Anjali Kumar

Music on the Mind: A Chain Reaction

Take a moment; think about how you got to where you are right now.

This could go back a few hours to your morning routine, what you ate today, the song you heard on the radio, the decisions you made to get you to the seat, the bench, or the toilet that you’re perched on. It could go back years to the people you’ve encountered, the jobs you’ve accepted or declined, and the billions of choices that have influenced your current state. Or it could go back milliseconds, to the chemical reactions that are metabolizing, catalyzing in your brain and controlling the micro adjustments your eyes made to read each sentence on this page. Regardless of how far back you go to unearth the source of your actions, you will dig up a series of unfolding events that fell upon one another to bring you here. It seems that our lives follow a sequence of reactionary experiences that fall, push and crash into different directions. For Dan Cohen, this chain reaction led to Music and Memory.

Dan Cohen, a native New Yorker with an audibly “long island” accent and calm demeanor has traveled a variety of pathways throughout his life as a technician, a consultant, a trainer for the US department of Education, and a social worker. Approximately 10 years ago, while Dan was practicing as a Social worker he overheard a journalist claim that iPods have become commonplace in the American household. Within the past 10 years 300 million iPods had been sold. “This made me wonder who benefitted from this growing industry” said Dan, as iPod use seemed reserved for the technologically savvy. Someone above the age of 70 had already lived around 65 years of life when the iPod came out. Its appearance into the mainstream may have seemed foreign, complicated, and difficult to manage for our elders. For those of us who have indulged in the use of an iPod, we know it is portable, easy to handle and individualized. In 2006, Dan began volunteering in nursing homes with the hope of spreading the benefits of portable music devices to those who were not apart of the 300 million. “People in Nursing homes haven’t been exposed to iPods, they don’t know what they are or how to use them, therefore we need volunteers and nurses to assist them” proclaimed Dan. Many people who are in nursing homes now are either unexposed to technology due to generational gaps, or have some extenuating circumstance such as dementia or Alzheimer’s which makes it difficult for them to keep track of and function such a device. With Dan’s help, some nursing home residents were able to explore the beauty of individualized music. There was no compromising on what to play next when they controlled the playlist on an iPod, which can be a beautiful alternative to the forced group activities that often occur in nursing homes (which also have their own benefit)! Using the positive feedback of these experiences, Dan started the non-profit organization Music and Memory, which hopes to bring personalized music to the elderly.

In 2014, around the time Music and Memory was gaining traction, a Smith College undergraduate student named Kyra Schor was browsing through potential internships on the internet that were related to some of her greatest interests, music and psychology. Kyra has always had an affinity towards music. “I wasn’t the coolest kid in middle school and high school” stated Kyra in a recent interview. Growing up in a Long Island where Ugg boots and yoga pants were fashionable, Kyra found solace in the Uggless world of drums and alternative music. Music was her scapegoat and through overlapping interests she found herself coincidentally interning for Dan’s newly developing music and memory non-profit. Music and Memory was the perfect combination of Kyra’s psychology major, and passion for music. Through her experiences at Music and Memory, she not only saw the power music has for her but also for those in nursing homes. Kyra can still recall the day she saw a resident of a local nursing home “awaken”. His family had brought a stack of old CD’s he used to admire, and Kyra put one on the CD player. Until this point, Kyra’s only experiences with this man were quiet and unrequited. After hearing his old time favorite tunes the resident began singing! “I remember crying after he sang because I had never seen so much emotion come out of this man” explained Kyra. Other family members and volunteers who have worked with elder populations have recognized this eruption of emotion and communication that music can elicit. This experience, along with a collection of many others, inspired Kyra to continue her work with Music and Memory post graduation. She chartered a Music and Memory organization at Smith College and has since been working with the company to publicize its work and aid in the chartering of Music and Memory organizations around the country.

