Category Archives: physical health

How to practice effectively [video]

This is a short video from TED Talk on how to practice more effectively. It includes some useful tips & really interesting information based on what we know about the brain & how we learn tasks.

This ties-in with my previous blogs on rehearsal & my own (admittedly rather limited) research on music and the human brain [see previous posts]. Let me know what you think!

If the above video doesn’t work, here’s a link so you can access the short TED Talk video on YouTube.

Enjoy! xx

New community music centre now open in Cumbria

Some of you may know I am involved with a few community music therapy projects in the north-west of England. Now think it’s time you met ‘me gaffer’, and had a wee peek at the new £2million centre which has recently opened its doors in Penrith, Cumbria.

Annie, Michael & the whole team at Sunbeams Music Trust have been working tirelessly for several years, and not just in fundraising for their brand new centre. Sunbeams Music Trust now provides community music across the region. Their ‘Music for Life’ & ‘Music for Dignity’ projects reach children and adults in schools, day centres, care homes & much more, bringing music (and improved wellbeing) to so many people who need & enjoy it. But there is always more work to be done and more communities & people to reach out to. This new centre will go some way to meeting that obvious need.

Featuring a large performance room, state-of-the-art digital recording studio and small music & therapy rooms, the new centre comes well equipped to meet the needs of the charity. A well-equipped kitchen & boardroom means they can also raise much needed revenue through conferencing & hosting events. The recording studio is also directly linked up to the performance hall, meaning the centre can also serve as a commercial studio capable of recording anything up & including a small orchestra!

Guitars laid out in ‘Lily’s Room’, at the Sunbeams Centre, Cumbria.

My only contribution to the new centre so far has been laying out the guitars on the floor (as above, however the remnants of which can also be briefly glimpsed in the video, via the link below). However, I hope to start leading a few of the projects there from 2017 and truth be told, I can’t wait! The new centre is, in a word, AWESOME!

Sunbeams runs entirely on donations & charity funding. If you haven’t yet chosen a charity to donate to for Christmas, or raise money for throughout 2017, please give Sunbeams some serious consideration.

Fundraiding information can be found on Sunbeam’s donation page.

Thanks, guys! xx

…And here’s the recent feature on the new Sunbeams Centre, courtesy of ITV News.

Music & Wellbeing (Part 7): Final thoughts & additional reading

I hope you have enjoyed reading these extracts from my dissertation on the value of music on our overall wellbeing. I wanted to finish off this mini-series with a few final thoughts.

First of all, it goes without saying that a lot more research needs to be conducted in all of the areas I have covered. From music’s impact on the brain to it’s beneficial applications within the education system, we have only begun to scratch the surface of what could be possible. Music’s transformative power needs much more investigation and research than, unfortunately, we seem able to support financially in the country at the present. Having said that, there are a few great organisations out there, most of them charities, which are performing Stirling work even in these most difficult of economic times.

Nordoff-Robbins are the UK’s largest and oldest Music Therapy charity. Most of the MT courses on offer at UK universities are provided in conjunction with them, usually following their methods of practice. Another fantastic charity is Sunbeams. Working in the North-West area (Lake District, Cumbria) with a range of people, including children and adults with severe or multiple physical and mental difficulties, Annie Mawson’s organisation has won great praise and acclaim for it’s community music practice. I wholeheartedly suggest you check these guys out and donate if you can.

All the papers, texts and books I referenced in my mini-series were worth a greater look and I would encourage you to look through my references list at the end of each article, and read as many of the titles as possible. However, of all of these, may I humbly suggest Daniel Levitin’s astounding book on music and neuroscience ‘This Is Your Brain On Music’ and Oliver Sack’s ground-breaking tome ‘Musicophilia’.

As for the practise itself, get out there! Get volunteering! Use your hard-learned musical skills in the community to enrich the lives of those around you, especially those less fortunate, children, the elderly, disabled, ill and the isolated. Music is very much the world’s universal language – let’s use it to the best possible effect.

