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Essay: Music therapy

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  • Music therapy
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Introduction

Music is the universal language. It can speak volumes without ever saying a single word. You can go anywhere in the world with a guitar and communicate with people just by playing a few chords. People will be able to feel connected with you and even play along with what you are playing whether or not they have any background in music. You don’t have to be fluent in music theory or know anything about music at all for it to evoke an emotional response. You don’t even have to understand the language that it’s in! Stories transcend language when told through music and take on a different form entirely. A lot of what music does can be described as a feeling. Whether it’s the physical vibrations moving your body or the emotion that it evokes, the relationship between music and human cognition is extremely complex and only beginning to be understood.

Neuroimaging shows that music has effects on a number of different parts in the brain which is why there is so much therapeutic potential. The human brain functions as a sum of its parts which is why therapies or activities involving more than one part of the brain are so beneficial. One area specifically that music has an extremely strong effect on is the mirror neurons. The mirror neurons are the part of the brain that helps us recreate actions that we see in others. When we watch someone carry out an activity requiring fine motor action, our mirror neurons are responsible for allowing us to recreate that activity without consciously having to learn the movements step by step. We benefit from these neural shortcuts everyday, especially when relating to other people. Neuroimaging shows that the mirror neurons, right amygdala, and insular gyrus all show increased activity when mimicking facial expressions, telling us that the mirror neurons play a bigger role in allowing us to connect with entities outside of ourselves. This is called empathy and when this ability is impaired, people experience a myriad of issues. When people have deficits in empathy, it can make relating to other people difficult and heavily impact their social life and overall emotional wellbeing. This project proposal is based around the goal of teaching empathy through music in an interactive workshop. The workshop utilizes theory based in research that shows that music activates different parts of the brain that are responsible for empathy and other higher level aspects of emotional functioning. While empathy is only part of how we relate to other people, it is the basis for understanding and interpreting the thoughts and emotions of other people so we can respond accordingly.

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Background Research

Neurobiology of Music

Since the beginning of time humans have been making music. For most people, music can be a form of celebration, communication and even a way of life. The human relationship with music started with simple rhythms banged on whatever we could find and as time went on the practice became more and more sophisticated. The long history of music suggests that it is as innate in humans as everything else we do to survive. A flute made from a vulture bone found in Danube tells us that a sophisticated form of music already existed in the paleolithic era, suggesting that musical understanding is natural to predeveloped human brains (Zatorre, Salimpoor, 2013). Music touches all cultures and speaks to us on an extremely deep level, deeper than most of us even understand. It has the power to elicit a range of emotions in just about anyone. Some songs remind us of the past and trigger extremely vivid memories when we hear them. Sad songs can make us cry when we are not feeling sad and happy songs can make us feel better when we are sad from listening to sad songs. Music continues to be a staple of human existence because of the complex effects it has on our brains. When we listen to music, a system of neural pathways activates several different parts of the brain which creates a seemingly multidimensional experience. Research shows that there is an overlap in the regions responsible for linguistic processing and the regions responsible for processing auditory stimulation. This information allows us to postulate that music, being a hierarchical organizational system similar to human language, is processed in a similar way to spoken communication. “Human language is a communicative signal with a similar hierarchical structure, in which phonemes are combined to form words, phrases and sentences up to the discourse level of speech structure (Hockett, 1960).” Hierarchical organization is the process of integrating lower-level units to form a more complex unit (Molnar-Szakacs, Overy, 2006). In the case of music, the lower level units would be individual notes that are played together to make a chord, then multiple chords are played in order to create a song. Akin to language, music has rules that govern which sequences of sounds “work” and which sequences of sound do not. In language these rules are described and explained as grammar, syntax, semantics, etc. whereas in music dissonant vs. consonant notes tell musicians which combinations of notes work and which combinations do not. The similarities in hierarchical organization of descriptive sounds in spoken language and the expressive sounds in music support the hypothesis that music and language are processed through the same neural substrates. While researchers have done extensive trials observing and confirming the structural similarities between the brains of primates and the brains of humans. it seems as though the biggest difference is the human ability to process hierarchical stimuli like language and music where primates cannot (Zatorre, Salimpoor, 2013). This is believed to be the primary reason primates have not developed the same sophisticated form of language as humans.

