Haslam D. When music is the best therapy. Practitioner July/August 2022;266(1860):31
When music is the best therapy
27 Jul 2022
AUTHORS
Professor Sir David Haslam CBE FRCGP, Past Chair NICE, Past President BMA, Past President RCGP
Article
I doubt if there has been a day in my adult life when I haven’t listened to music.
Music has always been important to me, despite my astonishing inability to master the instruments that I keep collecting.
For most of us music is not an optional extra. When you’re low, it can lift you. When you’re happy, it can take you higher. It goes to the places that words cannot reach, to the emotions that colour all our lives.
There is increasing scientific evidence that music can have a profound impact on our mental health.
The great neurologist and author Oliver Sacks once put it perfectly. ‘Music can lift us out of depression or move us to tears – it is a remedy, a tonic, orange juice for the ear. But for many of my neurological patients, music is even more – it can provide access, even when no medication can, to movement, to speech, to life. For them, music is not a luxury, but a necessity.’
Music can have a remarkably profound impact on our emotions. Which of us has not experienced a tingle down the spine when hearing a piece of music that really moves us?
I’ve always been fascinated by the existence of spinal tingles.
The physiology mystifies me, the evolutionary benefit puzzles me, but the near universality of the experience across every culture means that tingles must have evolved for a reason.
Some pieces of music elicit the tingle because they evoke a specific memory. However, sometimes a tingle can occur with a piece of music you’ve never heard before – particularly when triggered by a variety of chord progressions or harmonies.
Music can also have powerful psychological properties. A few years ago, when I was in the middle of a lengthy course of radiotherapy and chemotherapy I suffered from the most appalling nausea and resulting insomnia.
I found that none of the powerful antiemetic drugs and sedatives had much effect in the middle of those long and tedious nights.
However, the right choice of soft music, often played on repeat, had much greater success in calming and soothing me. The albums of the wonderful Northern Irish folk singer Cara Dillon were particularly effective and became a major part of my therapy, and of real importance in my recovery.
Indeed, there is increasing evidence of the impact of music on endorphins, on serotonin, on dopamine. Music is a therapy that has few side-effects, and low risk from overdose.
A very long way back when I was a medical student, one of my musical heroes was the disc jockey John Peel. Sadly, John died some years ago. He morphed from a hippy DJ to a Radio Four national treasure. Back in my student days his radio show introduced me to the most extraordinary variety of music and musical genres that I would otherwise never have discovered.
He wouldn’t think twice about playing didgeridoo music recorded deep in rural Australia, followed by the earliest of blues recordings from America’s Deep South, a Scott Joplin rag, folk music from the annals of the English Folk Dance and Song Society….
He would often say, after a particularly engaging piece of music: ‘Ooh, that was so good, it should be made available on the NHS.’
He was right.

