You Are the Music: How Music Reveals What it Means to be Human (22 page)

Fact 3:
Musicians do not get them more often. This is not a closed issue but present research suggests that it is not those with the most musical training who experience the most frequent and/or longest episodes of earworms. In fact musicians with the highest levels of training (more than fifteen years) often report fewer earworms than people with less training.
³⁵

Our research has found that people who enjoy music every day, in particular those who like to sing along, report the most habitual and recurring earworms.
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A nice side effect of this pattern in the data is that those people who like a good singsong are also more likely to enjoy their earworms.

A number of studies have tried to identify traits that predict higher risk of frequent or more disturbing earworm experiences. An interesting concept in this area is ‘transliminality’. If
you are the kind of person who measures high on transliminality then you are more sensitive to recognising thoughts and feelings that originate in the non-conscious mind. Another way to put it is to imagine that a layer or barrier exists between our conscious and non-conscious mental life. This barrier is more permeable in people who have high transliminality.

Mike Wammes and Imants Barušs reported that individuals who were high in transliminality were more likely to report persistent and distracting earworms compared to those who scored low on the same dimension.
³⁷

Other studies have reported a link between earworms and neuroticism,
³⁸
and between earworms and nonclinical obsessive-compulsive traits.
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No doubt other individual factors will emerge over time but it is interesting that at present most of the traits identified are marked by a tendency towards rumination, being more likely to focus on and worry about past or present events.

Studying the type of people who get earworms is one way of trying to get at the question of why they happen. Another way is to explore the circumstances under which they appear in daily life. That was the aim of a study of mine in which I analysed hundreds of earworm stories about why tunes got stuck in people’s heads.
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To be clear, only about a quarter of people in the study claimed to have any idea why a tune was stuck in their head, which leaves us a lot of unaccounted for earworm episodes.

What triggers earworms?

When people were able to describe the circumstances of their earworm they most often described recent and repeated exposure to the tune that was stuck in their head. This finding aligns with Oliver Sacks’ idea that the preponderance of easily accessible music in the modern world is at least partly to blame for the frequency of earworms.

But the prevalence of modern music can’t be the whole story; we know that earworms were a well-known phenomenon long before the modern age of ubiquitous recorded music. In 1876 Mark Twain wrote a short story entitled ‘A Literary Nightmare’, in which he describes a jingle getting stuck in his head and disrupting his concentration level so much that he is forced to pass it on to someone else in order to get rid of the experience.

Another common trigger of earworms, one that has nothing to do with hearing music, is the activity of involuntary memory. To give an example, one of the people in my study described seeing a licence plate that reminded her of the title of a Michael Jackson song (‘PYT’), and for the rest of the day that tune was stuck in her head, even though she had not heard it for a long time.

We are a long way from understanding why memory ‘pops’ in this way between thoughts
⁴¹
– between things we see and hear in the world and related images or sounds in our minds.
⁴²
From findings like the Michael Jackson story above, however, we can see that mind popping is a strong trigger for earworms. Short of sitting in a dark room with nothing to see or hear, there is little we can do to control this type of mental activity. Mind popping appears to be a natural consequence of the way our memories operate, and as long as music is held in our memory then there is a chance that it will be triggered by a random encounter with something that reminds us of its contents.

It is also possible that emotional conditioned responses may be behind some of our earworm experiences. In my survey, some respondents reported that they always experienced the same earworm in response to certain moods or circumstances. In my case, when I am happy I often have Doris Day singing a lively rendition of ‘The Deadwood Stage’ in my head. It always makes me smile.

Future research will help us untangle other possible causes
of earworms, including the prospect that some earworms may help to modify our state of attention or mood for the task at hand. It is a nice thought that the mind may be selecting tunes from our mental jukebox in order to support our activities in the same way that we ourselves might select a tune to boost our confidence before a night out or calm us down after an argument.

One thing we have little idea about as yet is the repeating, looping component of earworms. Why do they get stuck? Again, earworms are not the only type of thought to loop in the mind. Worries or rumination can also be cyclic, especially in times of stress. I have often heard people speak about other types of repeating sounds, such as words from poems, prayers or even jokes. The great thing about earworms is that because they are so regular and common compared to these other kinds of mental activity, they are a useful research tool that may help us better understand other types of repeating thoughts in the future.

Memory is so much more than a collection of stories, skills and ideas. As we have seen in this chapter, memory is vital to learning, whether we are training as a musician or simply learning about the music of our culture through everyday listening. It is an essential component of our experience of consciousness that keeps us connected to our past and future on the thin sliver of time that we think of as the present moment. Memory can also be involuntary, it can ‘pop’ and repeat on us for reasons we do not yet fully understand.

In all these three guises, ‘the star’, ‘the survivor’ and ‘the miscreant’, musical memory has shown itself to be crucial to our understanding of our musical world and also to our understanding of what we believe, what we have been through in our life, and how we came to be who we are today.

