Wieser, Heinz Gregor, and Roland Walter. “Untroubled musical judgement of a performing organist during early epileptic seizure of the right temporal lobe.” Neuropsychologia 35 (1996): 45-51.

Summary:
This article described the case of a professional organist with right temporal lobe epilepsy who experienced a seizure in the middle of performing an organ recital. He habitually recorded his own performances, and so the resultant tape was compared to both the original score and his own other presentations of the same work. The analysis of the section affected by the seizure showed that early in the event, the right hand continued playing as normal while the left began to deviate from the notated rhythm. As the seizure continued, the material played by both hands increasingly departed from the score but the right hand managed to improvise and cover the errors in the left in a musical way. The tempo remained steady throughout. Once the seizure progressed to a certain point, the organist stopped playing and was unresponsive for 5 minutes but then recovered and continued the performance.

Reflection:
I was absolutely astounded to read this article. This particular case illustrates for me just how resilient the human brain can be and how impressive are its adaptive capabilities. That the organist managed to continue to perform while experiencing the early part of a seizure is incredible. Not only did he carry on, but his brain went a step beyond and improvised solutions to the errors so that his playing remained musically meaningful.

The authors of this article presented a section of the score of the original piece along with a notated copy of the version played during the seizure. It was fascinating to compare the two and see exactly where and how they differed. I must admit, I would have liked to have the opportunity to hear the taped performance, to get a sense of the details that can not be described through notation.

I feel that this case is very useful for its demonstration that musicians can still continue to perform even while suffering with very serious conditions. It seems like it could offer some measure of hope. The clinical history section of the article included the information that the musician, although he had to undergo several surgeries, continued working as an organist and conductor.

This case also points to one important aspect of our musical training, the ability to continue playing no matter what occurs. Even through errors, we must keep our minds moving forward rather than dwelling on what has just happened. My musical education began in a children’s choir where we were taught about the “performance situation”. Our conductor could simply say those words and we knew to stand up straight, smile, and perform with no stopping. It is true that the organist in this situation did eventually end up interrupting the piece, but he clearly continued as far as he possibly could.

It could be said that a great part of his success in playing through the seizure was due to his skill at improvisation. I believe that organists tend to receive a fair amount of this type of training. It makes me wonder whether he would have been as successful in continuing a musically meaningful performance without this degree of knowledge. Would a musician with little experience of improvisation be able to do as well? I assume a non-musicians’ brain would be similarly able to continue doing the activity it was programmed to do through years of training?

Hearing With Our Skin

Reference
Storrs, C. (2009, November 26). People Hear With Their Skin, As Well As Their Ears. Scientific American. Retrieved from http://www.scientificamerican.com

Summary
A recent study by Bryan Gick and Donald Derrick from the Department of Linguistics at UBC shows that very small puffs of air directed at participants' hand, neck, or ear, contributed to their accurate hearing of the syllables "pa" and "ta." These puffs were equivalent to the air released when these sounds are verbally made. Without the puffs of air, "pa" was heard as "ba" and "da" was mistaken for "ta" 30 to 40% of the time. Accuracy increased by 10 to 20% when air puffs corresponding to these syllables were sent over their skin. There was no improvement with air sent to the ear.

For tests with the sounds "ba" and "da" that were accompanied by puffs corresponding to "pa" and "ta", participants' accuracy decreased by about 10%, compared with their accuracy without any puffs of air at all.

Gick explained that when we speak, the tiny puffs of air released help us distinguish sounds. A windy day can even stop us from hearing accurately.

Reflection
Though this article didn't pertain to music specifically, it did make me wonder about how we might perceive live music as compared to recorded music. Anecdotally, many people seem to enjoy concerts more than sound recordings. It's possible that the visual spectacle contributes to this preference, but even in more intimate venues, without flash and glamour, many still enjoy the live setting in a very different way.

This study makes me wonder if emotions in music might be more potently felt when heard in a concert hall, small club, outdoor setting, etc. This also means that if there are any disruptions to the air in the environment---in a crowded room, a smoky bar, etc.---audiences would respond in a variety of ways.

If music can be heard differently through our skin, I wonder how performers might be able to manipulate the environment in order to heighten particular emotional effects of their sound. What types of challenging messages might be sent if air that "contradicts" the content of music is channeled to listeners? What might happen in silences within a piece (while our brain processes the music that came before) by "playing" on our skin?

