Musicophilia: Tales of Music and the Brain

Music is as “essentially emotional as it is essentially intellectual” (312), but science has mainly studied it from the intellectual perspective. Music is usually appreciated both structurally and emotionally, but there are also those who can only understand it one way or the other. Sacks recalls a physician who, after a concussion, no longer felt emotion toward music for a period of several days, though his response to other forms of art was unaffected. Similarly, several stroke victims have reported losing interest in music, explaining that it brings up no emotional response in them. Sometimes, an injury to the brain may cause the emotional response to become scrambled, so that happy music may sadden a person, for example. On the other hand, some people may lose their technical understanding of music but maintain emotional appreciation for it. These cases imply that there is some physiological basis for music appreciation. Given that attachment to music varies so widely in the general population, Sacks wonders if a lack of exposure to music in early childhood may play a role. In his writings, Freud reflected that he could not understand the reasons behind the effects of music and thus could not derive any pleasure from it. Sacks calls this a “resistance” (322) to music rather than a distaste for it, as it seems Freud was mildly intimidated by the mysterious qualities of music and its relationship to peoples’ minds. Tolstoy similarly felt that music made him feel and imagine things that did not belong to him, and thus often avoided music as well.

Music’s power to induce feeling extends into the realm of grief, melancholia, numbness, and psychosis. Sacks himself reports feeling frozen in a state of indifference, unable to respond emotionally to the world following the deaths of his aunt and mother. In both cases, the spell was broken by an unplanned but perfectly timed exposure to a musical piece that expressed and released his grief. Similarly, Sacks notes how prominent figures such as the British economist and politician John Stuart Mill relied on music to release them from states of depression. Sacks also describes correspondence from a patient with bipolar disorder who reported that when he played music, he was able to level out his moods, and he notes that people with schizophrenia often respond to and rely on music to temporarily release them from a state of emotional disconnect.

One of the patients who had the most profound effect on Sacks was a man named Harry S. A severe aneurysm had damaged Harry S.’s frontal lobes, leaving him almost completely unable to feel emotion. The only time this patient did feel emotion was while singing, and he sang with the full feeling and splendor of any musician. Sacks saw Harry for 30 years and was still seeing him when he died. Sacks also remarks on correspondence he received from a fellow therapist who was treating a person with psychopathy: The patient seemed to express genuine emotion only while composing or playing music.

Sacks recalls a patient named Vera, who developed a love of singing and improvisation after developing dementia. Researching Vera’s condition, Sacks learned that frontotemporal (frontal and temporal lobe) dementia has been known to be associated with a sudden emergence of creativity, often in the form of visual art or music. Patients with this form of dementia also show decreased inhibitions and increased impulsiveness. He decided to meet with another neurologist interested in the subject, Dr. Miller, who introduced him to a patient named Larry. Larry instantly reminded Sacks of Vera, as he came in singing loudly and talking ceaselessly. Like Clive Wearing, Larry seemed to use talking and music to avoid the abyss of no memories. Larry’s factual knowledge of what he sang about was lost, but the emotion remained intact. Sacks concluded that many conditions he had examined and witnessed have shown to initiate musical talents and focuses that previously did not exist in the person, which is likely due to damage to one area causing another area to disinhibit or become more active. Most often, damage to the left hemisphere is related to this effect; damaged areas which previously acted to inhibit other brain areas are lost, leaving those unscathed areas to flourish in ways they had not before. There are also rare occasions in which these talents and newly acquired passions for music come out of nowhere, with no injury, illness, or condition to produce them.

Williams syndrome is a genetic condition characterized by a lack of development in the “occipital and parietal lobes” (365) combined with extensive development in the temporal lobes, which leads to intellectual deficits in visual-spatial reasoning and calculations, but also leads to proclivities in communication, language acquisition, and musical ability. Sacks notes that virtually all people with Williams syndrome are heavily drawn to music in one form or another, and that neuroimaging by Levitin and Bellugi (366) has shown that the brains of people with Williams syndrome are more widely activated than those without. This suggests that the vividly emotional experiences and attachments that they experience in relation to music are largely the result of an extremely intense neural reaction to it. Sacks visited a camp for people with Williams syndrome co-founded by the father of a famous opera singer named Gloria Lenhoff, whose own Williams syndrome facilitated a career singing opera in 30 different languages. Her father started the camp in an effort to provide a source of community for people with Williams syndrome, as the condition is extremely rare. The propensity for people with Williams syndrome to possess musical ability suggests an innate musical intelligence that this particular genetic condition tends to unlock.

Alzheimer’s disease is a progressive and degenerative brain disease that erodes various mental capacities over time. Sacks asserts that the full self is never gone, and that music therapy in patients with Alzheimer’s serves to “address the emotions, cognitive powers, thoughts, and memories, the surviving ‘self’ of the patient” (373). Musical memory has the power to survive when most others have been lost. Sacks recalls a letter about a pianist whose skills even improved as his Alzheimer’s worsened, and a woman whose father remembers little other than his beloved music. Sacks remembers a man with Alzheimer’s named Woody, who seemed quite jovial, his sense of self relatively intact, when Sacks first met him. Woody could sing many of his favorite songs with emotion and grace. Unfortunately, as with other Alzheimer’s patients, Woody’s memory for music could not be translated into procedural memory; in other words, songs created about their past or daily routines held no meaning or worth for them. As people with Alzheimer’s slowly become more and more disconnected from themselves and the world, music can pull them back, reigniting emotions, memories, and experiences. One music therapist who wrote to Sacks described music as “a can-opener for people’s memories” (381), something as true for those with neurological conditions as it is for the general population. Music therapy can include singing or drum circles, listening to music individually, and dancing. For people with dementia and Alzheimer’s, music has a power to recall the self that was seemingly lost; for all of us, music accesses the part of us that is most human. Furthermore, although most readers will not have directly experienced Alzheimer’s, everyone can relate to the experience of Music as a Tool of Adaptation, Resilience, and Healing:

There are undoubtedly particular areas of the cortex subserving musical intelligence and sensibility, and there can be forms of amusia with damage to these. But the emotional response to music, it would seem, is widespread and probably not only cortical but sub-cortical, so that even in a diffuse cortical disease like Alzheimer’s, music can still be perceived, enjoyed, and responded to (385).