Sunday, October 14, 2012

Robert Gupta - Music, The Mind and Medicine

Music, the mind, and medicine: A Q&A with Robert Gupta

Can music be a medical instrument? In a moving talk from TEDMed, Robert Gupta reveals that it certainly can be. He gives as an example the work of neuroscientist Gottfried Schlaug, one of the pioneers of melodic intonation therapy. Schlaug noticed that, while stroke victims with aphasia could not utter a sentence, they could still sing the lyrics to songs. In these patients, studying music essentially rewired their brains.
This issue is important to Gupta because, after college, he found himself caught between his two loves—neuroscience and the violin. While he chose the violin, he didn’t end up playing only in concert halls. Thanks to a violinist friend who suffered from schizophrenia and ended up living on the street, Gupta found himself founding the organization Street Symphony, playing for the homeless, mentally ill and incarcerated.
“The musicians become the conduit for delivering the tremendous therapeutic benefits of music on the brain to people who would never have access,” says Gupta. “The beauty of music offers them a chance to transcend the world around them.”
The TED Blog wanted to know more than Gupta was able to share in 18 minutes. So we’ve asked him some questions that came to mind while watching his talk.
There’s some fascinating neuroscience behind the blend of medicine and healing. Why has it taken time to bring this into medicine?
There’s this holistic, sort of new age-y, aspect of music being healing and that sort of thing, and that has slowly been filtering away, because of Oliver Sack’s “Musicophilia,” “This is Your Brain on Music.” Also because so many scientists are amazing musicians. They understand the power of music. They understand the power of art. And it’s something that I’ve been so thrilled that it’s been part of the consciousness here at TEDMED. That the E in TED stands a lot more for entertainment, and that what the arts are able to do sometimes transcends what science and technology alone can do. I think that it’s been a long time coming.
There’s been a lot of quackery in music — building chairs out of speakers and having you immerse your body in it — stupid things like that. But there’s been a lot of progress in neuroscience — ways that we can see the brain with fMRI, also with the way that we can track certain concentrations of neurotransmitters like dopamine very, very closely. I think, the next step in neuroscience and music is to be able to actually track which neurons are being activated from the auditory cortex, the ones that are right next to the ear, to the actual emotional triggers that can get us to secrete neurotransmitters. We cannot see that pathway yet because it’s something outside MRI. So in a way, neuroscience is still catching up to it. But in the clinical sense, we can clearly see where stroke victims, victims of brain trauma, with Alzheimer’s, dementia, Parkinson’s disease, with autism — we can see there’s a clear effect that music is having. And I see it happen with mental illness in my daily work with Street Symphony.
You’re talking about using this medicine in regard to neurological disorders where it sort of makes sense that the brain processing is really a part of the healing?
Very much so.
Does it feed into other areas, or is that strictly the realm of quackery? I mean, clearly you’re not curing cancer with this.
No, I’m not. But at the same time, there are also a lot of pathways we don’t yet understand that go deeper than the brain, or below the brain. There is evidence that it affects our endocrine system, because music lowers our stress hormones, like cortisol. At the same time it boosts human growth hormone. And these things are transient, they’re difficult to study. So no, I’m not going to say yet that music can cure cancer, but music has been shown to lower anxiety in chemotherapy wards, which can lead to the process and sort of progression of healing itself. It can also lower heart rate, it can lower blood pressure. And if it’s lowering stress then we’re removing a barrier to fundamental healing itself.
Street Symphony is a project that you just launched to bring music to homeless.
It was specifically to under-served communities. And we’ve honed that into serving specifically mentally ill individuals living within homeless and incarcerated and veteran communities. I started this with Adrian Hong, another TED Senior Fellow last year in 2011. He works with Human Rights activism in North Korea. We just started with events, out of my relationship with Nathaniel Ayers who I spoke about at my first TED Conference. And it’s really been a TED story for me, because the inspiration at TED and seeing the other TED fellows and their support and the support from the TED community, has launched this thing in a way that I didn’t think would be possible, and so quickly. We’re still trying to figure out what exactly it is. But it’s become something where we’re actively bringing music outside the concert hall alone.
Where do you play?
We play on skid row mainly, for clinics and shelters. We’ve also gone into a number of prisons in downtown L.A. And I’ve driven up to play at a couple of asylums as well. Just before I came out here, I was playing for a group of nine combat vets from Vietnam in a group therapy session, and on Monday I’m going to be playing for a group of injured veterans that are having plastic surgery done to rehabilitate any number of organs. It’s a complete pilot, it’s very flexible. The next step for us is to start a program to work with a psychiatrist or a social worker and gauge what exactly is happening in the course of therapy accompanied by the music, so that we can track that.
What’s the short-term response been like?
It’s been kind of overwhelming. When we play, there’s this dynamic that breaks, especially if it’s in a prison. The dynamic of the entire care is punitive, of course, whereas the music is an offering. You can feel it in the room. And then you see people, whether they are criminals or they are veterans, they start weeping when we play. Of course, the ones who are weeping are already in the right emotional state. But we hear, “That’s just what I needed to hear.” And especially those that have a higher sensitivity to it. It goes beyond what we do in the concert hall alone. It goes beyond beauty for the sake of beauty. And in that sense, music becomes the perfect conduit for human service.
What do you play?
We play serious programs. We’re doing Beethoven and Haydn and Mozart, even stuff up to Schubert and Schumann. And at first we thought maybe we should keep it a little bit accessible, do some tangos or show tunes. But a part of this is to humanize classical music, to make it accessible. If we could make it accessible to that public, we can make it accessible to anybody. And it’s on us now, as musicians and human beings, to humanize the process of making music — to humanize the composers themselves, to tell the stories of these composers and why we love that music. And the second that you do that, the audience comes 10 feet closer to you. If we can do it with that audience, we can do it with anyone.
What’s the response from the music community been?
Oh, it’s really a lot of fun. Suddenly we’re playing for a group that is incredibly receptive. Also, we’re not playing for the microphones hanging from the stage for direct-release to iTunes. At the same time, it’s the exact reversal of roles. Because when you come to see an opera at the Kennedy Center, you’ve subscribed and you’ve bought tickets, so you’re ready for the experience. Here it’s the exact opposite. We’ve got to prove ourselves within 10 minutes, because there’s nothing to say to them that they can’t just walk out. At one of our first performances in the asylum, this group of people that were very severely mentally ill started three or four of them walked off and left during our concert. I was just playing alone, and I thought, “Oh, it’s just not for them.” Their therapist told me later on that they left because they had tears streaming down their faces and they were sobbing and they didn’t know how to handle their emotions, and it was their emotions that landed them at the asylum in the first place.
So we’ve heard things like that — it’s overwhelming. Suddenly the purpose of why we’re making music has changed. It’s not about the ideal of perfection any longer, it’s about actually offering something.
Do you ever compose with medicine in mind? Is that something you think could be done? Or would it even be worth doing?
It’s interesting. I haven’t done it myself. There are a couple composers who have done it. There’s one composer who’s written music specifically for hospital spaces. Also, I ran into a pianist once that just plays in the lobby of a hospital. And he told me that one of the doctors came up to him some time and said, “You do more for healing here in the lobby — for the families, for the patients — than I can do in the operating room.” I would consider it, but it’s one of those sort of foreboding territories out there which I’d like to venture to at some point, but I want to find my anchor first.

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