BBC Article, Tuesday March 24th, 2009

“Music Therapy ‘Restores Vision’”

http://news.bbc.co.uk/2/hi/health/7959732.stm

Summary: Research in the United Kingdom suggests that listening to “pleasant” music could help restore impaired vision in stroke patients. A common side effect of stroke patients known as “visual neglect” is a development of impaired visual awareness. This can happen in up to 60% of stroke patients. They lose the ability to track objects in their visual field on the opposite side of where their brain has been damaged by the stroke.

Recent research suggests that music may help reduce this problem. Dr. David Soto of the Imperial College of London suggests that “Music appears to improve awareness because of its positive emotional effect on the patient, so similar beneficial effects may also be gained by making the patient happy in other ways”.

Visual Neglect is caused by damage to areas of the brain critical to the integration of vision, attention and action. Interestingly, this condition is not related to areas of the brain responsible for sight. Extreme cases of visual neglect may lead to patients only shaving half of their face, or restricting other activity like eating to one side.

A recent study conducted at the National Academy of Sciences involved three patients who had lost awareness of half of their field of vision. The study consisted of completing tasks under three conditions: 1) while listening to music they liked, 2) while listening to music they didn’t like and 3) while in silence. Results showed that all three patients could identify colored shapes and red lights in their depleted side of vision much more accurately while they were listening to music of their choice. Researchers believe that “pleasant” (music that the client likes) generates positive emotions which may in fact help to produce more efficient brain signaling, which in turn increases its capacity to process stimuli. Brain scans have confirmed that listening to enjoyable music activates areas which are linked to positive emotional responses. Not only does this research point towards the neurological benefits of music, it indicates that a positive emotional state can help a stroke survivor suffering from visual neglect.

Reflection: It seems as though all the benefits of music are far from being discovered. Music therapy in all its forms proves a powerful tool in an extremely wide variety of situations. It seems as though there are several assumptions running through this article; the term “pleasant” music is problematic for me, as it has not been properly defined. Naturally, the notion of “pleasant” music is hugely individualistic, but what of people who do not find music pleasant? Furthermore, does “pleasant” music necessarily, by definition put the listener in a pleasant mood? What if the listener’s music of choice is provocative and anger-inducing? This may be preferable to some who find this style of music cathartic. Can this kind of music be classified as pleasant? The definition of “pleasant music” was not entirely clear.

I find new research on the benefits of music very exciting, and I wonder how far stroke recovery can go with regards to music therapy. If music can encourage the brain’s capacity to process stimuli, could it have kinesthetic, speech or other functional benefits? Research says yes. Evidence is very strong that people who suffer from Parkinson’s disease move with greater ease when specific music is played. Furthermore, people who undergo melodic intonation therapy have reaped many benefits. I have a lot of questions related to the study, as it was not explained in detail. I wonder about the population tested. One would assume that the research participants were in the general age range of people who suffer from strokes, but it is a wide range. I also wonder what tasks the participants were required to perform. It seems they were asked to identify colored shapes and red lights, but I wonder if the shapes and lights were static, or if they were moving, and whether this would make a difference with regards to the rhythmic content of the music they were listening to. Also, it would be interesting to find out whether the participants were merely happier as a result of listening to so-called “pleasant music”, thus their brain activity was stimulated, or whether there was something inherent within the music (be it timbre, pitch, rhythm, harmony etc.) that significantly affected their performance.

Musical Expectation and the Brain

Reference



This event, called Notes & Neurons: In Search of the Common Chorus looked at cultural similarities and differences in our understanding of music. They discussed pitch, intervals, timbre, rhythm, etc. as universal elements of music. However, the way we employ these stylistically and interpret its combinations varies depending on preset associations in our brain.

What struck me most when I first saw this video is the ease with which a general audience can grasp the pentatonic scale. Now, it's not a terribly hard scale, but it shows how quickly expectation is created. Soon, Bobby McFerrin can have the audience sing while he "conducts" and they fill in the notes with ease. It's hard to say whether the audience came from musically diverse backgrounds, but quite possibly, most of them grew up in the western music tradition. I wonder how easily other cultures might grasp this scale---perhaps its wide use in a variety of cultures ensures that there is something "universal" about it. More likely, though, is that there is a universal capacity to be enculturated.

