Have you ever been so emotionally moved by a musical performance, live or recorded or one that you are performing?  Have you ever wondered how these sounds have an impact on your health?  To address how music effects our health and how music can be used to heal us, we spoke with Dr. Dale Taylor, a friend of Mobilized News and a frequent guest on our various television and radio shows in the past.

Dr. Dale Taylor, PhD, MT-BC is a music therapist, educator, author, and Professor Emeritus at the University of Wisconsin–Eau Claire. He is known for developing the Biomedical Theory of Music Therapy and writing Biomedical Foundations of Music as Therapy. He founded UW–Eau Claire’s Bachelor of Music Therapy program and served as chair of its Department of Allied Health Professions.

He has also served in public health and aging-related roles, including the Wisconsin Board on Aging and Long Term Care, the Wisconsin Music and Memory Initiative advisory board, and public health planning efforts in Wisconsin

You have spent much of your career showing that music is not just entertainment, but a biological force. What do you most wish the public understood about how music acts on the brain?

I most wish that the public understood that effects of music on the brain are profound and are still being investigated and developed by professional music therapists and neuroscientists. It is imperative that, in order to achieve desirable outcomes without causing harm to client emotional, cognitive and executive capabilities, a certified music therapist using procedures verified through controlled peer reviewed research should be the one administering therapeutic applications of music.

Music therapy interventions and evaluations must not be entrusted to just any volunteer, relative or friend who happens to want to help.

Your work helped advance the idea that music can stimulate changes in neural patterning. How does music therapy help the brain reorganize, recover, or reconnect after injury, trauma, or illness?

My original work in this area involved development and presentation of a theory of how the traumatically injured brain recovers lost functions when musically active but recovers to a much lesser degree when music is not involved. My presentation of this theory at a 1985 international conference in New York City was very well received and included the term “functional plasticity” as my title for the theory.

Although subsequent research that tested the theory did not confirm my hypothesis, it led to discovery of what in Europe was originally called “dendritic connections” while in America the term “plasticity” was retained in describing the cranial process known worldwide today as “Neuroplasticity” or “Neural Plasticity,” terms that did not appear in neuroscience literature prior to the summer of 1985.

Continued research confirms that music activates all parts of the brain thereby stimulating the neuroplasticity process which involves forming new neural connections to replace damaged or lost synaptic circuitry thus allowing the brain to reorganize and recover lost functions.

For people who hear the phrase “music therapy” and think it simply means playing calming music, what is the deeper science behind the practice?

It is understandable that the public reacts in terms of stereotypical images seen through the media in which people who have lost touch with reality are portrayed as screaming, destroying things around them, and endangering others.

In those scenes, the immediate response of caretakers is to do anything to calm them down which usually involves physical restraint, medications, or both.

However, the reality for anyone working with people suffering from illnesses such as clinical depression or psychosis is that most patients are too calm as they are unable to respond effectively to people and environmental stimuli around them in ways that would satisfy their own needs.

Because members of the public experience for themselves the calming effects of music, they react according to what is familiar and assign to music therapy the only “therapeutic” effect that they know which is to calm people down. This also leads to the erroneous belief that anyone who can produce calming music can function as a therapist.

However, the reality of “music therapy” practice involves detailed assessment of the musical and nonmusical capabilities, preferences and limitations of individual clients, formulation of a treatment plan based on knowledge of exactly how a specific kind of musical activity affects the part of the brain that needs to improve its function in order for the client to reach targeted behavioral objectives, and active implementation of that plan while continuing to track progress. Herein resides the importance of knowledge of the scientific basis of music therapy.

One must know that the illnesses and disabilities treated with music therapy are all due to abnormal brain perceptions, processing or production of coping strategies needed to survive and function in the world. In many cases, the goal is to activate, not calm, the person to improve their ability to respond to immediate and real environmental stimuli, make decisions, meet one’s needs, adjust to changes, and interact with others while exhibiting appropriate and effective social skills, physical capabilities, emotional responses, and both verbal and nonverbal communication.