Dan and Kyra’s narratives have flowed through a variety of different streams but converged in the delta that is now Music and Memory for one reason…the power of music. This evocative vehicle is the stimulant to many narratives that exist not only in our lives but also in our brains. For example, music’s ability to regulate mood and unlock memory is uncanny. This is one reason why music is a great resource for nursing homes. For example, Catie is a resident of a nursing home in Western Massachusetts (out of respect for this resident her name has been changed) with whom the current Music and Memory club of Smith College has been working with. A conversation with Catie consists of a jumble of indiscernible words. Her ability to maintain eye contact, and direct her speech at you is intact but the order of her words and what she is saying makes little sense. It seems she exists with you but separated by cognitive dissonance. When Catie is given a pair of headphones and an iPod, her demeanor changes. Her once argumentative tone deflates into a soft and smooth inflection of admiration. Sometimes music relaxes Catie into the solace of her wheelchair. Other times, it inspires her to tap her toes and even sing. Catie once sung all the words to Doris Day’s 1950’s classic “Que Sera Sera (Whatever Will Be, Will Be)” on pitch just seconds after making no sense in her conversation.

It’s very likely that Catie has Dementia or a more specific type of dementia known as Alzheimer’s. Alzheimer’s and dementia are characterized by neural (brain) degeneration, also known as cell death. This disease has it’s own reactionary chain of events that start with the decay of short-term memory, followed by autobiographical memory (memories from our past), semantic (memory related to common knowledge like the names of colors), and lastly procedural memory (the ability to complete tasks like moving a fork). It’s likely that along with the loss of memory come feelings of disorientation, fear, doubt, and frustration.

One way to alleviate these symptoms of agitation and memory loss is through music.

Daniel Levitin, author of “This is Your Brain on Music’, and other researchers have noted music’s ability to regulate mood, and decrease stress. According to a literature review conducted by Mona Lisa Chanda and Daniel Levitin of the University of McGill in Montreal Canada, different genres of music can change our heart rate and other nervous system responses. It is thought that music’s ability to influence heart rate, pulse, blood pressure, body temperature, skin conductance, and muscle tension stems from music’s ability to stimulate a part of our brain called the brainstem, which regulates these functions in our bodies. Relaxing music can inspire the brain stem to tell our bodies to calm down. Another study conducted by Bringman and his colleagues concluded that patients about to undergo surgery were more relaxed with music than they were with an anti anxiety medication. This may be because music mimics environmental cues that warn us of potential stressors. For example, soothing music may mimic the cooing and purring sounds that occur in nature during moments of ease. Music that is classified as stimulating may imitate alarm signals animals use for potentially dangerous or important events. You may have your own “relaxing” playlist sitting in your iPhone, or you may have experienced the unleashing of euphoric ease after hearing a song you find soothing. Next time you listen to it, think about the properties of the songs that make you calm. Is it the slow tempo, the chords used, the use of vocals, or lack thereof?

In terms of memory, it is unknown exactly why music gets so readily linked to events from our past, but there is undoubtedly a bond there.

You may have experienced this connection in your own life when you heard a song from your favorite childhood movie, or a song you screamed at after your first break up, or songs your grandmother used to sing to you to fall asleep. Neurologists are trying to uncover why music can un-lock recall of these memories. Researcher Petr Janata and his team from the University of California Davis believe that a part of the brain, known as the medial prefrontal cortex, (MPFC) may be where this connection forms. Using brain scans through functional magnetic resonance imaging, Janata and his team documented a group’s reaction to a selection of music. They found that the songs related to autobiographical memories inspired more activation in the MPFC of the individual’s brains. Another reason why music and memory are linked could be because of the connection between music and emotion. The more markers our brains can latch onto, the better a memory is preserved. If songs are emotionally important to us, they may be more likely to connect to an emotionally potent memory like a break up.

Lastly, the nature of how dementia impacts the brain explains why the relationship between music and memory stays intact. “Alzheimer’s impacts short term memory first” stated Dr. Reisa Sperling, a neurologist from the Harvard school of medicine has been conducting research in Alzheimer’s and dementia for many years. Therefore, long term memories stored in the preserved frontal lobe that was previously talked about are still capable of being recalled. It’s just a matter of reaching them. This in part explains why many have noted the unexpected musical memory that is intact for those with Alzheimer’s and Dementia. Other studies have shown Alzheimer’s and dementia patients who have lost many cognitive functions such as verbal communication are still able to accurately perceive emotional cues stimulated by music. For example, someone with Dementia can hear a sad song and feel its melancholic value despite not being able to have cohesive conversation about it.

Most recently Dr. Sperling and her team have been developing a drug intended to prevent the onset of Alzheimer’s and dementia. Dr. Sperling acknowledges the evocative power music that has on us and supports its use in clinical settings, but notes that the its biggest impact comes through it’s preventative effects. Music is phenomenally stimulating for our brains. Not only does it regulate mood and recall memory, but it also activates many other brain regions needed to digest the rhythm, melodies, harmonies, lyrics, and keys that exist in music. This stimulation can be invigorating for the decaying brain that is thirsty for some refreshment to slow its decline.