Music & Wellbeing (Part 5): Music & Pain Relief

Music & pain relief

So far, we have examined the positive effects of music on our wellbeing, both physically and mentally. However, if music can indeed make us ‘feel better’, is there any scope for its application towards pain relief? As well as being beneficial, can music be medicinal? There is historical evidence of music playing a role in treating disorders as early as ancient Egyptian times, circa 4,000 B.C. (Thompson, 2015). An additional benefit to the use of music is its lack of invasiveness, compared to other forms of treatment:

Music is perhaps unrivalled by any other form of human expression in the range of its defining characteristics, from its melody and rhythm to its emotional and social nature. The treatments that take advantage of these attributes are rewarding, motivating, accessible and inexpensive, and basically free of side effects, too. The attractive quality of music also encourages patients to continue therapy over many weeks and months, improving the chance of lasting gains (Thompson, 2015)

Rather than being a physical experience alone, pain is a ‘biopsychosocial experience’ (Gregory, 2014, p. 27) which exists in the mind as much as the body: ‘It is affected by psychological and social factors, such as the site and nature of the injury, personality, age, gender, anxiety, understanding and cultural factors’ (Godfrey, 2005, quoted in Gregory, 2014, p. 24).  In previous studies on chronic pain, it has been noted that patients who concentrated on other tasks or activities experienced less pain (Löfgren & Norrbrink, 2012, p. 2146). Since many sections of the brain are activated when listening to music (Levitin, 2006, pp. 270-271), it stands to reason that the use of music could be highly effective as a distraction from pain, reducing or cancelling-out pain signals.

A clinical study by Mitchell et al (2007) supported the idea of music as a means of distraction from chronic pain, if not a complete remedy to pain altogether:

Music listening, and in particular listening to our own preferred music, may provide an emotionally engaging distraction capable of reducing both the sensation of pain itself and the accompanying negative affective experience (Mitchell et al, 2007, p. 37)

Mitchell et al’s (2007) study paints a highly optimistic picture for the application of music as an effective means of distraction. In particular, they noted that the patients in their study who place a higher value on music, and listen to it more frequently, responded that they were ‘enjoying life more, having more energy and ability to perform activities, and feeling depressed and in need of medical treatment less often’ (Mitchell et al, 2007, p. 37).

Another study by Silvestrini et al (2011) produced similarly interesting findings:

The present study was designed to test the pain-reducing effects of pleasant music compared to silence, unpleasant music, and to an auditory attention task. Results partially confirmed our hypotheses. Compared to the silence and the unpleasant music, pleasant music had a significant effect on the pain ratings and pain tolerance to the cold pressor test but not on the NFR. This finding suggests that the auditory stimuli used in this study, and more particularly pleasant music, did not produce any central descendent analgesic effect on spinal nociception, which would have resulted in lower NFR. In contrast, music had a significant effect on the NRS, the sensory and the affective thresholds, and on the pain tolerance to the cold pressor test compared to silence and to the unpleasant musical stimulations, and these results are consistent with previous studies showing pain-reducing effect of music on reported pain experience (Silvestrini et al, 2011, p. 268)

Silvestrini et al’s (2011) report suggests that the areas of the brain responsible for processing pain signals are the same as the areas for analysing music we hear. This is mainly because our brains utilize several different areas and functions when listening to music. These include the areas which process movement: the Cerebellum; a combination of Cortexes (Prefrontal, Motor, Sensory, Auditory and Visual); and the areas which process emotions: the Amygdala and Nucleus Accumbens. (Levitin, 2006, pp. 270-271).

Does this mean music is a distraction? Pain acts as a signal in the brain, alerting the conscious mind of something which may be an ‘issue’ or problem. This is a survival-trait ingrained in us through our evolution. Like music, ‘the areas of the brain involved in pain experience and behaviour are very extensive’ (Melzack, 1996, p.134). However, some studies, such as those by Fabbro & Crescentini (2014), indicate that once we are aware of these ‘issues’ with the body, manifested as pain we experience in the affected area, it is possible to cancel out the signal. We can, in effect, ‘switch off’ pain, depending on the individuals attitudes to pain.