You developed a biomedical approach to music therapy that connects music, brain function, and measurable therapeutic outcomes. How did this theory change the field?

Changes to the field of music therapy were clearly ready and waiting to happen even before I introduced my thoughts and conclusions about the neuroscientific basis of music therapy.

After the first verbal presentation of my biomedical theory of music therapy, word circulated that I was writing a book introducing our field to the neurobiological effects of music in therapy and I began to receive multiple resources from individuals and groups whose research indicated predictable changes in brain activity in response to music.

As people sent me their papers and chapters or handed me their theses and dissertations at conferences, it became clear that many had been searching for ways to determine how these effects contributed to the therapeutic power of music. Also, prior to its writing, I received requests for translated versions of the book from music therapy organizations in other countries.

Version 1.0.0

Since publication of the first edition of Biomedical Foundations of Music as Therapy, numerous practitioners have related to me how their ability to ground their practices in scientifically verifiable data has changed their professional lives. They report affective changes and greater respect from people whom they encounter as potential clients, prospective employers, referring agents, and professional colleagues eager to hear their explanation of how “music therapy” works.

The biomedical understanding of music therapy is now utilized and available throughout the Spanish speaking world of music therapy through translations of the 1997 first edition by the medical and music therapy faculty at the National University of Colombia in Bogota and the 2010 second edition by the Faculty of Medicine of the University of Buenos Aires in Argentina.

New theories and approaches to music therapy have appeared based on the neuroscience of music, numerous practitioners and educators have returned to school to earn doctorates in neuroscience, national and international organizations have appeared focused on music in medicine, academic curricula and credentialing literature have been modified to include the biomedical approach, and new interventions have been developed for the NICU and for neurodiverse clients based on the effects of music on brain functioning.

What happens in the brain when rhythm, melody, harmony, memory, emotion, and movement work together? Why is music such a powerful whole-system experience?

The brain is physically compartmentalized to handle specific tasks in separate neural clusters. For example, sound perception, visual reception and motor behavior each are processed in three separate and distinct areas of the cortex.

While neuroscientists who study music have not as yet determined the specific areas devoted to processing each musical element, it is widely known and accepted that musical experience is processed in many cranial locations at the same time.

This is necessitated by the very nature of music itself, which consists of numerous types of stimuli with multiple characteristics such as those listed in the question, all of which are processed at once.

This multiplicity of simultaneous processing tasks necessitates all parts of the brain working together to understand, perceive, produce, remember and recall musical experiences. Herein lies the powerful advantage of music as a therapeutic intervention:

Because music requires whole brain processing, it does not matter what type of abnormal functioning is exhibited by any specific client due to an ill or injured area of that person’s brain. Therefore, musical interventions can be designed to activate and reorganize how that area functions and to simultaneously coordinate its activity with all other parts of the brain.

Mobilized News focuses on imagination in action. How can music help people imagine new possibilities when they are stuck in fear, pain, depression, isolation, or cognitive decline?

The human brain can become so fixated on thoughts about past issues, losses or ongoing threats to one’s well-being that the person loses the ability to think effectively about how to respond to the needs of everyday life. When a person’s functioning level reaches that stage, clinical interventions often are needed to help the brain refocus on meeting the demands of their current reality at the present time.

Because both passive and active musical participation require all parts of the brain to be actively engaged with the many varied components of music, the person must immediately switch their thinking over to the continuous momentary progressions of musical stimuli.

Once refocused, the music can be manipulated by the therapist to stimulate thoughts of new possibilities, new combinations of phenomena, and creative new ways to resolve or proceed with a series of events. This therapeutic application of music is very nonthreatening since the music can be selected to not include words that could contradict the client’s familiar world view or the therapist may determine ways to allow the client to select words or create musical progressions that suggest new options.

We live in a time of loneliness, stress, disconnection, and information overload. Could music therapy become part of a larger public health strategy, not just a clinical intervention?

Music therapy has often been used to help groups within a community as well as to assist the public at large, especially when there is a need to overcome a public catastrophe such as a weather disaster, act of war, or other human activity resulting in destruction of property and/or multiple loss of life.

