Big Picture: Music, Mind And Medicine

Big Picture ISSUE 10 JUNE 2009

MUSIC, MIND AND MEDICINE

BRINGING CUTTING-EDGE SCIENCE INTO THE CLASSROOM

Moved by music

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How music affects mind and body

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■ Music and emotions ■ Evolution of music ■ Music and medicine ■ Creativity and music

Big Picture

Big Picture on music Magical mystery tour It is hard to imagine a world without music. Most of us hear some form of music every day. It is a popular leisure activity and it accompanies many of the most significant points of our lives: our infancy, our marriages, our funerals. It is a powerful trigger of emotional memories.

It’s a beautiful noise

Often, we can tell the story of our lives in songs and music. Even so, music remains one of life’s great mysteries. How can it have such a powerful impact on us? What exactly is it for? When in human history did it appear and why? Do other animals experience music? And what exactly is music anyway?

Music always involves combinations of pitch, timbre, rhythm, loudness, tempo, melody and harmony. These elements can be combined to create a huge diversity of music – from African drumming to Johann Sebastian Bach, Inuit throat singing to Razorlight.

HARMONY:

TONE:

OCTAVE:

A regular sound of distinct pitch; musical systems are based on a discrete set of tones

Musical interval of eight full tones (e.g. from C to the C above it), over which pitch frequency halves or doubles

PITCH:

Combining notes of different pitches to create new sounds

LOUDNESS:

The volume of sound. o Dependent on D tthe amplitude of a sound wave

How high or low a note is. Linked to the frequency of a sound wave

TEMPO:

TIMBRE:

Why the same note on a trombone sounds different to one played on a violin

The speed at which a piece of music is played

MELODY:

RHYTHM:

A pleasing arrangement of notes

The organisation of musical stresses over time

Harmony in my head In the inner ear, the cochlea converts sound waves into the language of the brain: nerve impulses. Within the organ of Corti, tiny hair cells in the basilar membrane detect sound vibrations. Inner hair cells convert mechanical stimulation to an electrical signal. Their deformation opens ion channels, triggering a series of cellular events that ultimately generates an action potential in the auditory nerve. Because of the structure of the

basilar membrane, different parts of the cochlea respond to sounds of different pitch. At one end the membrane is narrow and stiff and vibrates in response to high pitches. The other end is wider and more flexible, responding to deeper sounds. But information doesn’t just flow one way. The brain can send signals that sharpen up responses of hair cells, so we can concentrate on specific aspects of sound in complex environments.

2 Big Picture 10: Music, Mind and Medicine

SOUND AND VISION The sound journey from ear to brain is summarised at Big Picture Online. See how the cochlea is beautifully structured to detect sound and transmit information to the brain. The website also includes an audio library providing auditory material to complement the articles in this issue.

ON THE WEB

www.wellcome.ac.uk/ bigpicture/music

Wired for sound The brain has a complex interconnected set of pathways for processing music. Brain imaging shows that music perception involves a wide range of brain regions. Many are specialised: music [lea_d]
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Our brains recognise octaves as special.

How are music and language related?

A Tibetan musical score from a Buddhist monastic ritual, circa late 18th–19th century.

Abacab Early music was passed on from person to person. Oral tradition remains the norm in many regions, including most of Africa. Generally, though, some form of musical notation is used. The ancient Greeks wrote melodies as lines of letters. But it wasn’t until eighth-century Church music that changes in pitches were shown: diagonal lines indicated rises or falls in the tune. More precise changes in pitch were written in the tenth century,

when a single line represented a fixed tone and pitch varied above or below this by set distances. By the 12th century, staves had four lines with pitches on alternate spaces and lines. We now have five. In Japanese music there is no consensus notation because the music is so diverse. The notation for the Shakuhachi bamboo flutes is pictorial: a symbol for each note with dots and lines for lengths and intonation.

Music and language have much in common. Both depend upon the brain’s perception of structured sound input. Links between the two were noted by the ancient Greeks, and Charles Darwin speculated about how they might be related. During the 20th century, attention focused mainly on their differences, with the idea that the brain had specific ‘modules’ for decoding music, distinct from those that handled language. In reality, the lines between language and music are not always clear cut. ‘Talking drums’, used to send messages in parts of Africa, and the whistling languages of Africa, Asia and South America resemble music but convey information as ‘normal’ languages do. Baby talk (the cooing intonation of ‘motherese’ or ‘parentese’) Photodisc

‘Happy Birthday’ is a well-known tune, written surprisingly recently (technically, it is still in copyright). As with all songs, if its notes are all raised by an octave (or multiple octaves) it remains instantly recognisable. A much smaller shift in frequency, if it does not match an octave, has a much more dramatic impact on melody and makes the tune harder to spot. Remarkably, our brains have an innate ability to spot the fact that notes an octave apart are the same. This capacity is even present in unborn infants, whose heart rate changes when they experience novel sounds. An octave shift, though, has a relatively small effect on heart rate. Perhaps even more remarkably, other primates share this ability. Rhesus monkeys trained to distinguish ‘same’ from ‘different’ can spot the similarity between different versions of ‘Happy Birthday’ (and other simple songs) but only when they are played an octave apart.

also blurs the boundaries. Similarly, the idea that there are separate musicprocessing areas in the brain has been challenged. Localised brain damage can affect specific aspects of music perception, but often disrupts both music and language. An emerging idea is that there are brain networks and areas for music that overlap with, but are not identical to, those used in language. So which came first? Did early humans chat or sing round the campfire? One possibility is that rhythm and early motherese-like communication provided a common foundation for both language and music. The two diverged as language became the principal tool of communication, with well-defined structures and rules. Music set off in a different direction. Yet their common ancestry lives on in the shared processing pathways in our brains. An African ‘talking drum’.

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Big Picture

In the mood The power of music is extraordinary. It can inspire, excite and influence e our mood profoundly. It can send chills down our spines and raise the hairs on the e back of our necks. ch How can something as simple as a coordinated set of noises have such dramatic impacts on our mind and body? dify More controversially, perhaps, music is often used deliberately to modify human behaviour – building on a long history of manipulation by music..

Emotion is fundamental to the musical experience.