In the next chapter we will see how musical memory is also an important ingredient in the potential of music to provide comfort and to support healing in times of illness and injury. In the final part of our musical life journey I will discuss the various ways in which music has been found to have a positive impact on our health and state of well-being.

Chapter 8

Music and lifelong well-being

‘One good thing about music; when it hits you, you feel no pain.’

BOB MARLEY

Throughout this book there have been countless points where I could have discussed how music can help to alleviate or remediate mental and physical conditions. Music has the potential to provide valuable and powerful support for well-being across the whole of the lifespan, from infancy right through to end-of-life care. In the end I decided not to bury these interesting ideas among the chapters but to bring them into a light of their own.

Before beginning down the road of exploring music for lifelong well-being, I want to make a few things clear. Firstly, and most importantly, music is not a cure-all for everything that ails us in life. If it was then someone would have noticed by now.

In 2005 John Sloboda
¹
wrote a wise cautionary note warning against the ‘vitamin’ model of music. This refers to the danger we evoke when expecting that certain music will have the same impact on everyone; the idea that music might be prescribed in tones, rhythms and timbres depending on the way you want to feel or for a particular health-related outcome. ‘This is the best music for heart disease’; ‘this is best for depression’; ‘this is better for sleeping’, and so on. To go down this road, given the individualistic nature of our musical skills, preferences and memories, is foolhardy.

You may see echoes of this kind of ‘pharmaceutical’ approach to music and well-being in some of the studies in this chapter. This is not a terrible thing, as demonstrating the potential power of music for well-being was an important early step for supporting future work and interest in this area. What is important now is where we go from here.

Similarly, I do not believe that music should be treated as a whole, something we use under one generic label. Music is the most wonderfully diverse human activity, full of different styles, instruments, voices and performance traditions. We need to honour this variety. We are only at the very beginning of understanding how music relates to health and well-being outside Western cultures, although efforts are being made to highlight this gap in our knowledge particularly by the fields of medical ethnomusicology and cultural anthropology.
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Finally, I make one pre-emptive observation that will become clear to you as I describe studies of music and wellbeing. As yet, we have only rough ideas of
how
music contributes to positive health outcomes. Much of what you will read or hear on this subject is speculation. Many researchers are still operating largely on intuition when engaging with the therapeutic impacts of music. It is early days for science in this area and we are finding our way. Once again, a hope for the future is that we can move towards isolating some of the mechanisms behind positive outcomes so that we can move from intuitive to more informed engagement with music for well-being.

In this chapter I am first going to talk about ways in which music can bring about positive impacts for lifelong well-being, and outline the kind of mechanisms that are currently the hot contenders for explaining positive effects. Then we will look at the different ways that people are engaging with music for well-being and the important differences between music therapy and music medicine.

Once all these concepts are settled in place I will move on to the research itself, spanning as it does the whole of the human lifespan: a selection of some of the most interesting studies to date, showing how music can support growth in babies and children, boost communication and support language development, aid movement, calm distress, and play a role in how the brain repairs itself after illness or injury.

As humans we have spent thousands of years developing, expanding and refining this amazing tool and ability that we call music, without any real drive or purpose other than the pleasure and passion that we feel as a result. That same music is now beginning to reveal its power to help us along our life’s journey.

I have thought carefully about the term to use when talking about the ways in which we engage with music for non-music related benefits. After a few false starts I decided that ‘wellbeing’ suited best.

Well-being does not have one single definition since the word is used across multiple disciplines including but not limited to medicine, economics, politics, social studies and psychology; it is no wonder that we can’t all agree. My preferred shorthand description though comes from an economic background: ‘doing well – feeling good’.
³

The ‘doing well’ part of well-being refers to objective standard of living. It may seem like this refers only to economic prosperity but you can think of it more widely as what a person can or can’t do well in their everyday life: for example, whether a person is mobile enough to work and take care of themselves or whether they can communicate well enough to take part in activities with family and friends.

The ‘feeling good’ part of well-being refers to our subjective level of life satisfaction, given our personal circumstances.
Feeling good is also about our sense of social identity, as personal reflection on how we may feel is compared to values and expectations, given our society and background, and to our perception of the people around us.

When we talk about music and well-being, therefore, we must think beyond the instant ‘feel good factor’ that we encounter when we play a bit of music to cheer us up after a long day and instead consider the widest possible well-being outreach of any music-related intervention.

Having set my net so wide, I now have to admit that there is no way that I could discuss all the well-being-related studies of music that exist. There are excellent texts devoted to this subject alone that far exceed the size of this book.
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My aim in using such a wide definition of well-being is to give myself enough wiggle room to touch on as many different studies of lifelong well-being as possible, to give you a broad flavour of the areas in which we are starting to see potential for music.

