traits. But the real surprise came over dinner.
Dr. P hummed happily and ate quietly and in a relaxed manner. However, when his song was suddenly interrupted, it was as if all the objects in front of him disappeared. Dr. P didn’t even remember he was eating.
When talking to the family, he found that this was a recurring situation. While Dr. P hummed, he was able to perform his duties normally and, when interrupted by the sound of a bell, for example, he was unable to perform them.
Sacks realized that the man gradually replaced his visual representations of reality with music, which he now governed from his simplest actions, such as changing his clothes in the morning.
When Dr. P asked him what to do, finding himself in a situation with no way out, Dr. Sacks simply recommended that he continue to live through music, preferably using a specific song for each action, thus being able to perform them to a certain degree. normality.
Or case of Tony Ciciora
Tony was never a music enthusiast. He never had any particular interest, nor did he learn to play any instrument.
All of that changed in 1993, when it was struck by lightning. Since then, he has complained of musical hallucinations. He listens to music all the time in his head. Piano solos, mostly.
Dr. Oliver Sacks explains, in his book “Musical Hallucinations” (2007), that the electrical shock may have, in a way, “reconfigured” some regions of Tony’s brain.
“Nerve cells are said to have been damaged or some kind of new growth has occurred, so that certain parts of the brain that were previously inactive have become constantly active,” the doctor said in an interview with the German magazine Der Spiegel in 2008.
The most impressive thing, however, regarding Tony’s case, is that he not only stayed with these musical hallucinations, but also developed musical aptitude.
Not only can he play Chopin pieces and fill an auditorium, he also makes his own compositions!
In the video below, Ciciora performs one of his own compositions, entitled “ Lightning Sonata ” or “Sonata para o Raio”, in free translation. Check out:
It is also interesting to note that the title of the work he plays has a double meaning that can only be understood in English.
“Lightning Sonata”, literally, means “Sonata para o Raio”, however, it can also be understood as “Sonata of enlightenment”, since the word “lightning” takes on these two meanings, making the title of the work still more poetic.
Dan Cohen is a huge fan of 60’s music. When he started to grow old, he thought about what his life would be like if he ended up in a home for the elderly. The idea of being deprived of listening to his favorite songs plagued him.
It was then that he had the idea of creating the Music & Memory Institute (Institute of Music and Memory) in New York, whose mission is to bring music to the elderly in nursing homes around the United States.
And the way he used to do that was the most interesting. Instead of gathering groups of musicians to perform for the elderly, he decided to use technology in favor of his cause: he uses ipods.
Cohen travels to the United States distributing individual iPods to the elderly and teaching nursing home staff how to make an individual playlist for each of the patients.
The use of individual playlists allows the creation of a musical treatment plan for each patient.
Cohen’s search is for music that has some special meaning for patients, as music is directly associated with events and particular aspects of our lives.
“Even with the loss of short-term memory, the songs we like the most are closely tied to our emotional system. And the interesting thing to note is that our emotional system remains intact even when we are no longer able to recognize the face of our own family members, ” says Cohen .
Based on these ideas, Cohen studies case by case, viewing the musical history of each patient so that he can create a unique playlist, especially aimed at the elderly. If a patient can no longer articulate words, Cohen and his team turn to the family and the results are impressive.
When I asked him why he thought music worked so well with the elderly, Dan replied:
“Music ‘works’ with just about everyone. What I think is that the elderly, due to the circumstances, were disconnected from the music that touches them, who are deprived of access to music. So, what we do here at M&M is simply reconnect them to the music itself. ”
The results that these personalized playlists generate in the elderly are impressive. It is as if these patients, who already suffer from profound dementia, suddenly “wake up” and return to who they were.