All the worst tunes: the ‘Devil's interval’ inspires dread.

Heartbeat Music can trigger powerful physiological responses.

NBCUPHOTOBANK/Rex Features

Music can elicit a remarkable range of emotions, from elation to the deepest sorrow. As well as provoking a mental response, it also has characteristic effects on the body. Music can give us the ‘thrills’, ‘chills’ and ‘shivers’. Heart rate and skin conductance may change. The hairs on the back of our neck (and elsewhere) really do stand up. These effects arise from the action of hormones, triggered by signals from structures such as the hypothalamus.

4 Big Picture 10: Music, Mind and Medicine

Emotions are associated with activity ctivity in a network of brain structures. Music is very good at stimulating activity in these areas – a sign of the tremendous emotional impact of music. Interestingly, emotional reactions seem to be an innate aspect of music perception. Dissonance, combinations of notes that clash with one another, is distressing. The phenomenon is often [nfbe_j[Z
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change from dissonant to consonant tones is appreciated as a resolution of tension in diverse cultures from Hindu to Western. The ‘Devil’s interval’ – two notes three tones apart (e.g. a C and an F sharp), played simultaneously or one after another – automatically induces a feeling of dread.

Stirring, martial music may stimulate the release of adrenaline; dance music can trigger a burst of endorphins, associated m_j^
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Big in Japan: Luciano Pavarotti, bass.

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Second that emotion

High-flying adored: Lesley Garrett, soprano.

Good vibrations

Psycho killer: film scores can evoke powerful emotions.

You shook me all night long

As any Hollywood soundtrack composer knows, music can be used to manipulate people’s state of mind.

Samuel Barber’s ‘Adagio for Strings’ has graced David Lynch’s The Elephant Man, Oliver Stone’s Platoon and JeanPierre Jeunet’s Amélie. In 2004, listeners to Radio 4’s Today programme voted it the saddest classical piece ever written. A dance version by William Orbit (remixed by Ferry Corsten) was a top hit in 1999. Soundtracks are vital to a film experience, tugging at the heartstrings, stirring the soul or scaring the living daylights out of us (think Jaws, Psycho). Film score composers are emulating classical composers, who used music to elicit an emotional response, from sombre requiems to Beethoven’s uplifting ‘Ode to Joy’. Interestingly, even cognitive scientists exploit this phenomenon, using doom-laden works by Prokofiev to induce low mood in experimental subjects. More generally, bland, relaxing music (‘elevator music’ or ‘muzak’) is used in public places as a calming influence (and to encourage customers to browse longer). In 2002, by contrast, loud classical music was introduced at Copenhagen’s main railway station to discourage drug dealers and sex workers. In 1989, loud music was also used during ‘Operation Nifty Package’, the US Government’s attempt to capture General Noriega, a military dictator in Panama. Loud music was blasted at the Vatican diplomatic mission where he had taken refuge. Music has been used on captives by US forces, for example at Guantánamo Bay and in Iraq.

People from diverse cultures agree that certain pairs of notes are harmonious (consonant) or disharmonious (dissonant). The discord comes from interfering vibrations of the ear’s basilar membrane, which lead to conflicting patterns of activity in the auditory nerve. But most musical preferences are learned. They change over history – sounds dissonant to medieval audiences might go unnoticed today. And they vary between cultures. Melodies that inspire sadness in one country may leave people from another unmoved. What accounts for individual taste in music? Some research has found a link between music taste and particular personality traits (see below). We will also naturally be influenced by the music we experience as we grow up – both the prevailing musical culture and the specific music our families listen to. Even factors such as socioeconomic status may be significant (jazz tends to be more popular among the well-off). Our tastes will tend to change over time. With experience, we may begin to enjoy more complex musical pieces. But we also lose our initial range of hearing. Changes to the brain can radically affect musical tastes. Classical music lovers with dementia, for example, have been known suddenly to acquire a taste for pop music. So what about musical quality? A century ago the question would not have

We are the world: diverse musical forms from around the world.

Clockwise from top: Don Bayley/ iStockphoto, Nancy Louie/iStockphoto, Lew Zimmerman/ iStockphoto, Neal Preston/Corbis

been thought worth asking: Western classical music was seen as innately superior. Colonial occupations imposed attitudes and culture as well as armies. Even today, classical music retains an association with social and cultural elites. Even so, what is seen as ‘quality’ shifts over time; composers come in and out of fashion. Stravinsky’s ‘Rite of Spring’ sparked a riot when first performed in 1913 yet is now widely recognised as a classic. Moreover, there is a greater willingness to accept musical plurality – that no one musical form is ‘better’ than another.

Luis Sandovai Mandujano/iStockphoto

Everett Collection/Rex Features

What is quality music?

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Milan Darula/ iStockphoto

Inevitably, business has also wised up to the power of music. ‘Audio architects’ develop soundtracks for shops that are as much part of the brand as their visual identity. Sports events have abandoned marching bands in favour of booming popular music. Music affects how fast people drive and how they exercise in the gym. Music volume affects beer consumption. Style of music can even affect wine purchases: when German music was played in an off-licence, shoppers were more likely to choose German wines, while French music led them to prefer French tipples.

A global study of 36 000 people found a range of associations between personality traits and musical tastes – some of them quite surprising. O Opera lovers tend to have high self-esteem and are creative and gentle; country and western dev devotees are typically hard-working and outgoing; heavy metal fans tend to have low self-esteem he an are not so hard-working, but are gentle. and Conversely, song choice can provide clues t personality. In one study, strangers were to Andy Hill/iStockphoto asked to judge what people were like (extrovert, adventurous, melancholic, etc.) based on a CD of their favourite music or other clues. The assessments based on the CD were significantly better matches than those drawn from looks, clothes or taste in films.

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Big Picture

Things can only get better What does it take to be a good musician? Is it all down to natural talent or can everyone become a virtuoso, given the chance? And once learned, do musical skills help us in any other way? Perhaps they could be applied to help heal the sick. For centuries music was seen as integral to the healing arts. Now, it is beginning to make a comeback – though hard evidence of patient benefits is scant.

