What effects does music have on the brain? How can music be used as a form of medicine?
In I Heard There Was a Secret Chord, award-winning neuroscientist and musician Daniel J. Levitin discusses music’s history and potential as a form of medicine. Drawing from scientific research, he demonstrates how music therapy can effectively treat conditions ranging from Parkinson’s to chronic pain.
Continue reading for a fascinating deep dive into the neuroscience of music.
I Heard There Was a Secret Chord: Book Overview
In I Heard There Was a Secret Chord, neuroscientist Daniel J. Levitin discusses music’s history and potential as a form of medicine. Drawing from scientific research, he demonstrates how music therapy can effectively treat conditions ranging from Parkinson’s and Alzheimer’s diseases to cognitive injuries, depression, and chronic pain—making a research-based case for music’s ability to restore health and ease suffering.
Levitin is an award-winning neuroscientist, musician, and best-selling author. In addition to publishing many articles on music, neuroscience, and human behavior, he’s published several New York Times bestsellers, including This Is Your Brain On Music and The World in Six Songs. Levitin has also enjoyed a successful career in music, performing and producing albums for well-known artists, including Stevie Wonder and Joni Mitchell, while also serving in academic positions at Stanford and McGill University. He is the Founding Dean of Arts & Humanities at Minerva University.
In Part 1 of this guide, we’ll explain how we process music and its impact on the brain, before exploring the everyday benefits of listening to and playing music. In Part 2, we’ll discuss the specific therapeutic benefits of music for a variety of mental and physical health conditions. Throughout the guide, we’ll explore the neuroscience behind music’s therapeutic value and provide examples of music therapy in action.
Part 1: Why We Listen to Music
According to Levitin, music is a universal part of human culture that has been around for at least 40,000 to 50,000 years. Though early forms of singing and rhythmic vocalizations left no physical traces, he suggests that music’s origins likely extend back to the emergence of human language itself.
Why is the draw of music so powerful? In this section, we’ll explore how music affects the brain and some of its benefits, including its ability to strengthen human connection and promote personal well-being.
How Does the Brain Process Music?
Levitin explains that our brains process music through a complex system of neural networks that begins with basic sound detection in the brainstem and extends to complex pattern recognition in the prefrontal cortex. These separate processing systems combine their analyses to create a unified experience of music—like how a mixing board in a recording studio combines different instrumental tracks into one complete song.
When your brain processes music, Levitin writes, you rely on three key abilities: First, rhythm recognition allows you to feel the beat and anticipate what comes next in a song—like knowing when to tap your foot or clap along. Second, pitch recognition helps you follow the tune, observing if notes are going up the scale or down, or if certain notes create harmony or discord. Third, timbre perception enables you to distinguish between different sounds, like those of a violin, a piano, or a human voice.
According to Levitin, your brain’s capacity to combine these abilities allows you to recognize songs, even when they sound different from the original version. For example, you would know “Happy Birthday” whether it’s played on a piano or kazoo, or sung at twice the speed or in a different key.
How Do We Experience Music?
When you listen to music, your brain engages with what you hear in one of two ways: through focused listening or experiential fusion. These distinct mental states shape not only how you process music in the moment, but also how you form and retain musical memories.
In focused listening, you analyze and attend to the music itself. During this state, your brain methodically processes technical elements like melody, rhythm, and harmony. You notice how different parts of the song work together, paying attention to changes in speed, volume, and the way instruments interact with each other.
In contrast, experiential fusion is a more immersive state where the boundary between listener and music begins to blur. This state engages what neuroscientists call the Default Mode Network (DMN)—brain regions associated with mind-wandering and self-reflection. With the DMN engaged, your mind drifts to personal memories or emotions evoked by the music, which causes you to form the rich autobiographical connections that make musical memories particularly enduring. Experiential fusion is what causes the feeling of nostalgia when you hear a song your grandmother used to sing or one that was played at a high school dance.
This dual-state processing explains why people can react so differently to the same music: While two listeners hear identical sounds, the unique emotional states and personal memories the music evokes shape completely different listening experiences. For example, Simon and Garfunkel’s “Bridge Over Troubled Water” might bring joy to one person who sang the song in their high school choir, while making another person feel sad because it reminds them of their late grandmother.