This might go some way to explain the variance in results found by Silvestrini et al (2011) and Mitchell et al (2007). Both seemed to find generally positive results when studying the effect of listening to music in relation to experience of pain. However, both reports clearly show mixed results amongst their test groups. Other research, while demonstrating an overall positive effect of music in medicinal use (Hargreaves & North, 2008, p. 301), met with similarly varied outcomes depending on the subject’s gender and age:

With regard to sex, music was less effective for males than it was for females. With regard to age, children responded more positively to music than did adults and infants (Standley, 1995, quoted in Hargreaves & North, 2008, p. 302)

This runs in accordance with the findings of Fabbro & Crescentini (2014), which stated that different people apply varying levels of importance and focus to the pain they experience. What one individual might experience as mild pain, another could feel something altogether more debilitating; the change in pain experience is determined mainly by the “expectations” of the patient’ (Fabbro & Crescentini, 2014, p. 545). Gregory (2014) agrees with this view. As we have already seen, pain is ‘an individual experience and the effectiveness of interventions can vary between individuals’ (Gregory, 2014, p. 24). Therefore, their ability to focus on music instead of the brain’s pain signals will be compromised. Giving focus to anything our minds have deemed important for our attention means the brain is devoting less processing energy to listening to the music. This renders as null the positive effect music can have on our experience of pain, because ‘even if you’re only paying attention to one other factor, our capacity to focus on the music may have already been cut in half’. (Green, 1986, p. 68)

It is especially interesting that both studies yielded more positive results when the participants were listening not only to pleasant music, but to music they preferred (Mitchell et al, 2007, p.37). Levitin (2006, pp. 231) states that we often make our preferred musical choices during our early teenage years, and we attach a level of emotional importance to this music. Therefore, music’s ability to have a reductive effect on pain must be, in part, the mental act of processing these positive emotional feelings when listening to music we enjoy.

 

REFERENCES

Fabbro, F., & Crescentini, C. (2014) ‘Review: Facing the experience of pain: A neuropsychological perspective’, Physics of Life Reviews, Vol. 11, pp. 540-552. Available from: 10.1016/j.plrev.2013.12.010.

Green, B. (1986) The inner game of music. United States: Pan Books.

Gregory, J. (2014) ‘Dealing with acute and chronic pain: part two – management’, Journal of Community Nursing, Vol. 28, No. 5, pp. 24-29.

Levitin, D. (2006). This is your brain on music: understanding a human obsession. Great Britain: Atlantic Books.

Löfgren, M., & Norrbrink, C. (2012) ”But I know what works’ – patients’ experience of spinal cord injury neuropathic pain management’, Disability & Rehabilitation, Vol. 34, No. 25, pp. 2139-2147.

Melzack, R. (1996) ‘Gate control theory: on the evolution of pain concepts’, Pain Forum, Vol. 5, No. 2, pp. 128-138.

Mitchell, L., MacDonald, R., Knussen, C. & Serpell, M. (2007) ‘A survey investigation of the effects of music listening on chronic pain’, Psychology of Music. Vol. 35 (1), pp. 37-57.

North, A. & Hargreaves, D. (2008) The social and applied psychology of music. United States: Oxford University Press.

Silvestrini, N., Piguet, V., Cedraschi, C. & Zentner, M. (2011) ‘Music and auditory distraction reduce pain: emotional or attentional effects?’ Music and Medicine. Vol 3 (4), pp. 264-270.

Thompson, W. (2015) ‘The Healine [sic] Power of Music’, Scientific American Mind, vol. 26, no. 2, pp. 32-41.

Music & Wellbeing (Part 4): Music & Movement

This blog is a continuation of my mini-series examining the value of music on our overall wellbeing. The next two instalments will look at the physical benefits of music as a means of healing and rehabilitation.

