Musicophilia: Tales of Music and the Brain
Reviewed by Florencia Rusiñol, music therapy intern
Oliver Sacks, a prolific neurologist, who was also of the most well known advocates of music therapy, researched and reasoned with how music affects the brain. Musicophilia, defined as the love of music, is a compilation of anecdotes, stories, research and rationalizations about music and the brain. Through each chapter, Sacks addresses a different scenario or illness involving music and the brain. For example, the first story he tells is of a man in his early fifties who was struck by lightning, had a near-death experience, and when he revived, had developed an intense love of music where he not only taught himself to play piano at the concert level, but also began to write music frequently. These types of stories comprise the majority of the book and paint a clear picture of the ways that music can touch people, both positively and negatively. In this book, Sacks extensively covers almost thirty scenarios in which music affects the brain, so much so that it could likely act as an encyclopedia on the subject. Because of that I am going to address the aspects of the book I found most relevant to music therapy.
In the chapter on music therapy and aphasia, Sacks states that music can be used to “de-inhibit” (Sacks, 238) the affected cortical areas because it is a different way of experiencing language. However, he also shared the perspective that in this particular form of music therapy, the relationship between the therapist and the patient is crucial to the effectiveness of therapy. Treating this disorder involves physical contact, gesture, imitation, and close proximity, in addition to musical interaction. Therefore, therapists must build a strong rapport with their patients with aphasia to build that intimate work relationship. Sacks also details music intonation therapy (MIT), describing how it engages the right brain in normal activity, which in turn helps it deviate from pathological activity, meaning aphasia. He offers stories of people who cannot talk but sing and those who learn to speak again, even if only functional language, with the use of MIT.
In Sacks’ chapter on Parkinsonism and music therapy, he talks about how a patient who shows typical symptoms of the disease (jerkiness, tremors, stuttering) can move with fluidity when music is presented. However, Sacks makes the point that it must be the right kind of music for that specific individual. He gives an example of a woman with Parkinson’s disease who was able to flow with her movements when legato music was playing, but experienced extreme jerkiness when staccato, percussive music was playing. He continues on to say that the ideal combination for these patients is music and movement, or dancing, which helps to control and facilitate movement. In my own interactions with older adults with Parkinson’s disease, I tend to be afraid to encourage them to move because of their stiffness. However, it is good to remember that this is precisely what they need.
Sacks also reveals a side of music not fully known and not often talked about. There are several chapters on musical seizures and musical hallucinations, which contain story after story of people who are, in reality, haunted by music. Many begin to hear music one day, after no particular occurrence, and continue to hear it morning to night, everyday, for the rest of their lives. Sacks shared a story of a woman who loved Neapolitan songs, but one day it began to trigger seizures. She could not listen to it whatsoever, until she underwent a partial brain lobotomy and was cured. Sacks offers only speculation of why this happens, consistently reminding readers throughout the book that there is still so much to be learned about the human mind. Even so, his compiling of these stories and this information into an enjoyable and easy-to-access way was a large stride toward instilling an eagerness to learn in his readers. Sacks did what every good researcher does—leave us with unanswered questions to continue the search.
I wholly recommend all music therapists read this book. At times it can be easy to grow cold to the enormously powerful tool that is music when we are using it day in and day out. It is easy to think, “We know all this already,” and to stop being excited about the incredible effect of music in various capacities. In Oliver Sacks’ intellectual yet compassionate manner, he presents music in a way that inspired me to love music more for what it can do. As obvious as it seems, we as music therapists are able to do what we do because of music alone. It is not only our tool, but it is truly our reason for existing as music therapists. Music is a beautiful entity, and we should be the first to recognize that.
Oliver Sacks passed away on August 30, 2015. As a future music therapist, I feel indebted to him for the advocacy he did for our field. It is my hope that music therapists will continue to be inspired by his work, just as I have been, but also that more neurologists, doctors, and other medical professionals will take after Sacks’ example, seeking to explore the benefits of this therapy that has touched so many. Thank you, Oliver Sacks.
Sacks, O. (2008). Musicophilia. New York: Vintage Books.