Listening in: how music can improve our wellbeing and encourage safe feeling

Research published in JAMA Network this month suggests that music might be as therapeutically beneficial as exercising when addressing common mental health conditions such as anxiety, stress, low mood and depression. How does music’s impact on brain function, chemistry and emotional regulation lend it so well to being used as a tool for improving wellbeing?

Written by Bryony Porteous-Sebouhian

In the past I have written about how sad music can, at times make us feel better, at the least, it can bring calm to a mentally distressed mind. This phenomenon, called the sadness paradox is solely focused on music that we would consider ‘sad’. But what about music more generally? So many of us fill our lives with it, on commutes to work, to celebrate, to distract us, to grieve, to drown out the bad. Why are we so drawn to music?

Music, our brains and mental health

The first two tracks on Max Richter’s ‘Recomposed: Vivaldi The Four Seasons’ merge into another, the opening is merely an introduction into Richter’s reimagined world of these well-known and beloved works by Vivaldi. The second, ‘Spring 1’, sets you into the sky.

The violin soloist leads the charge with bursting notes that dance about the ears, like cherry blossoms in the wind. The other violins echo the soloist while a chorus of cello’s anchor the piece, steadily growing stronger as if a spring sun moving over green fields.

Every time I listen to this piece of music by Richter, by the one-minute marker I feel my heartrate increase, I feel waves of a tingly ‘goosebumps’ sensation rush from the back of my neck around my head and upper torso and my breathing becomes staggered: short breaths and then big deep ones. By minute two I am smiling and feel distinctly, and immeasurably happy, without worry.

For a long time, I thought everyone felt this when they listen to music that resonated with them, only to meet a friend at university who, much to my shock and dismay told me she never experienced those ‘chills’ from music, something I would later learn is called, ‘frisson’.

Music: humanity’s old friend

It's no wonder we can have these intense, emotional reactions to music. In 2008, archaeologists found an intact bone flute as well as fragments of ivory flutes in the Hohle Fels Cave in southwestern Germany [1]. The instruments dated back to at least 35,000 years ago.

At the time of the discovery, Nicholas J. Conard of the University of Tübingen in Germany said the findings “demonstrate the presence of a well-established musical tradition”.

The presence of music in our own evolution is by no means a mistake. The aspects of brain function that have allowed humans to progress to where we are now: executive function, reason, social cognition, and emotional regulation are more tied to music than you might think.

Music is the only activity present in daily life that engages numerous areas of the brain, simultaneously. This brain activity seen when we listen to music encapsulates: hearing, listening, movement, attention, language, emotion, memory, thinking as well as engaging all four lobes of the cerebral hemisphere and the brain stem [2].

How can this help us to utilise music as a tool in wellbeing practice?

According to a meta-analysis published earlier this month in JAMA Network [3], which reviewed 26 previous studies with a total of 779 participants, there is a clear link between music and mental wellbeing. The research related the listening to and making of music to ‘health-related quality of life (HRQOL)’ and found that music ‘broadly’ promoted a better HRQOL. They measured music against other ‘non-pharmaceutical and medical interventions’ and found that it had a similar impact seen in people who use exercise to benefit their wellbeing.

In 2020, the Global Council on Brain Health (GCBH) examined how music influences brain health and formulated a series of 10 recommendations for how people might incorporate music into their lives ‘to promote mental well-being, increase social connection, and stimulate thinking skills.’ [4]

Included in the list of recommendations was the suggestion to dance, move and sing along to music as a stress reliever, to use familiar music as a comfort, especially if it ‘evokes positive memories and associations’ as this also causes the ‘strongest brain response and dopamine release’.

In the full report by GCBH, as well as the 10 recommendations they included seven ‘Practical Tips’ that can help people to use the recommendations to their best effect. One of the tips read:

“Consider using music to encourage mindfulness and minimize negative thinking; music is often used as part of cognitive behavioural therapy techniques to help improve mood, anxiety and depression.”