In such cases, music therapists use the power of music to help people experience their collective consciousness while reminding them of their societal strengths and traditions.

Songs are chosen which also reveal cultural ideals of a better more prosperous future. Such songs may also raise awareness of strengths, capabilities, loyalties and relationships existing among survivors and may help generate the confidence, motivation and collaboration needed to begin to move forward following a negative event.

In the absence of a tragedy that could have a unifying effect on the public, music therapy can be used to relieve stress among members of the public, to motivate people to pursue action in place of silence, to encourage cooperation rather than competition, and to assume leadership toward the sharing of information and ideas about building a better society for the future.

What have you seen in your work that convinced you music can reach people when words, logic, or conventional treatment cannot?

I have worked with adult men and women suffering from schizophrenia who could not initiate a conversation or follow a directive until given the opportunity to play their musical instrument. They could then express their wishes, cooperate with others, and correctly respond to instructions during the course of the musical experience.

I have used music to totally reverse antisocial behavior patterns of sociopathic adolescents and young adults who, as a result of the intervention, became self-motivated to begin functioning within the boundaries set by society and by authority figures within society. Procedures were designed that helped them understand and accept that such behavior meant inclusion within the social group instead of exclusion and access to their preferred musical medium.

I have worked with people exhibiting severe autism, advanced dementia, and other cognitive disorders who could not independently determine and exhibit appropriate verbal or nonverbal coping strategies to respond to the demands, restrictions and communications existing within their environment.

Using music to help the brain organize and process the environment’s signals, most were able to demonstrate measurable improvement in their coping capabilities.

With clients who had been treated unsuccessfully for eating disorders and suicidal depression, I have used music to bring about major changes in the way their brains cope with stress and process emotional responses to sources of pressure and conflict in their lives.

For individuals (including myself) who have suffered traumatic brain injuries due to accidents or violence, I have seen and experienced the effects of music in assisting in recovery of brain function by stimulating neuroplasticity which is the brain’s own natural repair mechanism.

How should schools, hospitals, elder-care systems, rehabilitation centers, and communities better integrate music therapy into everyday care and human development?

The best way for health care centers to incorporate the benefits of music therapy is to employ the services of a certified professional music therapist as a full member of their medical team. Certain medical complexes, health care companies and school systems each employ dozens of music therapists to cover the many applications of music in rehabilitation and human development.

Other facilities form contractual agreements with private practice music therapy companies who send professional music therapists out to a variety of centers to provide demonstrations, training, consultation, direct interventions and ongoing support for music therapy applications in everyday care.

An essential component of the process is the preliminary work needing to be done to educate health care providers, insurers, administrators, legislators and the public about the proven effects of music on the structure and functions of the human brain which forms the basis for predictable improvements brought about by therapists in the emotional, cognitive, social, physical, and communicative capabilities of individual clients.

Looking ahead, what is the next frontier for music, the brain, and healing — and what would it take for society to treat music as essential infrastructure for human well-being?

The future of music therapy as a profession is both promising and still developing. As music therapy advocates continue to make gains in protecting the public from uncertified claimants, more and more states are passing laws requiring licensure in order to offer services under the “music therapy” rubric. This trend shows increasing public perception of the medical, social and scientifically proven benefits of music therapy applications. A future goal of the music therapy profession should be to infuse into the medical education of certain medical specialties instructional units focused on music therapy applications and their predictable outcomes such as

a) obstetrics and surgery where music has been shown to raise the pain threshold resulting in less need for anesthetic medication,

b) neurorehabilitation where music has been shown to enhance cranial recovery from TBI by stimulating the neuroplasticity process resulting in recovery of physical coordination and speech communication,

c) geriatrics where familiar music has proven to stimulate at least temporary recovery of cognitive functioning in patients suffering from Alzheimer’s and other dementias, and

d) psychiatry where music therapy has a long positive history of acquiring immediate and lasting improvements in emotional expression, cognition, verbal and nonverbal communication, and numerous other functions.

