Music Therapy – The Healing Qualities of Music

Over the course of the 20th century, an unexpected scientific validation of an ancient conception of music took place: we proved to ourselves that music can be utilized as an effective treatment for various physical and psychological ailments. Today, music therapy is recognized by many as a powerful tool in the arsenal of medical treatments, one with possibilities that have not come close yet to being fully explored or implemented.

Most all of us have practical experience that exposure to music can change our mood. Various musical pieces can make us feel emboldened and strong, tranquil and happy, or even agitated, depending on both the specific qualities of the music and the individual contexts in which we subconsciously place them. Our perceptions from hearing music today are impacted by associations we make from our past in which the same music was present, or simply due to the way our internal “wiring” uniquely responds to the rhythms, tempos, pitches, and other aspects of the music. However, there are also certain fundamental constants—qualities of music that generally affect all of us in the same way because we are all human and share the same DNA structure and psychological makeup, a constitution that was refined through evolution over many, many ages.

Examples of music therapy are found in ancient mythologies and religious texts. Until relatively recently (mostly in the last 200 years), its effects were attributed to magical or spiritual properties. This contributed to the general regard for music as an esoteric, spiritual power, such as in The Bible, where we see in I Samuel how Saul was calmed by the harp playing of David and the “evil spirit” left him. The 9th century Syrian Al-Farabi was an early proponent of seeking a deeper understanding of music’s potential as a physical and psychological therapy, but it was not until nearly a thousand years after him that a scientific approach began to be employed in the West to demystify music and determine the specific mechanisms at work in its healing qualities. The experimental use of music in various hospitals, and the scholarly and anecdotal writings of 19th century music therapy proponents, led philosopher Friedrich Nietzsche (who, during his early days as a classical studies professor, had been a close associate of composer Richard Wagner) to take a keen interest in music therapy treatments and music’s impact on the human nervous system. Finally, the overwhelming flood of wounded soldiers and civilians in World War II opened the door to widespread experimentation of this relatively cheap and readily available treatment, and as a result, music therapy began to become main stream when numerous patients showed positive physical responses in their vital signs as a result of strategic exposure to music (in addition to reduced symptoms of post-traumatic stress disorder—what was termed “shell shock” at the time). Formal university programs for the study of music therapy were soon introduced and the National Association of Music Therapy was established, all by mid-century.

General knowledge about music therapy among the public has trailed along slowly. Some popular films and high profile cases in the news have helped. The 1990 film Awakenings, with Robin Williams and Robert DeNiro, portrayed how the now-renowned Dr. Oliver Sacks discovered that music could play an important role in engaging his post-encephalitic Parkinsonian patients with the external world. In the more recent films The King’s Speech and The Music Never Stopped, respectively, the stammering newly crowned King George VI is aided in overcoming his speech impediment by musicalizing his words and an amnesiac in the late 70s overcomes the devastating effects of brain tumor removal surgery through a music therapist’s program of listening to the music of the late 60s that held so much significance for him in his youth, prior to his near complete loss of memory. (The latter was based on the true story of one of Oliver Sacks’ own patients.)

The remarkable recovery of Arizona Congresswoman Gabrielle Giffords, who faced incredible difficulties in speech and language function following her gunshot wound to the left temple in 2011, is largely credited to the music therapy she received, which helped retrain the right side of her brain to take on important language related functions that are normally handled by the left hemisphere. “’She was able to sing a word before she could speak a word, and the damaged areas of her brain were circumvented through music,” relayed Concetta Tomaino, executive director of the Institute for Music and Neurologic Function.[i]’” ABC News aired a segment on this incredible story, which showed Giffords crying in frustration when unsuccessfully trying to speak, but then appearing joyful as she sung fluently. As Emily  Sohn of Discovery News wrote, this “paints a dramatic picture of the power of music to help people overcome brain injuries.”

