Here was the perfect solution, then: a tailor-made music therapy programme. The personalised aspect is something Levitin, whose new book is called Music As Medicine, knows to be all-important. As he explains to me from his home office in Los Angeles, “If you’re talking about therapeutic effects, you have to like the music. If you don’t like it, your walls are going to go up, your cortisol levels will spike. [You’ll say] ‘Get me away from this.’” As luck would have it, Mitchell had set down exactly what she’d need in these circumstances while she was well, and Levitin knew precisely where the nurses could find it – in the corner of the bookcase at the far end of her living room. He sent some extra material because he understood how getting in touch with a sense of herself would speed things along – Herbie Hancock’s River: The Joni Letters, and Our House, the song Graham Nash had written for and about her, with its opening lines: “I’ll light the fire / You place the flowers in the vase / That you bought today.”
Mitchell made steady progress with the help of speech and physical therapists, but Levitin sees music as a crucial part of the picture. “One of the things we know is that music you like increases dopamine, and dopamine is the neurochemical that motivates you to do things … having that music as a reminder of who she is, who she was, and what she cares about, helped her to do the very difficult job of recovery, and to follow through with the protocols of the therapists.”
In a touching anecdote from the book, Levitin describes how, a year after Mitchell’s stroke, he brought flowers on one of his regular visits. “She walked over to a cabinet by herself to get a vase for them,” he writes. “She moved some vases out of the way to find a particular one in the back, a glass vase with a single handle and flowers painted on it. ‘That’s a beautiful vase, where did you get it?’ I asked. ‘I bought it when I was living in Laurel Canyon with Graham.’ Oh. That vase.” (...)
In 2006 he published This Is Your Brain on Music, a mix of the technical and personal that became a runaway bestseller and was translated into 18 languages. It covered the gamut of musical theory – from rhythm, harmony and pitch (including the “Levitin effect” – the fact that even non musicians usually remember songs in the correct key) to their neural correlates and why our musical preferences are defined by what we hear up to the age of 18.
Music As Medicine marks a return to his core subject, after successful books on the neuroscience of ageing and the psychology of misinformation. “When I wrote This Is Your Brain on Music, I wanted to have at least a chapter on medical benefits of music, but there really wasn’t any good science about it – and I’m not one of those who doesn’t let the facts get in the way of a story. So I couldn’t write about it until now, because there’s actually been some good work,” he tells me. “We’re learning enough about the underlying mechanisms of music and brain and body that we can apply them, not just in the laboratory, but in clinics and hospitals and care facilities and outpatient treatments.” (...)
Since prevention is better than cure, is there any evidence that engaging with music can protect against dementia? Yes and no. “It’s not going to prevent Alzheimer’s, but it will prevent you from seeing the effects or symptoms of Alzheimer’s for some time.” And the more active your engagement, the better. “Playing an instrument is neuroprotective, because you’re creating something. You’re orchestrating your limbs and your fingers and your vocal cords in ways that you haven’t before. No two performances are ever identical, and so they’re creating new neural pathways.” This is the concept of cognitive reserve: “I think of it as being like an athlete. If you can bench press 250 pounds on a regular basis, even with a cold and a sore arm, you’re going to be able to bench press more than I can.”
So is music a bit like a workout for the brain? “Yeah: it engages every part of the brain that we know of. It invokes memory, emotion, reward systems, eye-hand coordination, planning. There’s a lot going on there, and even if you’re not a professional musician or particularly good at it, you get all the benefits.”
That’s why Levitin recommends (prescribes?) playing music, whatever your ability or age. For anyone who can’t see the point when someone like Yo-Yo Ma has a 65-year head start, he has a clear message: the idea that you need to emulate professionals or be well trained in theory is “bullshit”. “It was 500 years ago or so, when the Europeans built the first concert halls, that we created this artificial distinction between the performers and the audience. But for tens of thousands of years, music was participatory. Still, in most cultures on the planet – not in our hyper-success-oriented western culture – people are singing unselfconsciously in groups, and nobody’s making a big deal out of it.”