Shepard Sherbell/Corbis

Could anyone, given the opportunity, become a concert pianist or are there a select few with the potential to excel? A would-be musician must learn a new set of skills: generic skills such as reading music and specific skills associated with a chosen instrument. Across many areas of human endeavour, after initial training, further improvements tend to be gradual, peaking after many years’ effort – exactly when depending on the skill being learned. Typically, performance then declines slightly in later life. So an elite performer will generally take at least a decade – and often much longer – to reach their peak. Enhanced skills seem to depend on deliberate practice – repeatedly attempting specified tasks, assessing performance and striving for improvement. The aim is to prevent playing becoming ‘automated’ – mastered to the point that it no longer requires active cognitive thought. Although automation is an important step in mastering an instrument, to develop further a player must actively strive to enhance their performance. So simply rehearsing a piece hundreds of times will not necessarily lead to improvements. Typically, reaching a level needed to win international competitions means devoting more than 10 000 hours to deliberate practice. So is it all down to the right kind of practice? Possibly. On the other hand, a genetic study of isolated Finnish populations found evidence for genes associated with musical aptitude on chromosomes 4 and 8. This and other evidence suggests that innate musical ability will vary between individuals in a population.

What role is there for music in modern medicine? Music has been marginalised in medicine. Now, though, many doctors are arguing for its wider therapeutic use. Not surprisingly, given its power to influence mood and behaviour, its most popular uses are for psychological and psychiatric disorders, as well as neurological conditions and pain control. Music has proven value in situations likely to promote Wdn_[jo, such as children’s medical and dental treatment (right) and cervical cancer screening. Other well-established uses include interventions for people with chronic pain or tinnitus and children with migraine. But the effects are often not great and may not be long-lasting: in

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dementia, music reduces disruptive behaviour at the time but has little long-term impact. That said, absence of evidence is not the same as evidence of absence – it may just be that the right studies have not been done to assess a clinically relevant effect.

What does it take to be musically gifted?

Slice open the skull and a neuroanatomist could instantly spot signs of a professional musician. Musicians typically have an enlarged corpus callosum – the cables that pass from one side of the brain to the other. Certain areas of the cortex would also be well developed, particularly those dealing with sound, motor coordination and hand–eye coordination. A violinist’s brain might show enhanced grey matter in the motor areas specifically associated with the fingers of the left hand (used for fingering). He or she might also show greater activation in auditory areas in response to violin tones than to trumpet tones. There is also evidence that musicians use their brains in a different way, engaging a more ‘analytical’ strategy than non-musicians when listening to melodies. So musicians’ brains are different. Studies are now underway to see how the brains of musicians change as they go through their training.

6 Big Picture 10: Music, Mind and Medicine

A book of popular songs produced by Alka-Seltzer in 1937.

Mark Mortensen/iStockphoto

Is musical ability something you are born with or does it come with practice?

I can make you feel good

Fiona Pragoff

Day after day

Rock me Amadeus In 1998, the Governor of the US state of Georgia, Zell Miller, decreed that all Georgian children should be given a tape or CD of classical music. He believed in the ‘Mozart effect’ – that listening to classical music could boost your brainpower. In fact, Miller was overstating the case. Listening to Mozart only stimulated spatial reasoning – people got better at solving mazes – and only for about ten minutes after their dose of culture. And not everyone is convinced that Mozart is anything special. Some argue that the effect is simply down to mood and arousal. One study found a Mozart effect in young children listening to pop music. It’s also been seen in rodents navigating mazes. The biggest

effect, though, has probably been on sales of Mozart’s ‘Sonata for Two Pianos in D Major’ (K. 448). Yet there is a widespread belief that music is ‘good for you’. Indeed, there is some evidence that learning to play an instrument can enhance abilities in other areas – the transfer effect. For example, some mathematical reasoning comes more easily to the musically trained child. Other skills such as reading, motor coordination and conceptual reasoning also appear to be improved by musical education. Despite the enthusiasm of some parentsto-be for bombarding their babies with Mozart while in the womb, there is little evidence that any benefits result.

digitalskillet/iStockphoto

Does music make you smarter?

Listen with mother: playing music to unborn babies.

In a recent study of keyhole surgery, surgeons who played a musical instrument were significantly faster at suturing than those who did not.

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Crazy

I feel fine Music has a long history in the healing arts.

Tarantism is a peculiar chapter in the story of music and health. In regions of Italy and Spain during the 16th and 17th centuries, some women periodically fell into a stupor from which they could be roused only by music. The condition was commonly blamed on the bite of a spider (though not the tarantula of popular imagination). Musicians travelled the countryside trying different instruments and songs to rouse the ‘tarantati’. Rapid repetitive tunes with increasing tempo would bring patients to a dancing frenzy, often lasting several days. Thereafter, they would spontaneously dance whenever they heard a ‘tarantella’ (below). Many physicians attempted to explain the condition, drawing upon voguish theories. Today it would be considered a mass delusion. Many composers have drawn upon the Tarantella in their works, and it also appeared in The Godfather and inspired a jinx (‘Tarantallegra’) in Harry Potter and the Chamber of Secrets.

Franz Mesmer (from whom we get the word mesmerise and, indirectly, hypnosis) developed a form of therapy that aimed to improve the flow of ‘life forces’ (‘magnétisme animal’) through the body, often using a glass harmonica in his therapies. The French King Louis XVI ordered a high-level enquiry – which _dYbkZ[Z
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In ancient Greece, Apollo was the god of both healing and music. Music was seen to be a powerful influence over people. It was divided into three forms: ● Phrygian: stirring, martial music ● Dorian: solemn and slow, noble and pious ● Ionian: jolly and joyful. The meaning of these terms has changed somewhat since then. Internal balance of the four bodily humours (black bile, yellow bile, phlegm and blood) was seen as particularly important, an idea that survived until modern times. Music could exert its influence by acting on the humours. Music was thought to be detected in the ear by animal spirits, which transmitted reverberations through the body in the bloodstream. The 17thcentury German physician Athanasius Kircher illustrated the concept by showing how music affected vessels filled with

different kinds of fluid, representing the different humours. As more mechanistic views of nature developed, the German scientist Herman von Helmholtz linked the physics of sounds and the anatomy of human hearing. He proposed reasons for perceptions of consonance and dissonance and later showed how several physiological factors were affected by various aspects of music (pitch, loudness etc.). Music therapy has often been applied in mental health. In the 18th century, the singing of the castrato Farinelli reputedly brought King Philip V of Spain out of depression, and a daily dose of singing kept him well until his death ten years later. As treatments of mentally ill people became more humane in the late 19th century, music sometimes formed part of therapy – either listening or music making.