These types of examples, however, provide only a small glimpse into the vast potential of music therapy. Michael De Georgia, director of the Center for Music and Medicine at Case Western Reserve University’s University Hospitals Case Medical Center in Cleveland commented (in relation to Giffords’ case) that “In the last 10 years, we’ve just started to understand how broad and diffuse the effect of music is on all parts of the brain . . . We are just starting to understand how powerful music can be. We don’t know what the limits are.”[ii] Since the brain is a central component of all healing, music’s ability to kick-start healing processes extend far beyond addressing the various neurological ailments for which it is most known. In fact, music is now regarded as one of a relatively few forms of therapy that have a broad range of applicability (such as nutritional and physical therapies), and often can accomplish what other therapies and pharmaceutical drugs cannot.

To understand what types of music might be good for therapeutic treatment or experimentation (and, conversely, to determine what to avoid), a basic understanding of how music impacts our minds and bodies is valuable. Daniel Schneck and Dorita S. Berger offer an excellent overview in their book The Music Effect, a scientific work that is yet still fairly easy to digest once one familiarizes oneself with the clinical terminology. In essence, we learn from them that

“Music therapy has as its goal the permanent re-setting of systemic operating parameters (set-points) and input/output transfer functions, in order to derive functionally adaptive responses that result from mechanisms of entrainment. Music used for clinical therapy involves not only an immediate, in-the-moment relief of a circumstance, but also the setting of long-term goals for inducing permanent changes in physiological and psychological functions that are being addressed by the intervention. In this respect, music used as therapy assumes a role not unlike other forms of clinical intervention for diagnosed populations.”[iii]

What this means is that the human body (along with other animals) has various internal settings that are designed to contribute to the optimal physical, emotional, and mental health of an individual, what we call the homeostatic environment, such as pulse rate, ph level, the amount of hormones, enzymes, etc., to secrete, as well the levels for triggering internal responses, whether for general maintenance (sleep cycle, cellular production, etc.) or to respond to a change in environment or circumstances (body sweat, adrenaline release, etc.). Each of these settings—the systemic operating parameters, or “set-points”)—have the potential to become disrupted due to excessive strain, which can be caused by environmental factors, inadequate diet, use of pharmaceuticals or organic drugs and herbs, consumption of artificial foods, improper (or lack of) physical activity, inadequate sleep, or psychological stress. The repetition of these “forcing functions” on our system cause some of these settings to change because our bodies are designed to adapt to try to best handle any new situation it has found itself in, especially when it is a less than ideal one. These adapted settings can become the new norm, but the adjustments often trigger new problems and side effects, thereby generating their own new forcing functions that put stress on other bodily systems. Each setting is like a knob on a giant machine, and if one knob gets stuck in the wrong place, it can cause other parts of the machine to malfunction, and those malfunctions create further undesirable changes to settings and other malfunctions.

The sound vibrations of music are uniquely able to address this because of music’s power of entrainment. I explain entrainment in my A Big History of Music as follows: “The human body has a natural propensity to react in synchrony with external forces, and any such process is known as entrainment. Entrainment can be outwardly obvious, as in the example of the unconscious tapping of the foot upon hearing a piece of music with a steady pulse, or less noticeable, such as a change in the internal emotional state brought on by a feeling aroused by a musical piece. Entrainment can occur far outside the scope of our ability to even observe with our senses. It can be as complex and subtle as the sympathetic vibration of an internal organ or tissue in response to specific musical vibrations, or changes to brain wave or neural cell activity in response to the melodic, harmonic, rhythmic, or emotional content of a musical work (or the combined simultaneous effect of all these elements). By applying music in a clinical fashion, repetitive entrainment activities can be initiated which produce desired changes in the way our bodies function on a regular basis, changes that can have long-lasting beneficial effects on the way we respond to various physical and psychological stimuli.”[iv] Musical sound waves act as new forcing functions to reverse the effects of prior harmful experiences and return them back to their optimal settings.

Indeed, it is not just musical sound waves but even sound waves outside of the range of the human hearing apparatus that can induce changes to our bodily systems and tissues, as is already widely applied in the growing medical uses of ultrasound therapies.