The Benefits of Music in Everyday Life
Music shapes our lives in three powerful ways: It supports healthy childhood development, builds empathy between people, and enhances overall well-being. In the next section, we’ll explore each of these benefits.
Healthy Childhood Development
Levitin explains how, from infancy onward, music plays a vital role in child development. For example, when parents sing to their babies, the released oxytocin and prolactin help infants form secure attachments, learn to regulate emotions, and develop trust. These interactions teach babies how to self-soothe and connect with others, while also reducing stress for parents and strengthening the parent-child bond.
Levitin argues music also plays a role in creating a healthy home environment. Research suggests when families listen to music together rather than through personal headphones, they spend more time in shared spaces, feel closer to one another, and report greater happiness.
Increased Empathy
Finally, Levitin discusses how music can build empathy. Brain imaging studies reveal that when people listen to the same music, their neural responses synchronize, processing the music in similar patterns. For example, when the music swells, both listeners’ brains respond to the rising intensity; when it softens, both experience the shift to a calmer state. The music acts as an emotional conductor, guiding listeners through the same peaks and valleys of feeling, even if they interpret those feelings differently. Research shows that just 20 minutes of listening to music together can generate levels of empathy between strangers equivalent to a three-year friendship.
Music is so powerful an empathy-builder, Levitin writes, that it’s also useful for conflict mediation. He cites The Resonance Project (TRP) as an example. This organization brings small musical ensembles to aid in difficult diplomatic negotiations. In one test case, Israeli and Palestinian dialogue participants in California listened to live piano duets with flute or cello during their discussions. The participants reported deep feelings of connection and a heightened ability to imagine solutions, demonstrating how strategically placed live music can facilitate conflict resolution.
Improved Well-Being
While listening to music has clear benefits for individuals and groups, Levitin explains that actively playing an instrument (or singing) can be even more impactful. According to his research, learning a musical instrument enhances cognitive and emotional well-being at every stage of life. Children who play music develop stronger communication abilities and neural connections, while older adults show improved fine motor skills and mental processing after just one year of piano lessons.
Part 2: Music as Medicine
Levitin goes on to explain that music is more than just a source of pleasure, emotional connection, and personal development. He argues music is a powerful medicine. According to Levitin, music’s role in healing extends back at least 20,000 years, but, Levitins explains, there is now scientific research to support the medicinal power of music.
Through clinical studies and patient case studies, Levitin shows how music can be harnessed to improve patient outcomes and quality of life in ways that complement traditional medical care. In Part 2 of this guide, we’ll explore practical applications of music for five types of conditions: movement disorders, mental health conditions, cognitive decline, chronic pain management, and neurodevelopmental disorders. Then, we’ll explore the future of music as medicine, and what further research is necessary.
Movement Disorders
According to Levitin, music therapy is a powerful intervention for people with movement disorders—conditions that impair motor control and fluency. Music therapy can help them because our brains are naturally wired to coordinate movement with sound. By having patients synchronize simple, repeated motions to steady rhythmic beats, music therapy strengthens the neural pathways essential for movement control.
Even more remarkably, these benefits extend beyond pure motor function. Through the principle of “embodied cognition”—which recognizes that physical movement is linked to how we learn and think—music therapy can enhance both motor control and cognitive abilities simultaneously.
In this section, we’ll discuss specific musical interventions for the following movement disorders: Tourette’s syndrome, multiple sclerosis, Huntington’s disease, and Parkinson’s disease.
Tourette’s Syndrome
Tourette’s syndrome (TS) causes people to make movements and sounds they can’t control, which are called “tics.” These tics usually start during childhood, and often become less noticeable as people age. However, some people with TS find that their tics disrupt daily activities like reading, working, or socializing, and many experience physical discomfort or social anxiety due to their symptoms.
Levitin explains that music can help reduce tics, especially during activities like playing an instrument or dancing, which require focus and rhythm. He argues this works because Tourette’s disrupts normal brain wave patterns, and music helps reset them. The steady rhythms in music can synchronize brain activity, improving motor control and temporarily reducing tics.