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Big Picture

The times they are a-changing What is the point of music? Perhaps the biggest mystery in music is what it is actually for. A classical evolutionary perspective would argue that, as a seemingly innate aspect of human behaviour, music must have some purpose – provide some kind of survival advantage. But how would musical ability have helped our ancient ancestors? Perhaps instead it is an evolutionary quirk, a by-product of our advanced brains.

I heard it through the grapevine Why did music evolve? There are two ways to explain the evolution of music. The first, the adaptationist view, is that music must serve some purpose that has led to its selection. An alternative argument is that it has no direct purpose itself but is a by-product of some other human capacity (see below). If we assume music has some survival value, what might it be? Charles Darwin suggested i[nkWb
i[b[Yj_ed might be at work. Good singers or musicians might be signalling their fitness to potential mates. ● In 1925 the anthropologist Malinowski described a noted singer on the island of Kiriwina: “Mokadayu, of Okopukopu, was a famous singer. Like all of his profession he was no less renowned for his success

with the ladies. ‘For,’ say the natives, ‘the throat is a long passage like the wila (vagina), and the two attract each other.’ ‘A man who has a beautiful voice will like women very much and they will like him.’” There is some evidence to support this idea (such as the renowned success of pop stars at attracting mates). More recently, symmetry – generally thought to be a sign of ‘good genes’ – was found to be associated with an attractive voice. On the other hand, music is typically a group activity, and associated with rituals rather than courtship. The alternative view is that music acts as a bonding agent and emerged as part of the development of social groups. Among primates, humans are intensely social; much of our success has relied on our ability to coordinate our actions and communicate our state of mind to others. A coherent collaborating group would have been able to hunt better, see off enemies and protect vulnerable infants.

Jump to the beat: did music unite early humans…

…or was it a love thing?

Eat to the beat Stephen Jay Gould popularised the idea that not all features of an organism are necessarily adaptive (as classical Darwinian thinking would maintain). He used the analogy of ‘spandrels’ – the spaces between the arches in cathedrals, which served no structural function but were often filled with paintings by artists. They may have looked stunning but they were only there because a cathedral needs arches to stop it falling down. The writer Steven Pinker describes music as “auditory cheesecake”. We never evolved to find cheesecake tasty – it taps into our innate fondness for energy-rich foods.

She bangs the drums When did music first appear? Music is a part of essentially all human cultures, suggesting that it is very ancient and evolved early in human history. Early music may have relied on the human voice or basic percussion using natural materials. Some ancient artefacts may have been used to generate sounds, but the earliest unambiguously musical instrument is probably a flute discovered in Germany, which is about 36 000 years old. Bone flutes 8000–9000 years old have been found in China and play notes in ancient Chinese musical systems. Two 4000–5000-year-old marble statues show that well-defined musical forms had developed by the late Stone Age. They show

8 Big Picture 10: Music, Mind and Medicine

a flute player and a musician playing a triangular lyre or harp. By the time documented civilisations appear, all have well-defined musical traditions. What of other human species? What may be a 43 000-year-old Neanderthal flute was recently found in Slovenia, while Steven Mithen has argued in his book The Singing Neanderthals that the anatomy of their vocal systems would have allowed them to sing. His proposal is part of a growing reassessment of Neanderthals and their culture, suggesting that they were neither as brutish nor dim as once made out. Far left: An early South American flute made from a bone. Near left: Frieze depicting dancing figures.

Don Klein/Superstock

Above (left to right): Music from Nepal, Argentina and India. Bottom: Two Circassian accordion players.

of heroes. Their aim was to soothe and distract the patient and identify with the heroes’ courage. The roots of this rite are said to lie in the treatment of Kodgeberduko, hero of the Caucasian war, who had a bullet removed from his leg, with a folk tune acting as anaesthetic.

Pleasure and pain Music plays a central role in healing and medicine of the Circassian or Adyghe people of eastern Europe. A particular rite known as ‘Chapsh’ was used for injuries such as snakebite or bullet wounds. A violinist would play songs and children perform dances, often epic tales

Leader of the pack

The song of the canyon wren is said to cascade down the musical scale like the opening of Chopin’s ‘Revolutionary Étude’.

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‘subcultures’ often associated with adolescence – the emos, goths, etc. Why is music so important in this process? It seems to have a ‘special’ role, with characteristics – rhythms, melodies, harmonies, sound and words – that reflect the lives and states of mind and body of those who belong to the subculture.

Many species of animal – such as birds and whales – produce sounds sharing at least some similarities to human music. Mice also sing, though at frequencies too high for humans to hear. The highly evocative and complex sounds of humpback and blue whales are made during the mating season, suggestive of sexual selection. Humpbacks also appear to make feeding calls, suggesting a role for communication. Sexual selection and communication also lie at the heart of birdsong and gibbon song. Gibbons duet with one another, and also use song to warn of approaching predators. Birdsong has inspired numerous composers, old and new, from Beethoven and Wagner to Pink Floyd and Kate Bush (notably Olivier Messiaen). Indeed, it can trigger powerful emotional responses (beautifully captured in Keats’s ‘Ode to a Nightingale’). The palm cockatoo is a proficient drummer. A male will fashion a ‘drumstick’ from a twig it has broken off a tree and, as part of a courtship ritual, hold it in its foot and bang it against a hollow log.

Brian Kenney/Oxford Scientific

Can animals make music?

Music is an individual experience. But it also has a striking collective impact, helping to establish bonds that unite individuals around a common identity. National anthems, enough to reduce sports players to tears, can inspire loyalty to a national cause. Some countries have ‘national’ instruments (the bagpipes in Scotland, bouzouki in Greece). Several composers have been seen as personifying national values (Chopin and Poland, Wagner and Germany). Particular musical forms characterise certain ethnic groups (reggae among African Caribbeans, soul music in African Americans) and are often a key part of a population’s cultural heritage. Social identity theory suggests that we draw upon external influences when developing a sense of who we really are – particularly during adolescence, as we begin to establish identities independent of our families. Musical preferences are a way we can identify similar ‘ingroup’ members and distinguishing ourselves from ‘outgroups’. This may lead to the

Music is central to youth subcultures.