When people listen to music they experience pleasure, however the reason why has been puzzling researchers for thousands of years. In studies done by Robert J. Zatorre and Valorie N. Salimpoor at the University of California, evidence shows that highly emotional responses to music produce a dopamine release in the brain. In their study, the researchers asked participants to pick songs that they found highly pleasurable and emotional. They then measured the physiological response when they listened to that vs. music that they did not find highly pleasurable (neutral). Participants were specifically asked to pick songs that give them “chills” because chills are believed to be physical manifestations of emotional responses and related to increased sympathetic nervous system arousal (Blood, Zatorre. 2001, Panksepp. 1995, Rickard. 2004). Researchers compared the dopamine release in response to both neutral and highly emotional music and found that strong emotional responses to music lead to dopamine release in the mesolimbic striatum, confirming the hypothesis that music releases dopamine (Zatorre, Salimpoor, 2013). Now that the question of whether or not music releases dopamine has been answered, we can move on to why music releases dopamine. The main ideas revolve around the concept of temporal expectancies, their associated predictions and the reward value generated by those predictions (Zatorre, Salimpoor, 2013). When thinking about the reward system and why music produces dopamine, it is important to understand that the mesolimbic system does not work alone. Studies show that as mammalian brains become more complex, the relationship between the mesolimbic striatum and the prefrontal cortex becomes more defined. “The frontal lobes, particularly the prefrontal cortices, are involved in executive functions, such as temporal maintenance of information in working memory and relating information back to earlier events, temporal sequencing, planning ahead, creating expectations, anticipating outcomes, and planning actions to obtain rewards” (Petrides M, Pandya DN 2004, Stuss DT, Knight RT 2002). The cerebral cortex is where an organism stores information about itself over the course of its life so this is consistent with the hypothesis that emotional responses to music are subjective and related primarily to previously stored memories. “As such, cortical contributions to aesthetic stimulus processing are consistent with the idea that previous experiences may play a critical role the way an individual may experience certain sounds as pleasurable or rewarding” (Zatorre, Salimpoor, 2013). Basically, the cerebral cortex and the striatum work in unison to make predictions about potentially rewarding future events and when the prediction comes true we are rewarded with dopamine (Zatorre, Salimpoor, 2013). To investigate the neural substrates of predictions and rewards associated with music, researchers scanned participants with an fMRI while they listened to music they had never heard before. Researchers were interested in figuring out which musical sequences become rewarding to us over time and why. They found that activity in the mesolimbic striatal areas, especially the Nucleus Accumbens, to be most associated with the reward value placed on musical sequences. “The NAcc has been implicated in making predictions, anticipating, and reward prediction errors—that is, the calculated difference between what was expected and the actual outcome” (Pessiglione, M., Seymour, B., Flandlin, G., Dolan, Frith, 2006). Researchers found increased connectivity of the frontal cortex with the NAcc during rewarding musical processes, which provides direct evidence of temporal predictions playing a large role in the way that humans recieve pleasure from musical stimuli.

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The Reward System

The reward system is most easily explained as a mechanism that promotes certain adaptive behaviors while pruning off non adaptive behaviors. The brain automatically does this by providing dopaminergic rewards when we do something that is beneficial to our survival. Research suggests that, “the interactions that we observed represent greater informational cross-talk between the systems responsible for pattern analysis and prediction (cortical) with the systems responsible for assigning reward value itself (subcortical)” (Zatorre, Salimpoor, 2013). As much as the reward system is a mechanism that helps us adapt to our ever changing environment, it is also active in making predictions about any possibly rewarding stimuli. The findings of interactions between the auditory cortices, value related cortices, and the striatum can be measured to gauge how much a new piece of music is enjoyed by the listener. It is also important to note that while fulfillment of a prediction leads to a dopamine release in the striatum, a greater response is associated with a better-than-expected reward. (Zatorre, Salimpoor, 2013) This is evidence of a major link between the two bodies of research and suggests that music, being largely subjective, allows people to create their own experiences in which they achieve a chemical reward from making predictions about the incoming auditory stimuli. “In the case of music, this prediction may include sound sequences that signal the onset of the highly desirable part of the music. Previously neutral stimuli may thus become conditioned to serve as cues signaling the onset of the rewarding sequence (Zatorre, Salimpoor, 2013).” This is why highly emotional music can refer to music that is about highly emotional material or a song that we’ve forged a deep connection with that elicits an intense emotional response. The functional interaction between subcortical reward circuits involved in prediction and individualized regions of the cerebral cortex explain why different people like different music and how it’s basically a function of their previous interactions with similar sounds (Zatorre, Salimpoor, 2013). Based on this evidence, we can assume that humans process all incoming stimuli, regardless of whether or not it is auditory or visual, in terms of their understanding of the emotional intention behind the signal. The expressive nature of any human action or vocalization sends a signal of the intentional and emotional state of the executor, such that even footsteps can be interpreted as conveying emotion. (Molnar-Szakacs, Overy, 2006) This supports the phenomenon that an individual can convey intention and emotion through musical phrases alone.