Another tip aimed at professionals working on in-patient wards stated:

“Nursing facilities should use evidence-based music therapy, incorporating music that residents enjoy, to reduce symptoms of depression, anxiety and agitation, while decreasing the use of antipsychotic drugs and sedatives. Providing music that people enjoy can induce feelings of nostalgia, happiness and calm without the down-side risks of medications.”

Engaging with the chill and thrill of frisson

As I mentioned above, something I experience frequently when listening to music, is frisson. In an article published on Frontiersin [5], Luke Harrison and Dr Psyche Loui explain frisson as:

“…that moment when music resonates so deeply and viscerally as to elicit a physical, bodily response.”

This bodily response can come in the form of ‘gooseflesh’, where your hairs stand on end, you might feel a tingly sensation across your skin, a rush of an emotional thrill, tears, muscle tension or a ‘lump in the throat’.

The article points out a number of brain functions associated to frisson. Frisson causes arousal in the autonomic nervous system (ANS), emotional interpretation or ‘contagion’, as well as being involved in the dopaminergic reward system.

These three mechanisms that are induced when experiencing frisson have some interesting, inspiring and practicable associated therapeutic practices:

Causing arousal in the ANS: being hyper-aroused or hypervigilant is a common symptom experienced by people living with PTSD, complex PSTD, anxiety disorders and some personality disorders such as Emotionally Unstable Personality Disorder (EUPD). Being able to safely move into the ANS sympathetic state (fight or flight), out of that state and into a calming, restful parasympathetic state due to arousal by music can be a way to train the brain from getting stuck in that first sympathetic state.

Emotional interpretation or ‘contagion’: emotional numbness and difficulty expressing or identifying emotions is another common symptom of many mental health conditions, as well as being experienced by people with a neurodiversity such as those with ADHD or autism. Incorporating a musical stimulus into therapy, your own wellbeing practice or simply into your every day, whilst noting specific emotions that the music elicits can be a simple way to begin engaging with emotion safely.

The dopaminergic reward system: this system is split into two sections. First is the caudate system which is activated when we anticipate something positive or pleasurable (in this case anticipating a musical crescendo), the second is the nucleus accumbens, this is activated when we experience an emotional and physical release after that anticipation is fulfilled (in this case after the emotional and musical peak of the music). Many mental health conditions such as major depression and bipolar can result in dysregulation of dopamine in the brain, engaging this reward system is actively teaching the brain to produce that dopamine it might be lacking in a natural, non-pharmaceutical way.

Music, in many ways is a universal experience. Not only this, but it is accessible to most people and here in 2022 it is easier than ever to engage in new, stimulating music as well as enjoying the nostalgia from old favourites.

On our Instagram, we asked our audience a series of polls and questions about music, wellbeing and mental health.

When asked about feeling their mood lift when listening to music, 94% of 20 respondents said they do feel their mood lift, while 88% of respondents noted that they have ‘go to’ music they listen to when feeling depressed, anxious or stressed.

Circling back to my particular interest in the phenomenon of frisson, 89% of respondents reported that they do experiences it, while 11% reported no. Of this 89% when asked how they feel when they experience frisson:

• 27% feel ‘happy’
• 55% feel ‘emotional’
• 18% feel ‘sad, but in a good way’

The utility of music in wellbeing, mental health and therapeutic practice, is often overlooked with many choosing to focus on creative outlets such as journaling, art or physical outlets such as yoga or running. However, we can see from the evidence in the recent JAMA Network research, the GCBH recommendations, the exploration of frisson in the Frontiersin article as well as the contribution by our readers, that the therapeutic scope for music could be huge.

All it takes is a set of headphones, a quiet moment and a piece of music that sets you off into the sky, note by note, just as it is for me with Max Richter, Vivaldi and their strings. 

Reference list:

1. 'Flutes Offer Clues to Stone-Age Music'
2. 'Music on Our Minds: The Rich Potential of Music to Promote Brain Health and Mental Well-Being'
3. 'Association of Music Interventions With Health-Related Quality of Life A Systematic Review and Meta-analysis'
4. 'Thrills, chills, frissons, and skin orgasms: toward an integrative model of transcendent psychophysiological experiences in music'

Further reading:

'The sadness paradox: how sad music can relieve a depressed mind'