Emotive Images

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Music can be a powerful bonding agent.

magicinfoto/iStockphoto

Western music has tended to be polarised into ‘high’ and ‘low’ culture, with social elites favouring the classical tradition. But this formal music has always coexisted alongside informal music traditions – folk music. Towards the end of the 19th century, interest grew in European and American folk music, with composers such as Béla Bartók travelling widely in eastern Europe documenting songs and incorporating traditional music into their own compositions. In the UK and the USA, Cecil Sharp was influential in the revival of interest in folk music, and did much to ensure that traditional music and dance was recorded for posterity. It was probably Sharp’s interest that kept Morris dancing alive. Interestingly, because many traditional songs were passed on from person to person without being formally written down, they often varied from place to place. The ancient ballad ‘Barbara Allan’ (mentioned by Samuel Pepys in his diaries) exists in many different forms. Indeed, Cecil Sharp likened the process to evolution by natural selection – whereby different variants appear and those proving most popular in a particular population thrive and are passed on. In the 20th century, many efforts were made to capture and document traditional music. In recent decades, a surge of interest in ‘world music’ has seen many traditional forms of music reach Western ears. New and old forms of music have been combined in fusion music, including dance music incorporating traditional sounds and modern electronic beats. African musicians have absorbed Western instruments such as the electric guitar, creating unique and distinctive new forms of music. Nonetheless, creeping globalisation runs the risk of swamping local and traditional forms of music, just as other forms of Western culture threaten ancient ways of life.

Norbert Elsele-Heln/imagebroker.net

Music, like language, shows much regional variation.

Ozmen Ozturk

All around the world

JUNE 2009 9

Big Picture

Sound of the crowd Bring the noise Not everyone can hold a perfect tune. Some can’t but don’t really care, while some – tone- or tunedeaf people – can’t actually tell they are out of tune. True tone deafness (or amusia) affects about 5 per cent of the population. Generally, people with amusia cannot perceive music normally because of an underlying deficit in processing pitch and melody. It seems to be linked to characteristic brain abnormalities, including fewer ‘white matter’ connections between different areas of the brain. Some people with amusia still enjoy music. For others, though, music is just a cacophony – as one person put it, “like pots and pans

Hairs on a sound-detecting hair cell in the inner ear.

falling on a stone floor”. Amusia may develop after head injuries or strokes, but in most cases people are born with it. Perception of a bum note triggers two characteristic types of electrical activity in the brain. Interestingly, one of these signals is also seen in tone-deaf people, suggesting that their brains have spotted the discordant note even though it does not register consciously. Less often, people with amusia can hear tones but cannot hear any meaning in a sequence of notes – a melody. Others lack only the ability to distinguish timbre. Some specifically cannot perceive dissonant tones. Intriguingly, these people typically have lesions in the brain area involved in emotional judgements.

Alvaro Leiva/age fotostock

● Revolutionary icon Che Guevara may have suffered from congenital amusia.

A six-month-old baby from Taiwan had epilepsy triggered by loud music (musicogenic epilepsy). She was particularly sensitive to the Beatles.

●

Dr David Furness

Music may be near-universal but people’s musical experiences may differ greatly. Some people may struggle to perceive structures in music that are obvious to others. Some may experience music constantly playing in their head while a few even ‘see’ music. Understanding how unusual perceptions come about can reveal much about how the brain interprets music.

● After collapsing in 2000, a 52-year-old radio announcer recovered well but completely lost the ‘shiver down the spine’ he had previously always had to Rachmaninov – probably because of damage to his ‘emotional brain’ areas.

Now you’re gone Loss of hearing is an occupational hazard for musicians – and a problem for those who listen to them. Loudspeakers and amplified music have increased many people’s listening pleasure, but at considerable cost. High-volume music may be pleasurable at the time but it can store up problems for the future. The main problem is that sounds are detected by physical deformation of fragile hair cells, which can be damaged by loud sounds. The first to go are hair cells sensing high-frequency sounds in the first part of the cochlea. Short-term signs of damage include ringing in the ears (tinnitus) or temporary deafness. In the long term, these can become permanent. At particular risk are musicians regularly exposed to loud music. In the early days of rock, the dangers of loud music were not so well appreciated, and many musicians now suffer from impaired hearing (e.g. such as the Who’s Pete Townsend, who now works to raise awareness of the dangers). Why is loud music so appealing? There is some evidence that loud music can stimulate ear structures outside the hearing system – creating a ‘physical’ sensation as ‘p well as an aural one. Indeed, part a of the attraction of some forms of music, such as reggae or bass-heavy dance music, may lie in its physical impact.

I can’t get you out of my head Imagine having a song on o permanent play in your head. That is what people with musical hallucinations ha have to contend with. We may all know the feeling of having hav a song ‘on the brain’. brain’ But a musical hallucina hallucination is different: it is just like actually hearing the song. They are seen in a variety of groups, such

10 Big Picture 10: Music, Mind and Medicine

as people who become deaf in middle to later life, people with schizophrenia or some types of brain damage, and even as a side-effect of drug treatments. They are not always seen as a nuisance – in one study, around a quarter of people found them pleasurable. They may arise because the brain mistakenly characterises brain activity in musical processing areas as externally generated.

A study in Wales found that the condition tended to affect older people with hearing loss. They experienced all kinds of songs, from ‘Three Blind Mice’ to ‘Don’t Cry for Me Argentina’, though hymns were particularly common among the religious. It appears that songs from the past, with a deep emotional connection, are those that bubble up in the brain.

HURT

Red red whine

Musicians are at risk of a wide range of conditions. Read about the dangers of tinnitus, repetitive strain injury and ‘cello player’s scrotum’ at Big Picture Online.