Music therapy and music medicine

I attended a very inspiring conference a few years ago in Austria, entitled ‘Mozart and Science’. These were my first steps into the world of music and well-being research, and marked my first interactions with music therapists. Apart from a head full of ideas and motivation, this conference left me with one overriding impression: that music therapy and music medicine were two different things that should not be confused. I still think this is an important concept to emphasise.

We all use music in ways we may think of as ‘therapeutic’ when we need cheering up, consolation, support or comfort. What we do in these circumstances, however, would not be classed as music therapy in a strict sense. Definitions of music therapy vary but they all come down to a situation where ‘the therapist helps the client to promote health, using music
experiences and the relationships developing through them’.
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Music listening can be a part of music therapy but they are not the same thing. Music therapy needs the presence of a qualified therapist.
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I have had the privilege to observe a handful of music therapy sessions over the years in various situations, from a nursing home to neurological care and at a school for severely disabled children. I can say from this small experience that the presence of the therapist, as a guide, a focus and a source of connection for the client, was absolutely essential.

There are aspects of the human interaction in music therapy that we will probably never be able to quantify with scientific studies and I can therefore fully sympathise with practitioners who may be reluctant to engage with research on therapy. However, I believe that we should at least try to understand some of the mechanisms behind the effects of music therapy: by doing so we can learn more about the kinds of techniques and activities that are effective for different patients. Certainly at the conference I was attending there were plenty of therapists who were keen to explore the physiological and psychological mechanisms that may underpin their important work in order to make sure their approaches were as informed and as effective as possible for their clients.

Having defined music therapy, we are left with a large body of research without a name: studies where music was used with the aim of improving a condition or situation but where no therapist was present. If a researcher uses music for health-related outcomes in the absence of a therapist then we can use the term ‘music medicine’.

There are many advantages to considering music therapy and music medicine as options in care plans. At safe hearing levels there are no reported negative side effects to music. Music interventions can be planned in combination with just about any other form of therapy or medication without
fear of negative interaction effects. In addition, many music interventions do not require verbal communication, which makes them ideal for patients whose speech is impaired or absent. Music therapy and music medicine can also be viewed as overall cost effective: with their use, patients can often be discharged sooner, use less medication, and require less intensive staff care.
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How does it work?

Setting aside the differences between music medicine and music therapy, how might listening to music impact on our state of well-being?

Music has a varied list of measurable effects on our physical and psychological state that we have touched on throughout the book, relating to our emotions, moods, memories, attentional focus, and mental and physical arousal. One or two of these mechanisms deserve an additional special mention here.

Perhaps the most cited reaction to music that is associated with improved well-being is the relaxation response of the autonomic nervous system, which includes a variety of body markers such as the lowering of heart rate, breathing rate, blood pressure, muscular tension and oxygen consumption.

There are many beneficial secondary effects to this autonomic relaxation response, including the reduction of pain,
⁸
anxiety and stress. These combined outcomes can lead to positive effects in medical situations: for example, studies at Yale found that spinal surgery patients who could control their own pain medication used up to 43 per cent less when they had access to their favourite music.
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A second mechanism of effect for music and well-being are brain responses to our favourite music, in particular the release of neurotransmitters (for example, dopamine) that are associated with psychological experiences like motivation
and pleasure. Hearing favourite music is associated with the activity of neurotransmitters in the brain’s reward circuitry: deep connections between the limbic emotion centres of the brain and the higher pre-frontal decision-making and evaluation areas.
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The latest research indicates that even brand new music can stimulate aspects of this brain reward circuitry, if that new music comes from a style or genre that we already enjoy.
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The autonomic relaxation response, combined with the activity of the brain reward system, impacts on our hormone and immune response. The body produces natural opiates in response to our listening to enjoyable music and often we can see a marked reduction in levels of cortisol, a marker of a stress response in the body.
¹²
Even a single music therapy session has been associated with a significant increase in measurable salivary immunoglobulin A, a natural antibody in our immune system.
¹³

Finally, when we consider the effects of music
therapy
on well-being we must not forget about the less tangible but very real influences of increased human contact, communication and empathy, guided reflection and emotional support.

As a result of the sheer number of possible explanations for music’s effects on well-being it is not uncommon for researchers in this area to ascribe a positive impact of music to a collection of these mechanisms. The problem is that most studies have no idea how music leads to a positive effect.

I am no different. I have run these kinds of music and well-being studies and as a researcher you get really excited about the fact that music appears to be helping people, but then realise that, apart from a few intriguing leads, there is no clear reason why.

Another problem is that many music and well-being studies are correlational in nature; this means that researchers introduce music into an environment (for example, a hospital,
a care home) and then look for changes in behaviour and/or feelings of the patients/clients/participants. Any changes that the researchers observe could have come from any number of underlying causes, and probably emerge from a complex, unique combination of the brain and body mechanisms I have listed above.

The most comprehensive studies that I will tell you about in the next section take as many brain and body measures as they can to try to narrow down likely mechanisms in the effects observed.