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Mirror Neurons

When we watch another person carry out an action or a sequence of actions we seem to automatically know how we would do the same thing. We usually don’t notice this happening and because it’s so automatic we definitely take the process for granted. As it turns out, the neural networks responsible for this phenomenon are actually responsible for a lot more than we think. Researchers have dubbed them “Mirror Neurons” because they are activated when we are interacting or watching other people. The Mirror Neuron System (MNS) is the mechanism in our brains that allows an individual to understand the meaning and intention of a communicative signal by evoking a representation of that signal in the perceiver’s brain (Molnar-Szakacs, Overy, 2006). Evidence shows that there are two main networks of neurons with mirror properties. One of these networks runs through the parietal lobe and the premotor cortex as well as the caudal part of the inferior frontal gyrus. This network is called the parieto frontal mirror system. The other is formed by the insula and the anterior mesial frontal cortex. This is known as the limbic mirror system. Research shows that the parietofrontal mirror system recognizes voluntary behavior, while the limbic mirror system focuses on the recognition of affective behavior (Cattaneo L, Rizzolatti G. (2009). In this domain, the term “affective” refers to emotions, attitudes, and behaviors. These mirror neuron systems create a network of lobes that makes it easier for different parts of the brain to communicate. In clinical trials, it was observed that neurons within the parietal area PF and area F5 of the premotor cortex fired both when the primate observed an action being carried out by another primate and when it carried out an action itself. (di Pellegrino et al., 1992; Gallese et al., 1996; Fogassi et al., 2005). It has been theorized that mirror neurons in the parietal lobe have the unique function of coding motor actions as belonging to a sequence, predicting the intended goal of complex action (Fogassi et al., 2005). Neuroimaging also shows that the prefrontal cortex is extremely involved in interpreting the intentions behind the behavior of others (Iacoboni et al., 2005). It is this fronto-parietal network including the posterior inferior frontal gyrus (BA 44), adjacent ventral premotor cortex and the inferior parietal lobule (BA 40) that allows us to imitate behavior automatically. (Rizzolatti and Craighero, 2004) “Thus, a range of current evidence suggests that a human fronto-parietal mirror neuron system shows properties consistent with the ability to represent the actions and intentions of others, across modalities, by recruiting one’s own motor system” (Molnar-Szakacs, Overy, 2006). As more research comes out, the mirror neurons seem to play an even larger role than previously thought. It has been theorized that functions of these networks are responsible for several aspects of higher level emotional functioning such as “empathy (Carr et al., 2003; Gallese, 2003b; Dapretto et al., 2006), theory-of-mind (Williams et al., 2001, 2006) and self-other discrimination (Uddin et al., 2005, 2006)”. In addition to helping us understand the behavior of others, the Motor Theory of Speech Perception (Studdert-Kennedy et al., 1970; Liberman and Mattingly, 1985; Liberman and Whalen, 2000) theorizes that mirror neurons provide the basis for all two way communication in the shared representation that occurs when sender and receiver coactivate the representation of the shared interaction (Molnar-Szakacs, Overy, 2006). Which again supports the hypothesis of a shared neural substrate for the processing of language and music.