People with synaesthesia may experience music in radically different ways. In most people, the auditory nerve ferries signals from the ear’s hearing apparatus to sound-processing areas of the brain. In people with certain forms of synaesthesia, however, these connections seem to take detours. As well as hearing music, they may also ‘see’ it or ‘taste’ it. Sound–vision synaesthesia is relatively common. Musical sounds generate distinctive visual experiences. Particular notes may be associated with specific colours. Nikolai Rimsky-Korsakov is said to have had synaesthetically coloured musical keys, while Franz Liszt would startle orchestras by asking: “Gentlemen, a little bluer, if you please!” According to jazz pioneer Duke

Ellington: “If Harry Carney is playing, D is dark blue burlap. If Johnny Hodges is playing, G becomes light blue satin.” Perhaps even more remarkably, a case recently came to light of a musician with synaesthesia for musical notation. As well as seeing notes as particular colours, she could also taste intervals between notes (e.g. a major second was bitter, a major sixth tasted like lowfat cream). Interestingly, consonant tone intervals produce pleasant sensations, dissonant ones unpleasant ones. Very strikingly, the ability to recognise musical intervals is something that has to be learned, and so the synaesthesia has ‘evolved’ along with her musical training.

ON THE WEB

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www. wellcome. ac.uk/ bigpicture/ music

US singer Gloria Lenhoff, who has Williams syndrome, cannot subtract five from twelve or write her name legibly, and has an IQ of 55, but has a repertoire of hundreds of songs in a dozen languages. She cannot read music but has memorised each and every song.

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musical hallucinations and would try to sing along with them, only complaining when they broke up into short musical phrases (like a scratched record).

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mentally disabled but with astonishing musical abilities. They can play pieces of music almost perfectly after hearing them only once. Musical savants are often blind and have perfect pitch. Composer Robert Schumann suffered musical ^WbbkY_dWj_edi
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knot of blood vessels removed from his brain. The operation was a success but left Martino with severe amnesia. He had no memory of his past life as a guitarist. Years later, he picked up the guitar again and gradually revived dormant musical skills. Car accidents and strokes can also instantly destroy someone’s musical appreciation – or a highly specific aspect of it. Bizarrely, some people actually gain musical obsessions and skills after brain damage. In his book Musicophilia the neurologist Oliver Sacks describes how a man struck by lightning developed a consuming desire to hear and play music. He taught himself to play the piano and now composes music. A speculative idea is that damage to the brain is releasing (or ‘disinhibiting’) a block on musical processing in the brain. Normally, the brain dampens down music networks as it has so many other tasks to attend to. If this inhibition is lost, music may flood the brain. An echo of this may be seen in people with unusual mental abilities. Children with Williams syndrome are highly sociable and have a natural affinity for music (though not necessarily high ability). People with the condition have lost a set of genes on

JUNE 2009 11

Big Picture

Toby Jacobs/Lebrecht Music & Arts/Corbis

Eric Gaillard/Reuters/Corbis

Neal Preston/Corbis

Great composers and songwriters constantly innovate. But what do we know about human creativity and its application in music? New forms of music are often in the vanguard of social change. Are they driving change or simply reflecting new ways of thinking and behaving? And how much are they influencing the way people act – perhaps in antisocial or undesirable ways?

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What is this thing we call creativity and how does it apply to music? Artists of all forms are credited with ‘creativity’. Although difficult to pin down precisely, it can be seen as a mental process generating a new idea or way of doing something, as opposed to copying what has already been done before. In that sense, creativity is not solely the domain of the artist but covers all innovative thinkers – including scientists. All composers and songwriters are to some degree creative, producing novel works. But some are generally considered more innovative

You drive me crazy Musical geniuses: are they all mad? An ability to see the world differently is a feature of both the highly creative and the mentally ill. Is creative genius one step from madness? Anecdotally, there is a fine history of odd behaviour among musical geniuses. Mozart was renowned for his eccentricity (some suggest he had Tourette syndrome).

than others. Classical composers such as Mozart, Beethoven and Johann Sebastian Bach developed new forms of composition that profoundly influenced those that followed. Louis Armstrong pioneered innovations in jazz. Chuck Berry, some argue, invented rock and roll, while Kool Herc and others in New York created rap music. Do these disparate individuals have anything in common? Some models of creativity emphasise individual personality traits – creative people may be more ‘complex’, in that they can hold apparently paradoxical views in their heads, or they may be better risk-takers, or less worried about upsetting the status quo. Neuroscientific perspectives emphasise the importance of ‘divergent thinking’ – opening up new possibilities rather than closing them

A commonly hypothesised cause is bipolar disorder (manic depression), where individuals experience alternating periods of depression and intense highs. The young Rossini was astonishingly productive, writing 39 operas by the age of 37 (but none thereafter), possibly driven by mania. German composer Robert Schumann attempted suicide and spent his last two years confined to a mental institution (at his own request). Oddly, bipolar disorder and schizophrenia have a genetic component. Why are risk genes not eliminated? One possible explanation is that ‘mild’ forms, associated with enhanced creativity, actually improve reproductive success. A recent study of UK poets and visual artists provided some support for this idea. Creative people are more likely to act outside conventional norms of behaviour. On some measures of ‘abnormality’, they rate as highly as people with schizophrenia. Ideally, they can channel this instinctive non-conformity towards positive ends. Unfortunately, with no suitable outlet, or when swamped with negative emotions, these ways of thinking can become highly damaging.

down. The prefrontal cortex, the high-level ‘thinking’ area of the brain, may be particularly important. In a 2008 study comparing trained musicians and matched controls, the musicians showed greater divergent thinking and stronger activation in this region of the brain. Other work suggests that the ‘emotional brain’ and dopamine-based reward pathways are also important. On the other hand, creativity does not operate in a social vacuum. The musical expression of creativity is rooted in the circumstances of people’s lives – be it Mozart’s hothousing in Vienna court life or rap pioneers’ urban New York. Igor Stravinsky, arguably the most influential classical composer of the 20th century, was part of a broader ‘modernist’ movement.

Corbis

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Ravel may have had an unusual form of dementia affecting the frontal lobe of his brain, which could have influenced his compositions. People with this disorder have a tendency to repeat acts over and over, which could account for the repetitive style of his most famous work, ‘Boléro’). Curiously, Anne Adams, a scientist who also had a form of dementia affecting one part of her brain, was overtaken by an urge to produce visual art, including representations of music in paint, and became obsessed with Ravel.