Check out an excerpt from the documentary “Alive Inside”, which tells the story of Cohen and his institute:
After watching this video, it’s hard not to believe the ideas of the ancient philosophers, Dr. Oliver Sacks and Cohen’s own words:
“People tend to communicate better when in contact with their own music. They feel less pain, have better results in rehabilitation, swallow more slowly and better (when they have difficulty swallowing), become more relaxed and decrease their need for antipsychotic, antidepressant or anxiolytic drugs . In addition, they hallucinate less, become less aggressive, have an improvement in mood and come into contact with themselves, becoming more sociable people. ”
The history of music therapy is old. Our ancestors already had some notion that music had a therapeutic power that could be of great value in the treatment of various problems.
From ancient Egypt
The first written record talking about music therapy to which we have access are the Papyri of Lahun, a collection of ancient Egyptian texts that report on topics in the common life of the citizen of ancient Egypt, such as administrative, mathematical problems and medical reports.
Through these archaeological archives, it can be seen that music therapy, although not the same as today, was widely used in Egyptian temples.
In addition, it is believed that the practice was carried out in biblical times. This hypothesis stems from an excerpt from the Old Testament that tells the story of King David.
Before gaining notoriety for facing the giant Goliath, David was a harp player at King Saul’s court and used the instrument to calm the nobleman’s spirits. In Samuel, chapter 16, verse 23, we can read the following passage:
“ And whenever the evil spirit of God came upon the king, David took the harp and played. Saul calmed down, was relieved and the evil spirit left him. ”
There are also records that show that music has been of social and therapeutic importance since ancient Greece.
So much so that the pantheon (set of Greek gods) had entities such as Apollo, the Greek god of music and medicine , or Esculapius, another god of medicine, who cured diseases of the mind through music and songs.
The work of pre-Socratic Greek philosophers already discuss the possible therapeutic benefits of music.
Plato, for example, said that music affects emotions and can influence an individual’s character. Aristotle taught that music affects the soul and described it as ” a force capable of purifying emotions “.
For now, it is worth mentioning only that around 400 BC, Hippocrates, another philosopher, played music for the mentally ill and that this practice remained influential until after the end of ancient Greece.
Aulo Cornélio Celso, a great Roman encyclopedist, argued that the sound of cymbals and running water would be effective for the treatment of mental disorders.
The first time that the therapeutic potential of music was recognized was in the 9th century, during the Islamic Golden Age. In that society, music had wide therapeutic use.
The scientist, psychiatrist and musicologist Al-Farabi (872 to 951 – 79 years old) referred to the therapeutic effect of music in his treatise Meanings of Intellect , and the Arab hospitals of the 12th century had music rooms for patients.
Robert Burton was an English scholar and vicar at the University of Oxford in the 17th century and author of the book “The Anatomy of Melancholia”, considered by many to be the greatest literary work of the time.
The book is a compendium of texts and academic analyzes on the feeling that gives the work its title: melancholy (which includes what we now call “depression”).
In his book, the academic writes music and dance were fundamental for the treatment of mental illnesses, especially melancholy.
His work was very influential, giving rise to several others regarding the relationship between human beings and music.
The origin of contemporary music therapy
No less interesting than all the speculations made by ancient societies, the history of modern music therapy has its roots in a very curious place: the military hospitals of the second world war.
Music never failed to generate interest in doctors, but it was only applied systematically and studied on behalf of the United States Department of Defense. Music was used in these hospitals to aid the recovery of soldiers who returned from the war, and was especially geared towards patients with mental and emotional disorders.
Music therapy is not a new technique. Quite the opposite. It has long generated fascination and it is only from the twentieth century that more scientific investigations could be made regarding its therapeutic potential.
Furthermore, today, more than at any other time in human history, we are in direct contact with music. She is present all the time, in our headphones, in our cars and even at work.
Often, we do not have the time necessary to enjoy it as we should and it ends up serving as a simple background noise. However, if we see the therapeutic potential and the changes it can bring to our lives, perhaps we can lead a healthy life. If not healthy, at least more sonorously colored.
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