Although Dan’s organization is coined Music and memory, Dan understands that music has evocative powers that extend beyond memory recall and mood regulation. In fact, researchers have been exploring music’s impact on the brain for many years.

Through his own personal experiences Oliver Sacks a renowned neurologist, beloved writer, and avid learner has experienced music’s importance in healthcare. Between 1915-1926, after World War 1 hundreds of thousands of people suffered from what was called the “sleeping disease”, also known as encephalitis lethargica. To this day it is uncertain why this epidemic spread however theorists blame a circulating influenza as the root of its cause. For some, the disease consisted of a headache, double vision, fever, fatigue, abnormal eye movements, but for others the disease advanced into post encephalitic parkinsonism. The symptoms of this disease involved rigid bodily movements, explosive uncontrollable gestures, or coma like states (which explains where the “sleep” moniker comes from). Sacks’ first experience with music’s use in a clinical setting was with patients suffering from encephalitis lethargica. As a young neurologist Sacks worked in a hospital called Beth Abraham Hospital in Brooklyn New York where many “sleeping diseased” patients resided. Here Sack’s met a music therapist, a rare profession for this time period, named Kitty Stiles. Witnessing Kitty’s emotive, empathetic and expressive nature with music was inspirational for Sacks as he saw patients at Beth Abraham transform under her melodies. Those who were once confound to trance-like isolated states were suddenly able to move and communicate while or directly after hearing the live music. Others whose movements were unpredictable and disorganized were momentarily contained by the music’s rhythmic value.

Before and since the days of Oliver Sacks many have acknowledged music’s deep connection to movement. Matthew Schulkind, professor of Psychology from Amherst College believes this is why music is a unique tool for therapy “if you hear a song that you like, it is harder to stop yourself from moving, then it is to get yourself to move, right? Music elicits a motor response that a lot of other stimuli don’t”. With advancements in technology, neurologists are beginning to explain why this connection can be fostered to aid those with parkinsonism and other motor control disorders. Parkinson’s disease occurs from a deficit of a chemical in our brains called dopamine. Our brain relies on connections between different regions and circuits, and like a chain reaction if one isn’t working then other start to fail as well. This lack of dopamine occurs specifically in a brain region called the substantia nigra, and the substantia nigra feeds another brain region known as the Basal Ganglia with this dopamine. Interestingly, the basal ganglion is thought to control our bodies’ ability to time movements and synchronized rhythm. This brain structure is what researcher Jessica Grahn and James Rowe from Western University of London Ontario believe controls “how we feel the beat” in music. Perhaps listening to a rhythm takes ownership off of the basal ganglia to create timed sequences. A song with a steady beat may provide the framework that is otherwise lacking in the decaying basal ganglia for someone to initiate fluid movement and control mobility in their body.

Aside from mood, memory, and movement, music has also been shown to impact communication! Our brains are like maps of land regions that are constantly adapting to environmental changes. Specific regions, or clumps of neurons that we call “neural structures” carry out different tasks to make us the humans we are. For example in one “neighborhood” of our brain exists Broca’s area, found in the left frontal lobe. Broca’s area is populated by collections of neurons that work together to control speech and communication. If someone dropped a bomb on this neighborhood, like an arterial stroke, the community of neurons would no longer function. For some, the byproduct of this stroke renders its victims aphasic, meaning they can no longer produce speech. However, there are adjacent neighborhoods with communities of neurons who have not been affected by this attack….

Somehow, some people with aphasia are able to sing words they cannot speak. “Aphasia generally arises from damage to the left hemisphere of the brain, but the areas of the brain that support singing are generally unaffected in most cases of aphasia because many of these regions are in the right hemisphere” stated Meagen Curtis, assistant Professor of Psychology from Purchase College. Researchers have cultivated a therapy known as melodic intonation therapy, which calls upon the bordering neighborhoods such as the right hemisphere to rebuild a speech center within the brain. “People undergoing this therapy sing what they are trying to say, and gradually they are taught to transform the song into speech by changing the rate at which they’re producing the words.” Brain images have shown that melodic intonation therapy literally increases fibers within the brains of stroke victims that link the left hemisphere to the right hemisphere. In other words, this therapy leads to long lasting structural changes within the brain.