Kurt Cobain of Nirvana. A study found musicians less likely to commit suicide than painters, writers or sculptors.

12 Big Picture 10: Music, Mind and Medicine

According to a recent study, the average US adolescent hears around 84 references to substance use (mostly positive) every day in music (depending on what type of music they listen to). In 279 of 2005’s popular US songs, more than a third contained references to sexual activity (often degrading sex references). In this and another US study, published in February 2009, adolescents’ sexual behaviour appeared to be strongly influenced by their exposure to sexual lyrics.

Nikada/iStockphoto

Martyn Goodacre

Let’s talk about sex

Frédéric Soltan/Sygma/Corbis

Rhythm is a dancer Music is commonly accompanied by dance – indeed, the two may have evolved together.

Kick over the statues

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Music has been used both to suppress and to promote dissension.

In China in the 1940s, Communist authorities launched a huge campaign using revolutionary songs based on traditional folk music to educate the illiterate masses on Party goals.

●

Lesson of Kathak, a classical Indian dance.

hymns of Christianity, the Gospel music of Southern Baptism to the Islamic adhan (call to prayer). Music has a special place in Tibetan Buddhism. Monks use music to recite sacred texts and at various festivals. Dance has fared less well, suffering from its association with pagan rituals and entertainment. Even so, it remains at the heart of many religions, including strands of Christianity and Islam. In Hinduism, the entire universe is thought to have been conjured up through the dance of the Supreme Dancer,

Nataraja. A version of ritualistic dance survives today in the form of South Indian Classical Dance.

Dictators have been quick to apply music to social control. Rousing anthems may be used to cohere populations. And anything seen as vaguely subversive has rapidly been banned. Nazi Germany had firm guidelines on the type of music that could be performed. Wagner, Beethoven and Bruckner were in; Mendelssohn, Mahler and Schoenberg (all Jewish) were out. Conversely, it has also been a rallying call for dissenters. Folk music has often been a medium for commentary on social `kij_Y[$
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Like the written word, song can communicate powerful ideas, but can also unite groups and appeal to deep emotional forces in a way that books cannot. Evolution has crafted our brains to be especially predisposed to music – and performers tap into this primeval instinct to inspire, influence and inflame.

THE MESSAGE

● In The Jungle Book’s ‘I Wanna Be Like You’, the orang-utan ‘king of the swingers’ King Louie wanted to know the secret of fire: “Give me the power of man’s red flower”. Ironically, the syncopated ape and his cronies may already have had a key human attribute – the ability to sing and dance together.

Everett Collection/Rex Features

Music and dance often go hand in hand and it seems likely that their origins are closely entwined. The brain’s locomotion systems and auditory systems clearly interact. When we hear a sudden noise, we may blink or jump without intending to (the acoustic startle response), which involves pathways running directly from the ear to the spinal systems controlling movement. Of relevance to music, babies listening to six-beat rhythms can perceive it as a march (three pairs of beats) or a waltz (two sets of three) depending on how they are bounced on someone’s knee. Dance is often associated with rituals and plays an important social role. An attractive theory is that dance, like music, evolved to strengthen social groups. Music and dance would have provided a mechanism to reinforce group identity – and to impress potential enemies. Later, music and dance were appropriated by ruling elites to reinforce social structures and promote conformism. Religious movements in particular have used music and dance as a form of group identity – from the

Left: A Soviet-era song festival poster, used in the 2006 documentary The Singing Revolution. Above: Aretha Franklin and Martin Luther King.

Are bands corrupting the young by coding messages into their songs? Big Picture Online looks at the odd history of ‘backmasking’ – messages supposedly audible when songs are played backwards.

www.wellcome.ac.uk/bigpicture/music

ON THE WEB JUNE 2009 13

Big Picture

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their personal interests and perceptions of music’s wider role – and to share with us their ‘desert island disc’.

Adrian North

Troi ‘DJ Chinaman’ Lee

What do you do? I’m a music psychologist and Director of Psychology at Heriot–Watt University, Edinburgh.

How did you first get into music? I started playing the guitar at age ten and still play now, although I am absolutely terrible! A career as a musician was never a possibility.

What part does music play in your life? While lots of music psychologists study the process of making music, I examine the listeners’ point of view. One thing I’m exploring at the moment is the possible negative effects of rap and heavy rock music on young people. I also research the use of music in commercial environments such as restaurants and shops, which is a multimillion-dollar worldwide industry. My research means that I have become sensitised to the music that we hear around us, and I’ve realised how prevalent music is in our everyday lives. Also, I’m sure I’ll be monitoring what my son listens to when he’s older!

Who has been the greatest musical influence on you? It has to be the Beatles: clearly the best band in the world! They have wonderful melodies combined with wonderful musicianship and wonderful lyrics. There’s also the cultural aspects: they were at the forefront of the change that showed pop music could be art.

Why do we have music?

What do you do? I’m a DJ and events organiser who was born deaf. I founded www.deafrave.com.

How did you first get into music? When I was about ten I got my first Walkman. I’d put the headphones not over my ears, but over my hearing aids. People would look at me strangely, but that’s how I listen to music. I went to my first (hearing) rave when I was 17, and that really got me into the rave scene. I found that deaf people didn’t really understand raves though – it wasn’t in their culture. When I was 20 I was involved with a pirate radio crew and got my first decks. A deaf girl was having a house party and asked me to DJ there. My cousin, a professional DJ, lived round the corner, so I got a wheelbarrow and loaded his speakers in. It was a great party and a turning point for my career. Afterwards, at deaf nights in the pub, people kept asking me when the next party was. I decided to host one for 700 and Deaf Rave was born!

What part does music play in your life? For the last six years I’ve been putting on parties and raves for deaf people. These events are really important as they give deaf people a chance to get out and socialise. Nearly everyone at the parties knows each other. All people are welcome but I’d say around 95 per cent of people that come are deaf. There are different levels of deafness – some people have hearing aids or cochlear implants, but the majority don’t. Some parts of the parties could seem strange to hearing people, for example performers signing along to songs instead of singing them.

