The Neural Tango A Musical Transformation in Healthcare

my name is martha suma chadwick

and i’m so fortunate to have had a

lifetime of experience

working as a professional musician i’ve

seen music from many different elements

as a performer and a researcher and an

educator

but the most amazing thing that i’ve

seen about music is its therapeutic

power

to transform people with motor speech

cognition and pain management issues

i was really privileged to be able to

work with children with autism several

years ago

using neurologic music therapy

techniques and

the results were amazing a young man

who had kind of a kinetic stutter to his

gait

he learned to walk and then run

and then participate in the special

olympics

another young man who was nonverbal

learned the power of speech through

music

and a young lady who didn’t have any

ability to be able to focus her

attention so she couldn’t stay in her

great first grade classroom

used attention protocols for several

weeks and then mainstreamed back into

that classroom

and was able to stay there the entire

time

so these experiences and so many more

convinced me

that music could completely

revolutionize health care if we would

only move in that direction

now the ancient greeks knew about the

therapeutic power of music to transform

and they used it

very effectively in their healthcare and

educational systems

and this stayed through until the time

of the romans

we see in the great roman philosopher

boethius

what he wrote in 520 discussing

the music of the spheres musica mundana

that which is the most powerful form of

music can only

be sensed and felt but not heard

as the centuries have gone on

music for the aesthetic has really taken

over

from the music of the therapeutic but

along comes 2020

and we’re in the midst of the pandemic

reaching for music

to comfort us like we never have before

and i believe that we are now on the

cusp of society realizing once again

the therapeutic benefits of music as an

equal

to the aesthetic benefits of music

so how does it work neuroplasticity

actually

occurs in the brain with the advent of

imaging tools from the 1990s scientists

are able to actually look into the brain

and see what’s happening as the music is

interacting with it

and we find that there are new neural

patterns growing

and current neural patterns getting more

strengthened

the rhythm is the key on this rhythm has

a steady pulse so it’s anticipatory

it is intrinsic it’s going on in our

body all the time

we see it in a heart rate we see it in

how fast we’re walking in a gate speed

and each person has what’s called a

functional tempo

this is the beats per minute that the

therapeutic music will work the best at

for that particular person it typically

equates to the heart rate

and is a little slower in adults a

little bit faster in children

so physiological changes occur in the

brain

with music the the

brain oscillations start to work with

the music and entrain

the heart is altered by the music the

muscles start to work with the music

this is a process called entrainment and

i’m going to show you a very brief

example now

of how powerful this could be if

everybody watching this

could just find your own personal tempo

tap a finger tap a toe

and find your own personal tempo

and now what happens with this

typically your body just

jumped right into that and it knows

exactly what it needs to do

i’m going to show you some video now so

that you can see the power of

entrainment with a young man who is

non-verbal

he is moderately to severely autistic he

only had two words in his vocabulary

high and bi but his mom found out he

loved the song happy birthday

and so we’re about to add a third word

to his vocabulary

the word you as happy birthday is played

[Music]

now we see the same young man a year

later

he still loved happy birthday and you’re

going to see tremendous progress that

he’s made on this

he’s trying to actually sing all of the

words this time

and being successful with about a third

of them

[Music]

now we’re able to start working with him

with some of the words that he uses

every day

he had a device that he communicated

with where he’d push a button

and the button would say i want and then

he’d push another button and this is

what he would be wanting

so now we’ll work with one more

technique called melodic intonation

therapy

where we’re doing a very simple setting

of a tune

of i want cookie we’re going to warm up

on w first

and then go into that

[Music]

i want cookies

[Music]