Meagan followed her own chain reaction that brought her to the intersection between music and psychology. She has been studying music cognition for many years now but her interest in music started with composition. After taking a course at Hampshire College regarding music cognition taught by Professor Neil Stilling’s, she found herself consumed with curiosity regarding how the brain perceives music. “I’d been a musician for most of my life and had been pondering over many of the questions that are at the heart of the field. When I realized that people could build careers around those questions very questions, I was hooked.” Since then, Meagan and her colleagues have developed a perceptual training program used to improve pitch perception in those who have mild brain function deficits.

“We’ve generally found that people who have pitch perception deficits also have mild impairments in the detection of vocally-expressed emotion. This occurs because emotion perception relies on pitch perception, and if the pitch perception is not accurate, it becomes more difficult to decode one’s emotional state from the voice alone. We’ve found that the pitch training therapy can help people improve recognition of emotion by improving pitch perception.” Meagan’s work, as well as melodic intonation therapy, is built on the overlap that exists between music and speech. Every time we talk, the intonation in our words changes like the rise and fall of waves to express emotion. Meagan’s work is capturing this phenomenon to train people to understand and express this change is intonation as a means of expressing emotion.

Although music has unleashed unending timelines of healing properties throughout history, it isn’t the panacea to all neurodegenerative diseases. Much of the research regarding music’s healing properties in clinical settings is dependent on anecdotal evidence or personal experiences. This invites a lot of bias when trying to control variables and generalize research results to the public. Additionally, a lot of the healing that music provides comes from self-selected music. Music we enjoy is determined by our personalities and moods, which change on a daily basis, and varies amongst groups of people. Although Dan Cohen and Kyra Shor work for the same organization, their tastes and reactions to different music and musical genres are not the same. This makes it difficult to control the variables used in clinical studies that are tackling the question of how effective music listening and music therapy can be for people.

Professor Schulkind acknowledges that there are many studies showing that dementia patients have better memory recall when listening to music they know:

“The problem with some of these studies is that they are idiosyncratic. So the melodies that work for one subject don’t work for another subject. And often times when you read the literature it’s not a randomly selected group of subjects, it’s subjects for whom music was an important part of their lives when they were younger. So it could be that it’s a really salient phenomenon that works really well for a subset of people for whom music was an important part of their life.”

Jonathan Bruce Barber conducted a literature review on how music is being used for Dementia and Parkinsonism in 2012. Through his research he found that it is difficult to determine how effectively music can alter symptoms of neurodegenerative disease. A lot of the evidence is based on experiences, and many of the controlled studies and trials have ambiguous results with no certainty of sustainable rehabilitative impacts. Part of the reason this uncertainty exists is because of the variability in symptoms that arises from neurodegenerative disease such as Alzheimer’s and Parkinson’s. Moving forward it seems that somewhere the narratives of people’s personal experience and developments in neuroscience will converge to explain how and why music has such a profound impact on our lives…

Where experiences seem to fall upon one another in a succession of never-ending possibilities comes the unifying force known as music, the catalyst to these reactions. Music’s evocative nature is what reminds us of our past, our history and our existence. Music is what governs our movement, and sense of autonomy. Music is what we can grasp when other communication is lost. And most importantly, music is accessible to all of us. It has inspired the birth of the Music and Memory program and has connected the lives of hundreds of researchers and clinicians alike.

Since it’s start, Music and Memory has reached hundreds of nursing homes around the country that are getting Music and Memory certified. “Every month around 200-250 nursing homes becomes certified,” exclaimed Kyra. This certification ensures that Nursing homes are supplied with connections that allow residents to have access to personalized music. It also means more volunteers are needed to organize and bring that music to the homes and establish a routine with staff members so residents can have easy access to iPods loaded with their personal favorites. In this way, Music and Memory links residents with local community members involved in Music and Memory programs like the one Kyra started at Smith, which not only helps bring music to residents but also starts a reactionary chain of building friendships and bonds between nursing home residents, staff, and members of local communities. Dan and Kyra are continuing their efforts in making this happen while simultaneously becoming linked to the ever growing field that researchers like Daniel Levitin, Oliver Sacks, Meagan Curtis, Mathew Schulkind, and many others have and are contributing to.