It’s clear that people use music as a badge of identity, but they also use it as a medicine – dosing themselves throughout the day to get what they want from a situation. Just think of the kind of music used in gyms. iPods and other technology are changing the way we use music. When I was doing my A levels I’d walk around college with a bag full of cassettes, which still only covered a tiny proportion of my music collection. Now, people can take their entire collections with them. For many young people today, listening to music is a much more throwaway experience. There will be times when you really get into the music, but sometimes it’s just sonic wallpaper, on in the background.

Who or what has been the greatest musical influence on you?

What’s your desert island disc?

What’s your desert island disc?

It has to be the Beatles: Magical Mystery Tour, the most tuneful of the lot.

‘Fattie Boom Boom’ by Ranking Dread, a Jamaican singer who’s dead now. I play it everywhere I go.

14 Big Picture 10: Music, Mind and Medicine

The people I grew up with made a massive impact. Musician-wise, it has to be Public Enemy and Bob Marley.

What’s the point of music? Music brings people together, and without music there’s no energy. When I’m listening to music at home it makes me move, makes me feel emotion. I can’t imagine life without basslines and beats.

Oliver Burston

Jovana Cetkovic/iStockphoto

Jennifer Rohn

Melodic marvels

What do you do? I’m a scientist studying the genetics of cell shape and movement at University College London.

How did you first get into music? I started piano lessons when I was five years old and guitar lessons when I was eight. I also played trombone in a band and sang in choirs. I had always wanted to be a musician but I was interested in science too, so it was a struggle deciding what to do at university. In the end I wasn’t talented enough to be a professional musician, and I loved science more. At university I fell out of music but started to get back into it when I began working as a scientist. I’ve recently joined a band called Franka-delic as the singer. We’re a bunch of ageing scientists, ex-scientists and publishers – all in our 40s.

What part does music play in your life? I use it a lot in work. Science is quite laborious and there’s a lot of manual labour in my job – the mindless moving of small amounts of liquid from one tube to another. At those times I really appreciate music. Music is very important to labs and it’s hard to find one where there isn’t a CD player or radio on.

Who has been the greatest musical influence on you? I like all kinds of music. Playing the piano, I was raised with classical music, but my Dad is very eclectic. He has a huge record collection and loves everything: country and western, jazz, classical. I like most things too, including pop music. The only stuff I don’t enjoy is some types of jazz and modern music. Music has to make me want to move around.

ONLINE ACTIVIT

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A series of student activities exploring auditory effects has been developed to go with this issue of Big Picture. A variety of downloads relating to music, mind and medicine can be found in an audio library at www.wellcome. ac.uk/bigpicture/music. Teacher and student notes will guide you through exercises relating to these mp3 files. J^[
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Why do we have music? I think it’s a way to bring us together. Other animals vocalise, birds sing. It’s all about finding a mate or warning somebody off, communicating really basic emotions. I think we use music to communicate too.

What’s your desert island disc? I’m a romantic; it would have to be Woodface by Crowded House. It’s not fashionable but it makes me smile!

How exactly do deaf people experience music? Hear more about Troi Lee's life and work at Big Picture Online.

Education editor: Stephanie Forman Editor: Ian Jones, Isinglass Consultancy Ltd Writers: Ian Jones, Harriet Cole Illustrator: Glen McBeth Fhe`[Yj
cWdW][h0 Jennifer Trent Staves Advisory board: Nan Davies, Tim Griffiths, Peregrine Horden, Nigel Osborne, Michael Reiss, Laurent Stewart, Michael Thaut All images, unless otherwise indicated, are from Wellcome Images. The Wellcome Trust is a charity whose mission is to foster and promote research with the aim of improving human and animal health (a charity registered in England, no. 210183). Reflecting the profound impact today’s research will have on society, the Wellcome Trust also seeks to raise awareness of the medical, ethical and social implications of research and promote dialogue between scientists, the public and policy makers. ISSN 1745-7777 © The trustee of the Wellcome Trust 2009.

ON THE WEB

www.wellcome.ac.uk/bigpicture/music

This is an open access publication and, with the exception of images and illustrations, the content may unless otherwise stated be reproduced free of charge in any format or medium, subject to the following conditions: content must be reproduced accurately; content must not be used in a misleading context; the Wellcome Trust must be attributed as the original author and the title of the document specified in the attribution. MP-4388/7.6K/05–2009/RL

JUNE 2009 15

Big Picture

MUSIC, MIND AND MEDICINE

● Music is part of all human cultures. ● It is thought to have appeared very early in human evolution.

ons ● Music has strong connections he brain. to the emotional areas of the ● Composers use music to s. manipulate listeners’ moods.

● Music may have appeared before language but the relationship between the two is uncertain.

rt ● Music was an important part ries. of medicine for many centuries.

● Early music may have involved the human voice and rhythmic percussion using natural materials.

i medicine, di i ● Although music is now rare in it has been shown to be effective in some areas.

● Many animals make sounds with similarities to human music.

● Elite musical performance is primarily the result of intensive practice.

● The original purpose of music is not known for sure.

● Learning musical skills has spin-off benefits in some other areas.

● Its evolution may have been driven Xo
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of group bonding.

● Rituals involving music are an important part of many cultures and religions.

● Enhanced musical appreciation and, occasionally, musical skills are seen in some conditions.

● Music has been used as both a means e\
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● Musical creativity may be associated with particular unconventional ways of thinking.

● Alternatively, music may have no adaptive value but be a by-product of other human capacities.

M si is particularly ti larl effective effe ti att ● Music establishing group social identities. ● Musical preferences provide particularly strong insights into individual identities. ● Abnormalities in musical perception are seen in a number of conditions.

● Music is processed in the brain by a number of interconnected areas.

Published four times a year, Wellcome News provides you with up-to-date news and features highlighting the Wellcome Trust’s wide-reaching science and public engagement activities, grant schemes, policies and more.

● Damage to these areas can selectively remove specific aspects of musical appreciation.

Sign up for a free subscription at www.wellcome.ac.uk/wellcomenews

● Music has a number of distinct characteristics, such as pitch, timbre and rhythm.

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