music reaches both hemispheres of the

brain and so therefore

we can use it to work with all of these

various issues regarding motor

speech cognition and pain management

so let’s do some other examples for

motor

a gentleman with parkinson’s disease

could have the kind of typical

parkinson’s shuffle

he’s a jazz lover and so what we want to

do is we want to count his beats per

minute that he’s walking

subtract 10 percent from that and then

lay down just a jazz bass beat that he

can walk to that’s a little slower

which is going to elongate his stride

and let him take

fewer steps imagine

another speech issue we saw the power

of music with the young man earlier but

what about

a toddler learning the alphabet the

toddler says

um a c d a b

but then here’s that first

line of the abc song and suddenly all of

these

different letters go into

abcdefg one chunk that we’ve gone into

so it’s very powerful for learning

cognition

a woman could be in the hospital at this

point from a stroke

she can’t focus her attention we’re

going to give her two tasks one is to

pick up a pencil

the other is to squeeze a tennis ball

she’s holding in her hand

the therapist says when you hear the

bach prelude

i want you to pick up the pencil but

when you hear

the beethoven i want you to squeeze the

tennis ball

because we know she’s a classical music

lover this will motivate her

for pain management

a gentleman could come into the hospital

as a burn victim

and he also has alzheimer’s it’s

necessary now to change his dressing and

it’s going to be a very painful process

but we know he’s very religious and he

loves old-time church hymns

so the music therapist is brought in

singing amazing grace in some of his

other hymns at a tempo that’s going to

keep him relaxed

and the pain under control

all of these things use music to affect

a non-musical behavior or task and so

therefore

all these different diagnoses can be

helped with

the use of music it is not diagnosis

specific

it is conditional specific so

why isn’t this better known at this

point

particularly music for pain management

we’ve been in the midst of the pandemic

but we’ve also been in the midst of the

opioid epidemic for many many years

and music for pain management could

really help alleviate this

music actually creates chemical change

in the brain upon hearing it there was

fascinating research coming out of

mcgill university in 2015

where they were able to track what was

going on in the brain

when someone was listening to their very

favorite piece of music

and they found that on anticipation

of that really cool part of the music

coming

the brain actually issued a small amount

of dopamine

and then on the reward when that moment

happened that moment that gives you the

goosebumps happened

another shot of dopamine was issued

along with a small

dose of natural opioid

this has tremendous implications for

pain management

more research is needed but it has

tremendous implications

i met a woman a couple years ago she

came up to me after a concert

and said i need to tell you my story and

so we went out to lunch and she told me

she had been in a car accident

30 years prior to that had been put on

significant amount of pain meds at the

time

took a couple of falls more pain meds

more

falls more pain meds to the point where

her body became addicted

she had to drop out of society she

wasn’t able to work anymore

and really was just on a huge pain

threshold every day

but she found out that a musician who

she adored in high school was coming to

the area to do a concert

the musician was melissa manchester and

she was determined to go to the concert

she did as she was sitting in the

concert

she was close enough to the stage where

the vibrations from the music

were actually able to come right through

her body

and she realized at the time that her

pain threshold

had significantly lowered at the time

she was very excited went home and

called her doctor

got permission loaded her ipad up with a

playlist of all melissa manchester’s

music

and 24 7 for the next two months

she listened to the music of melissa

manchester

and at the end of that two-month time

period

she was off of her pain meds every

single one of them

this is very very powerful information

the subject of pain management and music

is very personal to me also i lost

a former much loved student a couple of

years ago to an opioid overdose

and he left behind a devastated circle

of friends and family

here in the area it was also unnecessary

because the drugs that he was able to

buy on the street

had filtered down from prescriptions

that were legitimate prescriptions

that people just kept refilling but not

using

if we could make the medical people

aware

of music for pain management we could

help alleviate

this crisis of the opioid epidemic

because that many prescriptions would

then not be written

so again why is this not already in the

mainstream this knowledge

it’s tremendous knowledge but i’ve been

working on advocacy efforts for several

years now and i’ve whittled it down to

basically

four big roadblocks to come and the

first

is there are a lot of misconceptions

about music therapy

old ideas ge music therapy is sit and

play the guitar and someone will feel

better

back from the 70s when it was a social

science

it is a neuroscience it is very

specifically

goal-oriented work based on research

based on science and we need

to move forward with that the second

item

is the fact that we have an enormous

amount of great science out there

but we have a system in education

where the researchers are basically

having to publish publish publish to

maintain their tenure track positions

but there’s no responsibility to then

disseminate the information down

where it can do so much good to the

consumer

so then we would need an advocacy group

to do that

but the music therapists are so busy

with their clinical and studio work that

there’s really not an advocacy group for

music therapy at this point

there’s only about eight thousand music

therapists right now so it’s a

relatively small group

and the fourth thing is what i call the

silo effect

individual groups tend to remain with

their own groups

doctors work with doctors musicians work

with musicians

therapists work with therapists and we

all need to sit around the same table

to be able to work together to be able

to do this

so some ideas for how this can succeed

getting the information down where it

needs to get

we had a very successful model created

here in chattanooga

for a performing arts series starting

several years ago

advocating directly to the audience for

the benefits of music and therapy and i

thought well i wonder if we could make

this go national

and so i talked to my good friends at

the erie philharmonic up in pennsylvania

and they were thrilled to agree to

participate

in a set of video educational units

that will be free of charge on their

website

that other organizations can use as a

model

or other organizations can just use flat

out

to help educate their audience about the

benefits of music and therapy

we need more centers of excellence this

is where the educational

university systems medical systems

community can all get together and we

can sit around that same table

and do what we need to do to to find out

what the solutions are to the problems

we’re also in the age of social media

which is a marvelous platform for being

able to get the word out

and if we can get some interesting

innovative ideas out there

that can go viral we’ll immediately

reach people on a worldwide level

a friend of mine and i were talking a

month or so ago and he said to me you

know

what is really the first thing that we

experience as human beings with music

and both of us immediately said oh it’s

the lullaby

and so why not create a national lullaby

contest where we

create and compose a brand new lullaby

but it’s to raise

awareness for the benefits of music and

therapy

so to wrap up the science

is out there it’s out there in huge

amounts all we need to do

is be able to bring it down to the

consumer

the doctor the patient the therapist so

that they are aware of it

and if we can do that and move music

into medicine

i remain firmly convinced that music

could revolutionize health care

if we’d only go in that direction thank

you very much

you