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