Music feels healing, but can it actually heal us? The answer is a resounding yes, according to Sound Health, a collaborative project run by the National Institutes of Health (NIH) and the John F. Kennedy Center for the Performing Arts. The Sound Health Network began in 2016 after a chance meeting of Dr. Francis Collins, the former NIH director, and Renée Fleming, the globally renown and five-time-Grammy-award-winning American soprano. Over the past eight years, the partnership, in association with the National Endowment for the Arts (NEA) and the University of California San Francisco (UCSF), has raised awareness about the healing benefits of music and advanced research at the intersection of arts and wellness.
The real question, they now ask, is how does music heal? As scientists, clinical researchers, music therapists, and musicians explore how the brain manages music, they study how music might be used to enrich the brain.
Ms. recently spoke with Renée Fleming and Dr. Francis Collins about their journeys to connecting music with health, what we know so far about music’s effect on the brain, and how we can use that knowledge to heal ourselves.
Morgan Carmen: Thank you both so much for being here today. I want to start out with: What brought you both to the intersection of music and health?
Renée Fleming: I have had a life in music as a performer. I’ve had the privilege of traveling all over the world every year, all the time, and I’ve learned a lot about how people respond to the arts. Because I can’t tell you how many people have come backstage and said “I had cancer “or “I had a terrible loss, and your music got me through.” So that was one really powerful understanding that I had, and the emotion behind those statements, it was so strong I thought, this is, this is the best review I could ever have—it’s that people have been somehow healed by what we do.
And so I also had my own issues, because I had to kind of sort out somatic pain as a hedge against performance pressure. So that got me really interested in the neuroscience, and following what I was reading in the in the papers, and I discovered that scientists were looking at the brain and music. And when I met Dr. Collins at a dinner party, I asked him, “Why?” And here we are several years later.
Dr. Francis Collins: I grew up in a family where music is very much what you did. We didn’t have a television. Lived on a farm with no indoor plumbing, but after dinner, oftentimes music would happen…
So music was for me, this incredible part of the enrichment of life. And then I got interested in science, and for a lot of the last 50 years or so as a scientist, I sort of felt like I got science over here, and I’ve got my love of music over there, and I don’t really like that. It feels like they should somehow have a way to integrate with each other and talk to each other. And I, for myself, knew that music could move me in ways that were extremely powerful, could lift me up when I was kind of having the case of the blues, could inspire me when I needed, could just make me feel totally alive. And that had to be something there that could be put forward in a more compelling way to help people who are suffering.
And I knew about the field of music therapy, but I didn’t really quite know how it would fit together with the sort of rigorous science approach that I was trained to do. And then I met Renée at this dinner party, and that idea that she had had some of these same inklings, that maybe music and science could really figure out how to talk to each other, was just what I was hoping for, too. So we cooked up a plan.
Fleming: Yes, and we collaborate with the Kennedy Center and the National Endowment for the Arts, and have been for some years, and it’s now become a kind of wellness arts and wellness program, but the science has just exploded, especially since the NIH started funding Arts and Health Research, that’s been really powerful.
Collins: And it’s just at the right time because neuroscience is just exploding with information about how the brain works, much more than “Well, you’ve got a left brain and a right brain.” We gotta get way past that now because we know about circuits, we know about what happens to your brain when you have a piece of music that touches you. What exactly does that do to your endorphins? And all of that can now be brought forward in a way to make music therapy even more effective because we know how it’s working, and we know how to adjust the approach for the person’s needs at that point. So it is energized a whole community that was pretty loosely knit and pretty small before and now has really grown.
Fleming: We created a whole network, Sound Health Network. Neuro Arts is another extraordinary plan, the blueprint, and it’s just been a privilege to see these things grow, and especially the quality of the research begin to really step up because that’s what will move the needle in the end.
I, for myself, knew that music could move me in ways that were extremely powerful, could lift me up when I was kind of having the case of the blues, could inspire me when I needed, could just make me feel totally alive. And that had to be something there that could be put forward in a more compelling way to help people who are suffering.
Dr. Francis Collins
Carmen: When you talk about this research that you were doing, what exactly did you find, and how did you find it? I’ve heard about you, Renée, singing in an MRI machine. But what did that look like, and where did the research go from there?
Fleming: Yes, that’s right. So this was an fMRI study, which measures oxygen in the brain. They had me singing, speaking, and imagining singing. I was in the machine for two hours at the NIH. They were surprised, but they discovered that imagining singing was the most powerful. My brain was the most active.
Carmen: More powerful than if you were actually singing?
Fleming: Yes, than actually singing, and they were a little surprised by that. But then they sort of said, well, you’re a singer, so singing is probably second nature for you. But what interested me, too, was learning that music is in every known mapped area of the brain. So it is a very complex activity, especially if you’re actively making music. And so that’s probably why it is powerful, why it is so great for childhood development, why it’s the last memory to go in patients with dementia and Alzheimer’s. If anybody has a family member with Alzheimer’s, you probably notice that they come alive when they are connected with music from their youth and can remember all the words, even if they can’t recognize their loved ones or speak.
Collins: Yeah, how do you recruit another circuit for the one that wasn’t working because you got the push from something that just made it impossible to avoid? Our project is doing a lot of basic science, just trying to understand how these circuits work that interpret music, turn it into electricity, which is what your brain has to do, and then has it connect with your emotional self in a way that is powerful in some instances. But it’s also looking at how we can apply this, particularly in areas that seem ripe for a lot of progress. We have a big project now on chronic pain—how could you figure out how to utilize the power of music instead of an opioid for somebody who’s suffering from chronic pain?