As always, if you have any comments, suggestions or would like any further information regarding any of the research provided below, please do not hesitate to drop me a line! Music therapy is still a relatively new field (especially when looking at the wider sphere of medicine), and a lot of this might be new information to some. However, there exists a huge array of prior research and reading material on the subject. If reading these articles has sparked an interest in learning more about music therapy, but unsure about the best place to start, I would be more than happy to point you in the right direction!

I got rhythm: Music & Movement

Levitin (2006, p. 174) states that the cerebellum, as one of the earliest parts of our brain to evolve, is responsible for motor functions, including timing:

The Cerebellum is the part of the brain that is involved closely with timing and with coordinating movements of the body…From phylogenetic studies – studies of brains of different animals up and down the genetic ladder – we’ve learned that the cerebellum is one of the oldest parts of the brain, evolutionarily speaking. In popular language, it is sometimes referred to as the reptilian brain. Although it weighs only 10 per cent as much as the rest of the brain, it contains 50 to 80 per cent of the total number of neurons. The function of this oldest part of the brain is something that is crucial to music: timing (Levitin, 2006, p. 174)

As one of our oldest brain functions, our propensity for rhythm is therefore hardwired into us. Combine these automatic functions with the reward-centre activation we experience when listening to music (Salimpoor et al, 2015), and it goes quite some way to explaining our natural need to set things in order; an ‘unconscious propensity to impose a rhythm even when one hears a series of identical sounds at constant intervals’ (Sacks, 2008, p. 264).

Sacks (2008) discusses studies which demonstrated that the motor cortex and subcortical motor systems were activated when listening to music, or even merely imagining it. He argued that keeping time, in both a mental sense and as a physical act, depends ‘on interactions between the auditory and the dorsal premotor cortex’ (Sacks, 2008, p. 262). The human mind is unique in its ‘functional connection between these two motor activations’ (Sacks, 2008, p. 262) which are so intricately integrated with each other. Further to this, when listening to music is coupled with a physical activity, such as finger-tapping or any other movement in the body, several more areas of the brain are utilised. These include the cerebellum and the areas of the frontal lobes commonly associated with ‘higher perceptual and cognitive control’ (Thaut, 2005, p. 179).

According to Thompson (2015), utilizing music’s effects on the brain has yielded a positive response in stroke patients with impaired motor skills:

Patients who engaged in this intervention, called music-supported training, showed greater improvement in the timing, precision and smoothness of fine motor skills than did patients who relied on conventional therapy. The researchers postulated that the gains resulted from an increase in connections between neurons of the sensorimotor and auditory regions…the hope now is that active music making-singing, moving and synchronizing to a beat-might help restore additional skills, including speech and motor functions in stroke patients (Thompson, 2015)

Thaut (2005) has also recorded positive results when using ‘rhythmic auditory stimulation to facilitate walking’ in patients who have been partially paralysed following a stroke (Sacks, 2008, p. 276). Again, we see rhythm at play here to increasingly useful effect. Similar research carried out by Jun, Roh, & Kim (2013) investigated the benefits of music therapy in rehabilitating stroke patients. They discovered that better results, and improved mood, were increased by providing music-based movement treatments on a more regular basis (Jun, Roh, & Kim, 2013, P. 29).

Parkinson’s Disease is another condition in which music has been proven to help in alleviating symptoms. Parkinson’s Disease is a progressive neurological condition (www.parkinsons.org) caused by the ‘degeneration of cells in the midbrain that feed dopamine to the basal ganglia, an area involved in the initation [sic] and smoothness of movements’ (Thompson, 2015). These symptoms worsen as the disease progresses (Ross & Singer, 2014). In later stages of the disease, it is not only movement which is slowed down, but also the ‘flow of perception, thought, and feeling’ (Sacks, 2008, p. 274). This highlights the roots of the disease in the brain rather than in other parts of the body, much in the same way that the body can be affected after a stroke. Most studies conclude that music supplants a rhythm where the patient’s brain has stopped carrying out movement functions automatically (Jun, Roh, & Kim, 2013; Sacks, 2008; Thaut, 2005; Thompson, 2015).