With so many of our current physical and psychological ailments arising from our hyperstimulating, psychologically stressful environments and lifestyles, it is readily apparent what sorts of music are best for restoring health. Alicia Ann Clair, Ph.D., writing for the Alzheimer’s Foundation of America, explains that “Typically, ‘stimulative music’ activates, while ‘sedative music’ quiets. Stimulative music, with percussive sounds and fairly quick tempos, tends to naturally promote movement, such as toe taps. . . . On the other hand, the characteristics of sedative music . . . include unaccented beats, no syncopation, slow tempos, and little percussive sound . . . ”[v] While stimulative music is helpful for those who tend to drift off and lose focus or engagement with the world—and indeed it can have a positive effect in stimulating thought processes in the brain–sedative music helps relieve agitation and stimulates the brain waves of rest and healing.

The entrainment reactions of our bodily systems to various musical qualities commonly results in striking chemical changes as well. Martial and aggressive music is a catalyst for the release norepinephrine, aka adrenaline—something that can certainly be useful if one is drowsy but must stay awake and alert, but which is to be avoided if seeking a restorative state. Relaxing music, on the other hand, releases serotonin, a vital key to mood regulation and brain function. Lively, upbeat music can act as an elixir for the delivery of dopamine and endorphins, which also play a central role in restoring us to our physical and psychological homeostatic environment—our ideal state of being.

Armed with this information, we can begin to make different musical choices throughout our day–including perhaps the choice to add music where there previously was none—and experience different, positive outcomes. We can also set aside time to specifically immerse ourselves in music that has some tailored, therapeutic value for us. What’s more, we can engage directly in creating music–whether we consider ourselves musicians or not–by playing instruments and singing more often. As with any other therapeutic treatment, professional counsel should be sought for any dysfunctional or abnormal conditions. You can find a music therapist in your area by sending an email inquiry to the American Music Therapy Association at findMT@musictherapy.org. One need not wait until an extreme condition exists, of course—as the AMTA states, music therapy is a powerful tool for promoting wellness, managing stress, alleviating pain, expressing feelings, enhancing memory, improving communication, and promoting physical rehabilitation. Indeed, many “clients” are ordinary individuals seeking a more balanced, fulfilled, and healthy life.

It is high time we embrace the science and treat music as a central component to our well-being. And as with all other aspects of our health, it is incumbent upon us to take a prominent role of personal responsibility in this. In this way, we can easily follow the axiom of the future: “Musician, heal thyself.”


[i] Anni Layne Rodgers, “Music: Sound Medicine for ADHD,” ADDitude magazine online (additudemag.com)

[ii] Emily Sohn, “How Music Helped Gabrielle Giffords Heal,” Discovery News.com, January 8, 2012

[iii] Daniel J. Schneck and Dorita S. Berger, The Music Effect, p. 136

[iv] Brad Raylius Daniel, A Big History of Music, p. 739

[v] Alicia Ann Clair, Ph.D., Education and Care, Alzheimer’s Foundation of America, http://www.alzfdn.org/EducationandCare/musictherapy.html

Music and the Inner Sounds of Silence – Harmonizing Lou Reed, Yehudi Menuhin, Terence McKenna, and Richard Wagner

In Lou Reed’s last interview, given on September 21, 2013, he related to film director Farida Khelfa his musical fascination with inner sounds. “There is a sound you hear in your head; it’s your nerves, or your blood running. It’s kind of amazing to hear that.” He also referred to the sound of our mother’s heartbeat as the first sound we all hear, and a powerful influence for the rhythm of our music. If you’re familiar with John Cage, or have read my book A Big History of Music, then you’ll recognize that Reed’s comments hearken back to the unorthodox composer’s experience in an anechoic studio—a room with no external sounds or echoes—and how that visit was a life-altering event for him due to his perception of these inner physiological sounds and his recognition of their significance to our subconscious mind and our concept of music. These inner sounds are also the typical sounds of common tinnitus, a condition in which they are simply amplified. They constantly play at one volume or another for all of us. They literally provide the background music to our lives. As such, they warrant serious consideration and beg for deeper inquiries. How exactly have they influenced our musical pursuits through time? And, for that matter, how have they influenced our spiritual lives (given that music and spiritual matters have been inexorably bound together in human development)?