Multiple Sclerosis
Multiple sclerosis (MS) affects the body’s nervous system, damaging the protective coating around nerve fibers. This damage disrupts messages between the brain and body, which can cause fatigue, make walking difficult, weaken muscles, and affect balance and coordination.
According to Levitin, rhythmic auditory stimulation (RAS) can help people with MS move more easily. The treatment is straightforward: Patients walk to music or a steady beat, which helps their brain and body get back in sync. Over time, this practice can improve their walking and balance.
Levitin provides the example of Courtney Platt, a professional ballet dancer who performed with Ballet Arizona, but was best known for her appearance on Season 7 of So You Think You Can Dance. When Platt was diagnosed with MS at the age of 23, she was afraid it would end her dancing career. However, according to Levitin, by participating in RAS treatment regularly, she was able to maintain her balance and coordination despite her diagnosis. Practicing walking and moving to specific rhythms allowed her to manage her symptoms and continue dancing, eventually becoming both a performer and teacher while advocating for MS awareness.
Huntington’s Disease
Huntington’s disease is an inherited condition that causes brain cells to break down over time, almost always proving fatal. People usually start showing symptoms in middle age, experiencing uncontrollable movements and severe declines in their thinking abilities and personality. As the disease progresses, they begin to lose their independence, requiring full-time care as they become unable to walk, speak, swallow, or care for themselves.
Levitin explains how a treatment called Huntington Speech Music Therapy (HSMT) combines music with speech exercises to treat the symptoms of the disease. Patients practice speaking while following musical rhythms and melodies, which can help them maintain clearer speech and better control of their movements. These exercises seem to help “rewire” the brain’s pathways, temporarily bypassing some of the damage caused by the disease. Though this treatment can’t stop the disease’s progression, it offers a way to help people maintain their abilities longer.
Parkinson’s Disease
Parkinson’s disease affects the brain cells that produce dopamine, a chemical that helps control movement. When these cells break down, people experience symptoms like tremors, stiff muscles, and difficulty with coordination, which can make daily activities challenging.
According to Levitin, music therapy has proven to be a powerful and customizable tool for managing Parkinson’s symptoms, with options ranging from walking exercises to singing and playing instruments. These treatments work in two ways: First, music’s steady beat acts as a timing device for the brain, helping patients achieve smoother movement, better stability, and improved coordination compared to traditional physical therapy alone. Second, music naturally triggers dopamine release in the brain, which can be so effective that some patients are able to reduce their medication doses when combining them with music therapy.
However, music therapy doesn’t work for everyone, as evidenced by the experiences of musician Linda Ronstadt, diagnosed with Parkinson’s mid-career. Unlike some other musicians, Ronstadt has been unable to harness music as a source of relief. Her experience with the disease specifically impacted her ability to perform the repetitive motions necessary for singing, forcing her to stop performing.
Mental Health Disorders
While the therapeutic benefits of music may vary for those with physical conditions like Parkinson’s, research suggests it can be particularly effective in addressing mental health challenges. According to Levitin, music can improve mental health outcomes in two ways: First, listening to and playing music produces brain chemicals that improve your mood. Second, music offers a means to express emotions and connect with others when someone doesn’t want to talk or doesn’t have the words to describe their experience.
Let’s explore in greater detail how music therapy helps treat specific mental health conditions.
Depression and Bipolar Disorder
Depression and bipolar disorder both result from disrupted dopamine activity in the brain, which contributes to persistent low mood, diminished interest in activities, and poor emotional regulation. The key difference between these conditions is that depression typically involves ongoing sadness, while people with bipolar disorder alternate between depressive lows and manic or hypomanic highs, reflecting distinct patterns in how brain chemistry imbalances manifest.
Many people with these conditions instinctively turn to music for relief, and research has validated this approach. According to Levitin, when patients listen to music they enjoy, their brains release dopamine in the nucleus accumbens (the brain’s pleasure center). This release occurs both during emotional peaks in the music and in anticipation of those moments. Since this provides a healthy, nonaddictive way to stimulate the dopamine system, music therapy can be an effective tool for managing symptoms, helping to naturally counter the disrupted dopamine activity that underlies these conditions.