While there are frequent reports of individual physicians who currently insist on using music in the operating room, awareness of these benefits has been acquired after entering medical practice such as during medical residencies upon hearing about it from a coworker or colleague.

Also, many reports reflect use of music preferred by the surgeon with no regard for benefits to be gained through use of music selected from patient preferences. By including music therapy in medical education, physicians will become aware of the large and growing research foundation for the use of music to reach patient medical objectives.

When physicians begin using music throughout the health care arena, public awareness and acceptance will follow as will increased coverage for music therapy services.

We’re always asking: Why do drugs cost so freaking much?

And it’s a complicated question. There are a bunch of reasons — to be sure. But in our reporting over the years, like our stories on insulin and tuberculosis drugs, experts cited one big reason over and over again:

The pharmaceutical industry wages sophisticated legal battles to keep monopoly control over their best selling, most lucrative drugs — blocking generic competition, and increasing their prices along the way.

How did it come to be this way?

In this first episode of a new series – what we’re calling An Arm and a Leg 101 – we’re doing a crash course in the history of the drug patent system.

And the rags-to-riches story of one amazing guy is going to help us do it.

Al Engelberg got schooled in the Art of the Hustle at a young age, collecting dimes at an illegal bingo game on the Atlantic City boardwalk.

Later, he’d put those street smarts to use as he sat at the negotiation table in Washington D.C., hashing out the details of a law that would usher in the generic drug industry as we know it. Then made millions from the rules he helped write.

And as he admits, his legacy is mixed.

On the one hand: The rules Al Engelberg helped write — a grand bargain between generic drugmakers and patent-holding brand pharma companies — unleashed the power of generic drugs to save Americans money.

Nine out of ten prescriptions written today get filled with a generic.

On the other hand: In the process of making his fortune, Al Engelberg discovered loopholes, gaps, and perverse incentives in that grand bargain.

Gaps that allowed brand and generic drugmakers to profit by keeping generics for many hit drugs off the market.

So we now spend more than ever on medicine — and more than 20 percent of Americans report skipping their medication because they can’t afford it.

Al Engelberg, now 86, has spent the last 30 years — and millions of his own dollars — trying to close those gaps.

“I live in a world — a pharma world — where half the people think I’m dead, and the other half wish I was,” he tells us.

You can read more of Al’s story — plus his prescription for fixing the crisis of high drug prices — in his book, Breaking the Medicine Monopolies: Reflections of a Generic Drug Pioneer.

And you can hear our earlier reporting on drug patents here:

John Green vs. Johnson & Johnson (part 1)

John Green vs. Johnson & Johnson (part 2)

The surprising history behind insulin’s absurd price (and some hopeful signs in the wild)

An Arm and a Leg 101 is made possible in part by support from Arnold Ventures.

Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.

It’s a case you’ve (probably) never heard of: This week, the Supreme Court is hearing oral arguments in Hikma v. Amarin — a legal battle that could impact how much you ultimately pay for prescription drugs.

Here’s why the case matters: As soon as a generic version of a brand-name drug comes to market, its price typically drops by half. Within 10 years, by more than 75%. Meaning: the sooner we have access to generics, the less we pay at the pharmacy counter.

But one of the fastest legal pathways for generic companies to get their drugs to market may be about to get a lot narrower – depending on how the court rules later this year.

Amarin, a brand-name drugmaker, has accused Hikma, a generic company, of encouraging doctors to infringe on their patent for a drug called Vascepa.

The case revolves around the legal concept of skinny labels: a carveout in drug patent law that allows generic companies to bring drugs to market when one of the brand-name drug’s patents has expired, but others haven’t.

And it raises the (unexpected) question of whether it’s OK for a generic drug company to call their product the generic version of something.

Legal experts help us unpack the nerdy details — including how this case came to be — and what’s at stake for both generic drug companies and anyone looking forward to one day paying less for an expensive brand-name drug.

Want to learn how these drug monopolies work – and came to be in the first place? Check out our previous episode: Why drugs cost so much, 101: Medicine monopolies

Send your stories and questions. Or call 724 ARM-N-LEG.

And of course we’d love for you to support this show.