What if I told you that the right kind of sound or music could reduce pain and stress, help with symptoms of depression and schizophrenia, improve the social skills of children with autism, and even aid folks with dementia?
Welcome to another installment in my “What is EcoMedicine?” series, part of my goal to create a compendium of well-researched scientific blogs on the various kinds of ecomedicine or nature therapy out there. Since there are so many kinds of ecomedicine out there, I want to help you find what you need to begin to feel better—with actual scientific facts about what works and what doesn’t.
Today: what is sound or music therapy? What are soundscapes? Who and what are they for? And what does science say about them?
Sound as a form of therapy
Dr. Oliver Sacks once wrote, “In forty years of medical practice, I have found only two types of non-pharmaceutical ‘therapy’ to be vitally important for patients with chronic neurological diseases: music and gardens.”
As both a doctor and an avid gardener myself, I’ve covered the healing power of gardens on this blog before in many forms, including gardening for dementia, therapeutic horticulture, ecotherapy, care farms, forest bathing, and earthing and grounding.
The research shows that Dr. Sacks had the right idea. Music therapy specifically, and sound therapy more generally, have both been shown to have incredibly positive and varied effects on our mental and physical health, containing “multiple mechanisms that can provide physical, psychological, emotional, expressive, existential and social support.” Sound has a huge influence on both our central and peripheral nervous systems, so it only makes sense that this influence can be harnessed to create a powerful personal medical impact on our bodies and minds.
Music therapy vs. sound therapy vs. soundscapes
While these terms are all interrelated, they’re not quite the same, so let’s define them before we get into the weeds.
Music therapy involves music as we know and understand it—beats, rhythms, structures and tones, sometimes lyrics. Whether it’s your favorite Fleetwood Mac song or the more ambient music popularized by Brian Eno, music therapy is just what it sounds like: using music as a gateway to healing.
Sound therapy is a more general or umbrella category that encompasses the power of many types of sounds and vibrations beyond music in order to heal. For example, I’ll talk about a study later which measures the impact of low-frequency sounds on its participants; this would be sound
therapy, but not music therapy. Soundbaths—the type popularized at yoga and meditation studios which use different crystal or metal bowls, flutes, gongs, and more—would also fall under the category of sound therapy, though it might also be considered music therapy depending on the style of the sound practitioner!
Finally, soundscapes are an even more amorphous category that can be understood as analogous to landscapes—but in auditory form. Soundscapes can include the sound of traffic, the hum of technology, the twittering of birds, and the rushing of a nearby river, as well as the human-generated sounds of anyone talking, laughing, or whispering. If a landscape is everything that’s in your field of vision, a soundscape is everything in your field of hearing.
Part of what the study of soundscapes aims to learn is exactly which of the sounds in our “soundscape” promote healing and restoration and which ones increase stress and impede healing. This means the study of soundscapes is less about helping the symptoms of any one patient or disease and more about building healthier sonic environments.
All three of these fields—music therapy, sound therapy, and soundscapes—can be used and studied in different ways to promote healing. What they all have in common, though, is that they’re attempting to harness the physiological and psychological powers of sound in order to promote or understand healing.
The science behind sound therapy
So what exactly are music therapy and sound therapy good for? Read on to learn what medical conditions can be helped by the introduction of the proper tone or tune.
Sound therapy and stress
Music lovers know this intuitively, but the data’s finally in: listening to certain kinds of music really does reduce your stress!
A study from 2013 found that participants who took a standardized psychosocial stress test—after having been randomly assigned to different resting conditions—returned to baseline cortisol levels “considerably faster” when rested with relaxing music rather than without any acoustic stimulation. Sounds like a great reason to throw on your favorite relaxing playlist before a big meeting or test!
Sound therapy and mental health
One meta-analysis from 2017 on the effects of music therapy on depression found short-term beneficial effects for folks with depression and, when combined with “treatment as usual” (TAU), improves depressive symptoms better than TAU alone. Music therapy was found to be effective in both decreasing anxiety levels and improving functioning (e.g. maintaining involvement in job, activities, and relationships) in depressed patients.
A similar meta-analysis from the same year found evidence suggesting that music therapy—in addition to standard care—can improve the mental state, social functioning, and quality of life for folks with schizophrenia or schizophrenia‐like disorders.
Sound therapy and autism
An area in which there’s a fair bit of promising research is the effect of sound and music therapy on folks with autism. A 2014 meta-analysis examined the short- and medium-term effect of music therapy interventions for children with ASD. They found that music therapy was superior to placebo therapy or standard care in a number of ways: social interaction within the therapy context, generalized social interaction outside of the therapy context, non‐verbal communicative skills within the therapy context, verbal communicative skills, initiating behavior, and social‐emotional reciprocity. Improvement in secondary outcome areas like social adaptation, joy, and quality of parent‐child relationships was also significant.