The great violin virtuoso Yehudi Menuhin mused about the origins of music having some source in these inner sounds: “Music must have begun out of natural sounds impinging on our ears, and those to which we listen with our inner ear in silence.” Prominent composers have professed the inner sounds to be a source of creative impetus for their works. Leoš Janáček, when writing about the inspiration for his cantata Amarus, said, “I look down into my soul. Innumerable notes ring in my ears, in every octave; they have voices like small, faint telegraph bells. . . . This is the sound of silence.” Richard Wagner wrote about lying down after a long walk and drifting into a drowsy state in which the flowing music for the overture of his opera Das Rheingold appeared to him for the first time, not just in his imagination but in a vivid, multi-sensory experience. This incident was quite profound to him because, as he put it, “I then quickly realized my own nature; the stream of life was not to flow to me from without, but from within.”

The modern philosopher and polymath Terence McKenna was a proponent of this inner music—something that everyone can partake of. In a recorded lecture he went so far as to assert that “nothing is more exquisite than the interior music, and all music is obviously an effort to approximate this interior music.” We can appreciate this as a global statement about the forces that drive us to make music, and about music’s underlying purpose—clearly, he did not mean that all musicians and listeners are consciously engaged in the pursuit of realizing their own inner music. But since music has undoubtedly served a central role in our attempts to commune with the divine and discover our true selves, we should carefully consider not only how external “music does lead deeper into these visionary states” (and, I would add, this is especially true to the extent the external music is evocative of, or attunes one to, the inner music) but also how those visionary states themselves are largely comprised of one’s own internal music. Thus, as he put it, “if you can cast loose from exterior musical input [after perhaps using music to help you achieve greater awareness] this interior music will rise into perception and reward you for that.”

McKenna’s comments may seem strange to those who equate inner music with simply the imagination, but make no mistake: they are based on “sound” reasoning, direct experience, and a thorough understanding of humankind’s historical quest to understand its place in the universe. Coming from no apparent external source, the inner sounds have been regarded for many thousands of years as esoteric and mystical (and indeed, they still are by many), rather than the stuff of physiology. Thus, they were elevated to a holy status, just as Janáček in the above quote referred to them as residing deep in his “soul.” The inner sounds inevitably became the focus of silent meditation and were equated with the sound of spirit, or more specifically, the sound of the underlying cosmic vibration that supports and animates all of creation. They became the path and the goal of meditation. In the East, they were referred to as “Om” and regarded as one and the same as the non-material force of spirit.

Descriptions of the inner sounds abound in ancient literature, and there they are intimately connected with early religious thought and spiritual endeavors. As I wrote in A Big History of Music, “Inner sounds of meditation have been variously described in ancient works as sounding like a horn, flute, string, ocean, bee, or flute (among other sounds), and also a combination of all such sounds. The tradition of listening for this sound and meditating upon it has survived even up to modern times and is still widely practiced by a variety of religious groups, in both technologically simple and advanced, modern cultures. Many of these modern-day practitioners state that they also hear these ‘spiritual sounds,’ just as the ancients did.” Not surprisingly, these descriptions match the common sounds heard today by those who sit in silence, as well as those with symptoms of tinnitus.

Although listening to these sounds ultimately contributed to the creation of all kinds of imaginative worldviews and religious philosophies, the sounds themselves are not the result of a collective fanciful imagination—they are part of the common human experience. While it may be seen as ironic that we subsequently learned, through the aid of modern technology, of the existence of universal vibrations, at every level of creation—that periodic vibrations (i.e., musical tones) are ever present in the fabric of existence, even on a cosmological scale—it is quite astounding to come to the conclusion that it was the quiet reflection upon these inner sounds that originally opened the door to an intuitive understanding of this reality by primitive humans. Listening to the inner tones quieted the mind, which created the space needed to receive intuitive revelation.