As we saw when looking at musical interventions on stroke patients, one of the key factors to the success of music therapy in patients with Parkinson’s Disease is down to timing. In regard to Parkinson’s Disease, there are particular observations to be made about the patient’s own perception of timing:

‘An observer may note how slowed a parkinsonian’s movements are, but the patient will say, “My own movements seem normal to me unless I see how long they take by looking at a clock. The clock on the wall of the ward seems to be going exceptionally fast.”’ (Gooddy, 1988, quoted in Sacks, 2008, p. 276)

Regarding this example of relative time, using music has a positive effect because it ‘imposes its own tempo’, effectively overriding the impulses to speed up or slow down that Parkinsonion patients experience (Sacks, 2008, p. 276). Sacks (2008) continued that for as long as the music lasts, the patients’ rhythms returned to pre-illness speeds of movement. In other cases, where one side of the body is operating at a different speed to the other, getting the patient to play on an organ brought his limbs back into synchronicity again (Sacks, 2008, p. 277).

In many of the case studies provided by Sacks (2008), he mentions that the patients ‘come alive’ and in some examples shake off all visible signs of Parkinson’s Disease; walking more fluidly; singing; and even dancing energetically. In one case, an especially motionless patient is seated at the piano and not only frees up in her movement, but plays beautifully from memory; the act of imagining the music has the same effect as physically hearing it (Sacks, 2008, p. 278).

The phrase ‘come alive’, to me, suggests a happier state of mind when music is present in these patients. This is similar to the stroke patients in Jun, Roh, & Kim’s (2013) study that experienced an ‘improved mood’. While music is being applied here seeking physical improvements, it is simultaneously improving the patient’s mental wellbeing. Therefore, music can be seen to have an overall positive effect on the patients’ combined wellbeing. I agree with the research in these chapters, and believe that further implementation of music-based interventions within the National Health Service will show quicker recovery times in patients. This, in turn, should lead to a greater overall mental wellbeing in the patients as their health improves. As for the National Health Service, they are optimistic about the positive use of music as a means for treating stroke and Parkinson’s patients. However, they wish to see larger studies with more varied groups of patients. (National Health Service, 2008).

REFERENCES

Jun, E., Roh, Y., & Kim, M. (2013) ‘The effect of music-movement therapy on physical and psychological states of stroke patients’, Journal of Clinical Nursing, Vol. 22, No. 1/2, pp. 22-31. Available from: 10.1111/j.1365-2702.2012.04243.x.

Levitin, D. (2006). This is your brain on music: understanding a human obsession. Great Britain: Atlantic Books.

National Health Service (2008) Music aids stroke recovery. Available at: http://www.nhs.uk/news/2007/January08/Pages/Musicaidsstrokerecovery.aspx (Last accessed: 07/05/2012).

Parkinson’s Society (2015). Available at: www.parkinsons.org

Sacks, O. (2008). Musicophilia: tales of music and the brain. 2nd Edition. United Kingdom: Vintage Books.

Salimpoor, V., Zald, D., Zatorre, R., Dagher, A., & McIntosh, A. (2015) ‘Review: Predictions and the brain: how musical sounds become rewarding’, Trends in Cognitive Sciences, vol. 19, pp. 86-91. Available from: 10.1016/j.tics.2014.12.001.

Thaut, M. (2005) ‘Rhythm, human temporality, and brain function’, in Miell, D., MacDonald, R. & Hargreaves, D. (Eds.) Musical communication. United States: Oxford University Press, pp. 171-191.

Thompson, W. (2015) ‘The Healine [sic] Power of Music’, Scientific American Mind, vol. 26, no. 2, pp. 32-41.