“If anybody has a family member with Alzheimer’s, you probably notice that they come alive when they are connected with music from their youth and can remember all the words, even if they can’t recognize their loved ones or speak.”
Renée fleming
Carmen: So do we know what parts of the brain are being affected by music?
Collins: It’s like Renée said, it’s pretty much the whole brain if you look closely enough. I mean, we know the pathway when sound comes in: it goes to your acoustic cortex, which is close by your hearing apparatus. And we just have recently learned, this is work by Eddie Chang at UC San Francisco, that you actually have special circuits for music. They determine pitch, they determine the interval between the previous note—did it go up, or did it go down? And then the most interesting one is there’s a circuit that predicts what the next note is going to be.
Fleming: We’re the only primates—the only creatures that have that.
Collins: Which means it must have been some advantage of some sort…once you know that [we have that], you can kind of start to interpret your own experience. When you’re listening to an unfamiliar piece of music, your brain is really trying to predict where it’s going to go. But you have this sort of paradoxical reaction if it doesn’t go where your brain said. You might be a little bit like, Oh, that was discord. Or you might be like, Oh, that was really interesting. So yeah, if you’re listening to Stravinsky, you get a lot of, oh, I didn’t know that was gonna happen.
Carmen: I have two questions left. The first is for Renée. You’ve said that “We aren’t thinking beings who feel, but feeling beings who think.” Is that something that’s come out of this Sound Health partnership? And what does it mean to you?
Fleming: It makes perfect sense…it’s the nervous system being such a powerful driver in us, which is a relatively recent discovery, right?
Collins: The philosophers kind of knew this. David Hume famously wrote, “Reason is a slave to the passions.”
Fleming: There you go. There you go.
Collins: So, yeah, we are feeling people who occasionally think. Jonathan Haidt, who wrote this recent book The Anxious Generation, has this metaphor of the rider and the elephant. The rider, which is your thinking person, thinks that the rider has control. The elephant is your feelings, your emotions, and they pretty much are going to decide where you go. I like Blaze Pascal’s quote about this, because I’m a big fan of Pascal, which is “The heart has reasons that reason knows not of.”
Fleming: True—three ways of saying the same thing. But I, for instance, find it very interesting that we feel rhythm whether it’s on the street or—I had this experience where I heard it from a bar, but I didn’t consciously hear it. I just noticed I was walking in sync with someone across the street, and then I realized we were both hearing this music that came out of the bar. So the rhythm goes in through the spine, evidently, and then comes into the brain and into cognition. And there are probably a lot of experiences like that.
For instance, [a] scientist just told me two days ago, she said, “We react physically very differently to the word ‘rock’ and the word ‘stone.’” So this language is also very powerful and musical in a way, certainly. But I mean, it makes you really think, what? How are we affected, all day long, by our environment, everything in our environment.
Collins: It will be interesting to figure out. If there’s circuits for spoken words and there’s circuits for music, where does poetry fit?
Fleming: I just read this today that poetry is very similar to music in where in the brain it affects us—
Collins: —‘cause of the rhythm.
Fleming: Exactly. It’s even musical rhyming words—the rhyming. And in our history. You know, poetry was history. We didn’t have writing. Way before writing, it was all memorized.
…Give yourself permission to see art as something good for your health.
Renée Fleming
Carmen: I know the research is ongoing, but is there something that you want people to know about how they can use music to connect with people or to heal themselves? What do you think people should take from what you’ve learned so far?
Fleming: Forty-five minutes of engaging in any type of artistic experience reduces anxiety by 25 percent. That is a really valid thing to know, whether it’s reading or walking in nature or engaging with the visual arts. I go to museums everywhere I go. I love theater. Of course I go to music concerts. I would say give yourself permission to see art as something good for your health.
Collins: Right there. I mean, look at the current state of our societal malaise, of the loneliness, of the isolation, the sense that we’re all polarized and divided. And those other people over there are people I don’t want to deal with. Think about what music can do in every one of those situations, especially if you’re willing to do it with other people. There is no way I think you can sing with a group of other people and feel much animosity towards them. And like you said, there’s no way you can do that and not have your depression go down and your loneliness go down. And we’ve just gotten out of practice.
At my house, we have music parties where we invite 40 or 50 people who will say, ‘Oh, I don’t know if I’m much of a singer,’ but I invite them, and intentionally invite people from different political perspectives, and then get everybody to start singing.
Fleming: That’s how we met.
Collins: That’s how we met! Absolutely!
Fleming: At a dinner party with Supreme Court justices right after marriage equality was decided, and they were not speaking to each other.
Carmen: Did you have them all sing together?
Fleming: Oh yes.
Collins: We did, we forced it. And we had never met each other until then.
Fleming: That was the first time we met each other, and everybody finally had a great time and carried on and left it behind them. We’re talking about Ruth Bader Ginsburg, Antonin Scalia, and Anthony Kennedy.
Carmen: I think that is an amazing note to end on. Thank you both so much for taking the time.
For more on the medicinal power of music, check out Renée Fleming’s book Music and Mind: Harnessing the Arts for Health and Wellness.
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