I have a beginner-level piano student who has just learned "Engine, Engine" on the black keys. I asked her to make up a song on the black keys, and after playing it she said, "That sounds more asian." This is a student who doesn't listen to much music at home, and has somehow, through our culture, made this association.

To be honest, I am quite simply amazed at how the brain forges pathways of thought. This can be advantageous in that a receptive mind can be taught quickly. But the potential for a stubborn mind also exists. Defying expectation can lead to further learning and expansion of the mind. I'm curious to know what happens in a brain that rejects anything other than what it expects.

Vocal Psychotherapy: A fine balance of objectivity and subjectivity

A Summary and Review of a Vocal Psychotherapy presentation at the 2009 CAMT (Canadian Association for Music Therapy) 35th Annual Conference, May 6-9, 2009.

Summary: Earlier this year, I attended the CAMT Annual Conference, a gathering of many of Canada’s music therapy practitioners, researchers, teachers, interns and students. The conference consisted of many different events including workshops, lectures, poster presentations, ceremonies, video screenings and motivational speakers. The various facets of the conference offered opportunities for everyone (including people like me with little to no experience in formal music therapy) an opportunity for learning and growth. The presentations covered an incredibly broad range of subjects including stories from the palliative care patient’s beside to bringing the practice of music and cognition together to medical music therapy and the development of a clinical approach for people receiving hemodialysis. Several were particularly moving, including one of Dr. Diane Austin's talks.

Dr. Diane Austin, a music psychotherapist, founder of The Music Psychotherapy Center in New York and teacher at New York University gave a beautiful and brilliant presentation on vocal psychotherapy titled “When words sing and music speaks”. Her talk consisted of several anecdotes of patients she has worked with, and their journeys towards recovery. Using psychotherapeutic principles in combination with music and songwriting, such as free association to access the subconscious through writing lyrics and singing them, Dr. Austin was successfully able to help many clients open up about repressed feelings, and helped them solve unresolved issues. Dr. Austin discussed the principles of vocal psychotherapy including “free associative singing”, a technique that can be implemented when words enter the vocal holding process. It is closely linked to Freud’s technique of free association, however it differs in that the client is singing and not speaking. Furthermore, the therapist is also singing and adding to the client’s musical stream of consciousness. There is frequently a repetitive riff-like accompaniment which the therapist provides that serves as a backdrop to both the client’s and therapist’s voices. The music provides a sense of forward momentum as the client sings words, phrases, etc. Often, the therapist begins by repeating a word or phrase which the client sings, and often adds layers such as harmony, alternative rhythms, and other forms of variation. The repetition is meant to create and facilitate a safe environment in which the client feels comfortable expanding their vocal ideas. This practice is deeply rooted in psychotherapy practices involving the unconscious and is often used for clients who have suffered from trauma. Many music therapy practices are often employed when working with trauma sufferers, and has been shown to have astounding healing effects. I know of many case studies along these lines, but nothing was quite as powerful as when Dr. Austin played a tape of a session with one of her clients who was struggling with overcoming sexual abuse in her childhood. This client was a woman of about 45, and the session we heard was one of many that Dr. Austin had done with her. The dynamic between the client and Dr. Austin began very simply and steadily, and gradually increased to an intense, loud, emotional and rich musical expression of a childhood destroyed. Both client and therapist were singing with such power and expression that it almost sounded pre-scripted, although there was a sense of spontaneity and improvisation, since that is exactly what was happening. It was a beautiful expression of the power of music to unlock facets of the mind that may have otherwise been unaccessible.

Reflection: Although I have been witnessing and hearing about the incredible effects of music for a while now, I never cease to be astounded at the impact that music therapy can have. Almost every person sitting and listening to Dr. Austin’s client express herself through song wound up in tears. Something I have perpetually struggled with as an aspiring music therapist is the ability to engage clients in such intensely emotional work, but remain a somewhat objective participant. How can music therapists not become emotionally engaged and moved by the process? It seems to me that music therapists, as well as many other healthcare professionals have the responsibility of balancing their objectivity with a sensitive subjectivity necessary for the client feel a sense of mutual trust. I assume that in order for a client to be able to open up and share a part of themselves, they need to feel as though what they are offering their therapist does not fall on unfeeling ears. To me, empathy is such a huge part of the client/therapist relationship, however too much can be unproductive and even harmful. This is where objectivity comes in. In order for the therapist to be able to offer perspective and guide the healing process, they need to be somewhat cognitively stable, and they need to anticipate further action that would benefit the client. How can this role be fulfilled if the therapist is too emotionally engaged? Furthermore, the therapist has the responsibility to reign in a client, particularly with free associative singing if the client feels out of control (which is sometimes the case). Naturally, these questions and concerns are dealt with by therapists on a daily basis, and the training they undergo allows for, anticipates and provides coping mechanisms for these situations. Still, it seems to me to be a fine balance.