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Empathy

Defined as adopting the feelings of others to understand their thoughts and feelings (Davis, 1980), empathy is one of the more sophisticated or higher level aspects of the functions of human emotionality. It allows us to relate to other peoples experiences even if we haven’t experienced them. Empathy allows us to form deeper connections with the people around us. However empathy as a function of the human brain goes beyond walking a mile in someone else’s shoes so we can understand their pain. Researchers theorize that empathy is at the basis of essentially every interaction a human has with another human. This is believed to be because of the connection between regions responsible for processing visual stimuli and regions that process emotion, more specifically the prefrontal cortex and the insula (26). The relationship between these two regions explains how humans use mirror neurons to process action representation and the intentions of the sender. This also explains why mirror neuron dysfunction is believed to be at the root of Autism Spectrum Disorders (ASD) and other developmental disorders that affect self-other discrimination. Deficits in empathy can have a wide array of effects on an individual, especially in social settings. If someone’s ability to connect with others is impaired, they can experience repeated patterns of rejection that could lead to serious isolation. They may experience symptoms of loneliness which can lead to anxiety and depression. There are a number of developmental disorders that affect empathy in different ways, however, the most well known disorders that causes impairments in social functioning are Autism Spectrum Disorders including Aspergers. A study done on the activity of mirror neurons in children with ASD showed that children with ASD have significant impairment of mirror neuron regions. Researchers used an fMRI to investigate neural activity during the observation and imitation of facial expressions (Dapretto, M., Davies, M. S., Pfeifer, J. H., Scott, A. A., Sigman, M., Bookheimer, S. Y., & Iacoboni, M. 2005). They collected data from a sample of 10 typically developed males and a sample of 10 high functioning ASD males. The results showed that the typically developing children used the presumed neural pathways mentioned in other sections to interpret and imitate the facial expression while the ASD males showed no activity in the mirror neurons. The researchers observed activation in visual cortices (including the fusiform gyrus), premotor and motor regions of the face and the amygdala, indicating that the participants indeed attended to the stimuli and attempted to imitate the expression (Dapretto, M., Davies, M. S., Pfeifer, J. H., Scott, A. A., Sigman, M., Bookheimer, S. Y., & Iacoboni, M. (2005).

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All Together Now

As previously explained, the complex cognitive effects that music has on the brain are so powerful due to the coactivation of different regions. These properties allow us to speculate that music can be a valuable tool for restorative therapies. Researchers have found that by using the MNS as a basis for understanding how communicative signals are perceived, they are able to improve people’s ability in language using various forms of imitative therapies. For example, researchers found that music lessons can improve language ability in children with dyslexia. “The proposal of a common neural substrate for music, language and motor functions is supported by evidence from studies of language disorders. For example, it has been shown that children with dyslexia exhibit specific timing difficulties in the domain of music (Overy et al., 2003), motor control (Fawcett and Nicolson, 1995; Wolff, 2002) and language (Tallal et al., 1993; Goswami et al., 2002) and that music lessons with dyslexic children can lead to improvements in language skills (Overy, 2003)”. To put it simply, patients with damage to one region of the brain can improve functioning in that region with a therapy that uses the activation of the MNS to strengthen the damaged region. In a different study, researchers found that patients with severe non-fluent aphasia due to damage to the Broca’s area showed significant speech improvement using Melodic Intonation Therapy (MIT), an imitative speech therapy that involves singing. “The success of music/speech therapy methods such as MIT might thus be due… to the fact that their imitative elements involve a direct transfer of sensory information to a motor plan, leading to a strong recruitment and co-activation of brain regions involved in the perception and production of both music and language” (Molnar-Szakacs, Overy, 2006). Furthermore, recent research also implicates Broca’s area in the functions of perceiving and understanding hierarchically organized information, i.e. music and language (Molnar-Szakacs, Overy, 2006). On the basis of this research, playing musical games that engage the mirror neurons with imitation will improve empathy which will improve social functioning.