Religions that refer to silencing the mind, whether for its own sake or to specifically help in hearing the voice of God, are far too numerous to mention and include all the primary ones known to us today. Listening to the inner physiological sounds is no doubt an inevitable consequence of following this advice, for what else does one hear when not consumed with listening to one’s own thoughts, when one is “still” and realizing the omnipresence of God? To some, the inner music is an invaluable tool for achieving that rest from the constant mental workings that block out higher input, whether one calls it intuition, the voice of angels, or the spirit of God. So, it is no wonder that some have gone so far as to regard this inner music as not merely a tool but as the actual goal.

External music, being a reflection of this internal music, is thus a reflection of the cosmic music. It contributes to our realization of the basic truths of our existence, including the musical vibrations of our own bodies. Yehudi Menuhin also touched on this point by saying “I believe profoundly that music helps keep us in touch with the entire vibrating world, and thereby centers us in our being.” It is a concept addressed in detail in the work of the German philosopher Arthur Schopenhauer, who felt that music is the only art which is not representational of images of the world, but is in fact evocative of what he called the noumenon, the otherwise undetectable life force that supports and animates all of creation–the essence of everything. This is why, he believed, music speaks to us from the “utmost depths.”

Our musical heritage is far from devoid of references to these fantastic correlations. Wagner, an avid follower of Schopenhauer, would allude to them in his later works, such as in his opera Tristan and Isolde, which ends with the famous “Leibestod” (love death) of Isolde, who sings “In the heaving swell, in the resounding echoes, in the universal stream of the world-breath—to drown, to founder—unconscious—utmost rapture.” Numerous examples can also be found in modern, popular music, both in arrangements that are imitative of the inner sound as well as in song lyrics. The Moody Blues’ On the Threshold of a Dream opens and closes with a representation of the inner sounds, and their songs “The Word” and “Om” from In Search of the Lost Chord encapsulate the experience and its philosophical implications (from the popular Eastern religious paradigm). In The Doors’ “When the Music’s Over,” we get a swelling organ note from keyboardist Ray Manzarek to denote the inner sound, immediately following the descriptive lyrics “I want to hear the scream of the butterfly,“ sung by Jim Morrison. In that Doors classic, the inner musical stream is the “very gentle sound” that you hear “with your ear down to the ground“ (i.e., with careful attentiveness).

Understanding the inner sounds’ physiological nature should help us in both deconstructing various popular myths about them and in regarding them with greater scientific circumspection. While we continue to look to theologians, religious elders, and philosophers (and now, to a certain extent, quantum physicists) to help us make sense of that which lies beyond the reach of the external senses but is yet still within the scope of our awareness, we can now assign a greater role to psychologists, music therapists, neurologists, and even otolaryngologists to help us understand the intricacies of the physical mechanisms at work with the inner sounds, as well as their effect on us. It is not only external music which we should hold in high regard for its value in helping us move towards a more sacred consciousness, greater fellowship with our fellow humans and the world in which we live, and even in healing the body, mind, and spirit, but also internal music.

Armed with this information, we find there is much new light shed on the central question of why music is consistently regarded throughout human culture as a means of invoking a divine atmosphere and communing with the Creator. The particular qualities of the inner sounds’ tone and timbre may be regarded as evolutionary happenstance—a byproduct of the overall composition of human beings—but it is quite amazing that this oddity of nature has served as a primary catalyst for helping us recognize our interconnectedness with creation, as well as a platform for releasing our imagination towards the stars and an impetus for helping us craft an amazing type of audible art with far reaching powers. And we have much yet still to learn about music and life from listening to these inner tones and exploring their role in the development of music and religious thought.