Another particularly interesting and common occurrence is countertransference, a Freudian concept which involves the therapist’s emotional entanglement with the client’s emotions. It can have several different meanings and facets, and can be hugely problematic if not dealt with. Although I do not know the extent to which counter-transference can go, I do know that it needs to be recognized and dealt with, or else it can have intensely difficult consequences. Closely related is the notion of the “wounded healer”, a Jungian term which refers to a therapist (or psychoanalyst) finding that a patient’s wounds activates their own. It is closely connected to countertransference and can also be potentially dangerous, as it can adversely affect the patient’s healing process and the therapist’s well-being. Dr. Austin discusses being a “wounded healer’ herself, yet she approaches it in a positive light in that she is very open about the various affects of her own childhood trauma and how she deals with it in light of the work she does with her clients.

On the whole, vocal psychotherapy has proven to be beneficial in many ways. It raises many issues regarding the therapist/client relationship and can be intensely emotional, however I do believe that the fine balance of therapist objectivity/subjectivity can be achieved.

Is My Brain Getting Too Big For My Skull?

Music and Brain Blog #2
Brian Graiser

Music of the mind, BBC News Online (Health), May 8 2001. http://news.bbc.co.uk/2/hi/health/1319753.stm

Synopsis: Significant evidence has been discovered through brain scanning that the brains of musicians may be physically altered by years of practice. Presented at the 2001 American Academy of Neurology meeting in Philadelphia, this research shows that certain regions of musicians’ brains are packed with a greater number of cells than those of an average person. In a study of 15 musicians and 15 non-musicians, German Professor Gottfried Schlaug used MRI scans to observe the size discrepancies in at least four regions of the brain, including those which process auditory cues and those which control physical responses to visual stimuli. However, at the time of the study it was unclear if this extra brain mass is a result of years of musical training, or if it is a pre-existing condition that routinely pre-disposes people towards pursuing musical careers. According to Professor Schlaug, “additional study is necessary to confirm causal relationships between intense motor training for a long period of time and structural changes in motor and non-motor related brain regions. An alternative explanation may be that these musicians were born with these differences, which may draw them towards their musical gifts."
In a similar study which seems to promote the notion of reshaping the brain, researchers from University College London (UK) scanned the brains of taxi drivers, and found that they had a larger hippocampus (associated with navigation in animals and birds) than average. Furthermore, the researchers noted a correlation between hippocampus size and career length; those who had been taxi drivers the longest had the largest hippocampi. However, according to Dr. Eleanor Maguire (who led the UK research team), it was unknown at the time whether such changes could occur in other areas of the cortex, or only in the hippocampus (thereby neither confirming nor denying the possibility of years of music practice physically altering the brain).

Reflection: It’s important to note that this article is from 2001; following today’s thinking on brain plasticity and development, it seems more apparent that music practice did, in fact, affect the brain (and not the other way around). Based on different recurring personality types one encounters at the average music school, I’d say it’s a safe bet that there are certain psychological and neurological conditions that pre-dispose people towards musical careers. However, the notion that years of practicing music can change the size and shape of my brain is particularly intriguing.
Given how physical percussion performance can be, I’ve long since learned to trust my brain when I practice, in the sense that if I will my muscles to perform a certain task over and over, eventually that motion will be ingrained in my muscle memory so that I don’t need to consciously think about every motion. However, it seems strange to me to equate the thousands upon thousands of such memorized mental commands with added physical mass in my brain. After all, during his autopsy it was found that Albert Einstein’s brain was physically average in size and weight; surely, if thought leads to added brain bulk, wouldn’t Einstein’s brain have to be huge?
I suspect the answer to this problem lies in the nature of what we consider brain plasticity. Rather than simply adding mass to parts of the brain, plasticity would instead reassign certain parts of the brain to tasks other than those for which they were originally intended. I would be interested in finding out if the researchers in this article were able to determine which regions of the brain had “loaned” their mass, or if they had even considered this. On that note, I would also be interested in finding out what, if any, quantifiable relationship there is between mental activity and the amount of mass “reassigned” through brain plasticity; how many years would I have to practice (or drive a cab) in order to add 15 milligrams of mass to my cortex? In extreme cases, could this redistribution of mass theoretically lead to headaches or other physiological problems? Is there a limit to how much of my brain that can be reassigned? Food for thought, to be sure.