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Workshop

The workshop is going to use a variety of musical games and activities created with the goal of activating mirror neurons and displaying the relationship between music and empathy. The first activity we would do would be a simple drum circle to wake up the mirror neurons and get the group acclimated with one another. Once everyone is warmed up and on the same page. We are going around in a circle and clap a simple 332 Caribbean rhythm in unison. First the group claps the rhythm together to make sure everyone has the timing down. Then everyone provides a back beat while going around the circle each player then takes a turn clapping a solo for two bars. The goal is to go all the way around the circle transitioning seamlessly from one person to the next and making it all the way back to the person we started with. Next we would play a call and response drum game where participants would pair up and sit across from each other and take turns clapping or banging on the table leading and following. The leader plays a beat and the follower repeats it. Copying the leaders movements and repeating the sounds will have a similar effect on the mirror neurons as MIT. The next step to the activity is an emotion guessing game. There will be a stack of cards labeled with different emotions such as ‘excited’ or ‘scared’. The first player picks a card and claps a pattern that he/she thinks represents the emotion. The other player repeats the pattern then tries to guess what emotion they were trying to display.

My target audience will be people that are looking to improve the way they relate and interact with others, maybe they feel that they have had trouble connecting with other people so they want to improve their empathy centers. They may feel like their relationships are lacking and they want to feel more connected to the people around them. There are a lot of different neurological and developmental disorders that can affect people’s ability to understand and process the emotions or facial expressions of others. The activities in this workshop will help improve people’s social functioning, which will help with their overall level of happiness.

My key stakeholders are professionals that work in the field of helping people in therapeutic environments. Workshops like this could be beneficial to anyone that struggles in the various areas that contribute to problems connecting with others and forming relationships. This could be anything from a students in a special ed classroom using the activities to help kids with learning disabilities like ADHD or dyslexia to different organizations that work with adults reintegrating into society like a prison reintegration program. Programs that work with teenagers like Spectrum or an organization that works with adults like the Howard Center could integrate this workshop into their all ages curriculum. I would say that the goal of most therapeutic programs is to teach empathy in one way or another therefore basically any program could benefit from the information in this literature review. The games outlined will be engaging enough that they would work with any population at any age. For research I reached out to several therapists I worked with while I was in therapeutic boarding school as a teenager. The school specializes in helping angsty teenagers with learning disabilities change the way they relate to the world around them. By employing several different therapeutic techniques, they create a safe environment that fosters emotional growth and personal strength. To say that I wouldn’t be who I am today if I hadn’t put the work in there is an absolute understatement. I skyped with Mario Duran and Heather Tracy, who are two of the four owners of the school. Mario is the head therapist and director of the other case managers and Heather handles more of the finances and educational aspect. To be honest I don’t know what Heather’s exact job is other than owner and director but everyone is afraid of her. They both have PhD’s and since they opened New Summit Academy in 2006 they have helped hundreds of teenagers turn their lives around. To say these two are anything but experts would be another massive understatement. After explaining my background research I asked them if they thought a workshop like this would be beneficial and if they thought their students would participate. They answered with a resounding yes and offered to put together a focus group of students to try some of the games out on. Audience feedback

Heather made some really interesting suggestions about other directions I could go with the workshop. She suggested using the activities as experiential exercises in schools as team building workshops. She brought up how people use rope and outdoor adventure courses to build teamwork and this could be a good alternative for handicapped kids. She also said that because the games would work so well for early childhood, they would be perfect for helping kids with learning disabilities at a young age. She also suggested having different levels to the workshops by age or musical ability. She was really intrigued by the empathy aspect and how these games work so well for getting people in sync with each other in a group setting. She also brought up how games like guitar hero and rock band have a similar concept and could be adapted as a more high tech version of the activities.

One of my external experts is Eric Sample. He is a professor in the Sonic Arts division at Champlain and has a great understanding of rhythm and music. He also does activities like these in his classes so he has lots of experience leading these activities. Eric is also very entertaining and high energy so he would be great at helping engage people that have trouble coming out of their shell.

One of my core professors is Erik Esckilsen because of his interest in music. My other core professor is Steve Wehmeyer because of his interest and experience in native drumming.

There have been several similar workshops at Champlain that are based around the relationship between music and cognition. For Professor Colombo’s healthy aging class I ran a couple workshops with another student that focused on the relationship between music and memory. I know that Professor Colombo has also run other workshops on campus about music and emotion. While my workshop will probably be similar to those other workshops, mine is going to be unique because of its focus on music and empathy as a tool for better understanding social interactions.

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