Sound therapy and dementia
There are some very promising studies looking at the effect of music therapy on the quality of life of folks with dementia. One exploratory randomized controlled trial from 2013 looked at the effect of individual music therapy on agitation in those with moderate/severe dementia living in nursing homes, as well as its effects on psychotropic medication and quality of life. The crossover trial randomly assigned 42 participants with dementia to either six weeks of individual music therapy or six weeks of standard care.
Researchers found that while agitation disruptiveness increased during standard care, those severe symptoms actually decreased significantly during music therapy. Prescription of psychotropic medication increased significantly more often during standard care as opposed to during music therapy.
Sound therapy and brain plasticity
Music and sound therapy might not just help with symptoms: it actually impacts the plasticity of our brains.
A fascinating study from 2013 looked at how music-supported therapy (MST) might affect sensorimotor plasticity in 20 chronic stroke patients, who received 20 MST sessions of 30 minutes to play notes, and test motor improvement using MST. The therapy produced neurophysiological changes in cortical plasticity by EMG, and significant improvement of the subjects’ motor performance.
A 2014 study that aimed to evaluate the brain activity potential following music stimulation of patients with impaired consciousness enrolled two patients in a minimally conscious state (MCS) and five patients in a vegetative state (VS) due to severe diffuse brain injury, along with 21 healthy adults. They found that music stimulation activated the bilateral superior temporal gyri in both the healthy adults and patients in an MCS—and while four out of the five patients in a VS showed no significant activation, the remaining patient displayed the same activation as the healthy adults and the MCS patients. What’s more, that same patient improved from vegetative state to a minimally conscious state four months after the study, suggesting that music stimulation (and the resulting information gleaned from an MRI) can help doctors objectively evaluate consciousness in their patients.
Sound therapy and pain reduction
Many of these studies have focused on music therapy, but it’s not just music that can move us to heal: the right frequency sound may be all it takes to see health benefits!
Take this 2015 open-label, uncontrolled small clinical study on the effect of two sessions of 23 minutes weekly for five weeks of low-frequency sound stimulation on 19 middle aged women with fibromyalgia. Researchers saw significant improvements in patients who received low-frequency sound stimulation on just about every scale they used to measure the patient’s pain: medication dose was reduced in over 73% of patients and completely discontinued in over 26%. Time sitting and standing without pain increased significantly, and their muscle tone changed from hypertonic (or abnormally high) to normal.
Soundscapes: sound therapy for communities
As mentioned previously, soundscapes are very much related to the field of sound therapy, but the research around them is a little different. Studies on soundscapes tend to be seeking specific information about which kinds of sounds promote restoration and which ones don’t—and this is less intuitive than you’d think! For example, you might guess that birdsong is more relaxing than traffic—but did you know that it depends on both the season, the type of bird, and the specific height at which the bird is singing?
Take this 2020 study on the effect of birdsong, a common natural soundscape, on the perceived restorativeness of Harbin Sun Island Park in China. Two-hundred and forty respondents responded to a survey whose results showed that different types of birdsong have different perceived restorativeness effects in different seasons. For example, crow birdsong tends to have the worst effect on the perceived restorativeness of the environment in both summer and winter. And the results showed that the perceived restorativeness of the soundscape was best when the birdsong came from a height of 4 meters rather than .5 or 2 meters. Who knew?
As you might be able to tell, the sort of information gleaned from studying a soundscape is less about targeting specific patients with specific needs and more about how to create comforting and restorative environments, information which can be extrapolated to places like parks, hospitals, homes, offices, and schools. The 2020 study hoped to lend itself to those designing urban parks, but the implications of these sorts of studies on soundscapes have a broader use for green architecture more generally, a fascinating area that I believe will only become more and more popular as we look for ways to live greener and healthier not just as individuals but as communities.
Last words
Music and sound have been used as a tool for healing for centuries in cultures all around the world. And now that the science is finally catching up, it’s clear: sound is an incredibly powerful tool that can heal not just our souls but our minds and bodies as well. So be conscious and careful about the sounds you surround yourself with and the “soundscapes” you wander into: listening to your favorite album or to relaxing natural sounds might also be an opportunity to heal what ails you!
(Remember: Nature therapy is a far more diverse and interesting field than people might realize—it’s much more than just “going outside!”—and so the purpose of these blogs is to show you the exciting range, diversity, and nuance of the many therapeutic interventions that fall under the umbrella of nature therapy. You can check out the other blogs I’ve written on the site, on topics like gardening for dementia, therapeutic horticulture, pet therapy, adventure therapy, blue care, ecotherapy, care farms, forest bathing, hydrotherapy, breathwork in nature, earthing and grounding, greening the indoors, light therapy, culinary medicinal herbs, and culinary medicinal spices.)