Arts Training & Cognition

Reference
How Arts Training Influences Cognition
By Michael Posner, Ph.D., Mary K. Rothbart, Ph.D., Brad E. Sheese, Ph.D., and Jessica Kieras, Ph.D., University of Oregon
http://www.dana.org/news/publications/detail.aspx?id=10762

Summary
The authors of the study sought to examine how arts training can improve cognition via attention mechanisms in the brain. They hypothesized that executive attentional areas of the brain can be improved through specific training. Enthusiasm for the arts, including music, might allow children to pay closer attention to artistic pursuits. This enthusiasm may therefore lead to improved motivation, allowing for better attention, and therefore cognitive improvement.

Surveys with adults showed that interest in a particular art correlated with actual engagement in the art. A general openness towards the arts led to an appreciation for the arts (except dance, which it seems the survey did not define well as some took it to refer to dancing that happens socially, rather than as a performance art).

Tests on children showed that motivation (by means of a reward or through knowing how they did on a task) leads to better performance on tasks, especially when the motivation is sustained for longer periods. They stated that “findings support the idea that interest in the arts allows for sustained attention, providing an increased opportunity for the training to be effective”, though the way the study specifically supports this is unclear. By their own admission, “[t]he link between arts training and motivation, though plausible, remains speculative, and needs to be tested through experimental research.” Nonetheless, the idea is that if children are open to and interested in the arts, then they are likely to be motivated to pursue that art and to sustain attention through artistic activities.

The researchers also used attention training to examine the executive attentional network (midline and lateral frontal areas) in the brain, which is engaged in self-regulation of cognition and emotion. The aim of this training, which was related to emotion and cognition regulation, was to see if it improves cognition. The exercises were designed to be interesting and motivating. EEG results showed that the training did improve the function of the executive attentional network in resolving conflict. The network in these children (6-year-olds) resembled that of adults. These children also scored better on intelligence tests.

Not all children benefited from the attention training. Genetic differences seem dependent on the form of a dopamine transmitter gene present in the child. The researchers involved in this study are therefore continuing research in genetics to determine whether certain genes lead to interest in the arts, and to greater attention.

Reflection
The ability to sustain attention is usually a characteristic teachers long to find and further develop in their students. Often, we associate attention or focus with learning, or at least the increased possibility of it. Teaching very young children has certainly posed many challenges for me and I continually seek ways to attract their attention.

Unfortunately, this article did not specify the tasks involved in the attention training given to children. The researchers assume that interest creates motivation and sustained attention, but do not explain how the latter can be improved by certain activities. In this study, the attention tasks used seem to be related to conflict tasks, though it is not very clear. In the introduction, they state that the training consisted of conflict resolution training, but their outline of the actual study conflates the details of the tasks, making it difficult to give a clear summary. They say that the conflict-resolution tasks were interesting in the way they “assume arts training to be for children with the appropriate interests.” It would have been helpful to know what caught the children’s interests.

I also noticed that this study used training exercises that were not artistic, but it nonetheless claims that artistic training likely improves attention and that this would translate to improved overall cognition. Supporting the hypothesis about the link between the arts and cognition without using artistic tasks leaves me wanting further direct explanation.

From my own experience, it does seem that musical training instills a sense of focus and perseverance that is linked to motivation. The physical and mental training involved in acquiring skills of musicianship require patience, and continued practice may train the executive attentional networks of the brain in the way any continued exercise reinforces neuronal pathways in the brain. I continue to wonder how to train these networks, though. I find that studies on attention as it relates to music frequently claim that music study improves attention but the “how” question has not been answered in any study I’ve come across. I think many teachers would benefit from knowing the types of activities that train students to focus.