PTSD and Trauma
PTSD and trauma disorders are characterized by a dysfunctional fear response system, where the body remains in a heightened state of “fight-or-flight” arousal and can be easily triggered into overwhelming stress reactions. As a result, ordinary stimuli, like loud noises or crowds, can provoke debilitating panic attacks, flashbacks, or emotional shutdown. To avoid these experiences, survivors may start to restrict their lives, limiting opportunities for work, relationships, and new experiences.
Levitin argues music therapy has proven particularly effective for these conditions because it can directly activate the body’s natural relaxation pathways, helping to calm an overactive stress response system. Clinical trials demonstrate that regular music therapy leads to measurable improvements in patients’ ability to regulate their emotional states. Participants show reduced stress levels, enhanced emotional stability, and improved daily functioning, with better overall well-being and capacity to manage day-to-day responsibilities.
Cognitive Decline
Cognitive decline encompasses conditions that affect memory and mental function, from mild age-related changes to severe dementia, which impacts over 55 million people worldwide. These conditions can make everyday tasks difficult and often force people to depend on others for help with basic needs like cooking, managing money, and remembering important information.
According to Levitin, music therapy is an effective treatment for cognitive decline because the brain’s specialized musical processing networks often remain intact even as other cognitive functions decline. Unlike typical memories that depend on recalling specific details, musical memories are encoded through pattern recognition, making them more resistant to deterioration. This explains why many people with advanced dementia, who may no longer recognize family members or remember recent events, can still sing entire songs from their past with remarkable accuracy.
Levitin explains how music therapy helps address cognitive decline through multiple mechanisms:
First, when people with dementia engage with familiar music, it stimulates the release of dopamine, reducing agitation and anxiety. The songs can also serve as memory anchors, helping people access associated memories from their past.
Second, for those recovering from strokes or other brain injuries, music therapy supports speech recovery by engaging multiple neural networks simultaneously.
Finally, and perhaps most importantly, shared musical experiences create meaningful moments of connection between people with cognitive decline and their loved ones, helping maintain emotional bonds even as other forms of communication become challenging.
These benefits have led many care facilities to implement personalized music programs, where residents listen to curated playlists throughout the day. Research has demonstrated that this approach significantly reduces anxiety while helping people maintain connections to their memories and relationships.
Pain Management
According to Levitin, music offers a different approach to managing pain. Pain is the most common reason people seek medical help, and doctors typically prescribe medications like aspirin or opioids to treat it. While these drugs can be effective, they often come with serious drawbacks. Over-the-counter pain medications can damage the stomach and liver when used long-term, while opioids carry risks of addiction and require increasingly higher doses to maintain the same effect.
In contrast, Levitin explains that music can alleviate pain by:
- Redirecting attention away from discomfort
- Improving mood, which can make pain feel less intense
- Triggering the brain to release its own natural painkillers
- Enhancing pain relief through the power of positive expectation—when people believe music will help, it often works better
How effective is music-based pain management? Research shows that using music during and after medical procedures can reduce the amount of pain medication patients need. For instance, patients who listen to music during surgery often require less anesthesia, and those who listen after surgery often ask for fewer pain medications. Scientists are now studying which specific elements of music—like speed, musical key, or choice of instruments—work best for pain relief.
Neurodevelopmental Disorders
While music therapy shows promise for various medical conditions, some of its most fascinating applications, according to Levitin, involve neurodevelopmental disorders, particularly Williams syndrome (WS) and autism spectrum disorder (ASD).
Williams Syndrome
Williams Syndrome (WS) is a genetic condition affecting about 20-27 genes on chromosome 7. People with this syndrome typically have IQs ranging from 40 to 112, with an average of around 68, placing them in the mild intellectual disability range. Despite these cognitive challenges, they often show remarkable strengths, including enhanced musical abilities, unusually high sociability, and surprisingly strong language skills relative to their overall cognitive function.
Brain scans show that people with Williams syndrome process music differently than others. They show less activity in the hearing-related brain regions that are typically activated when people listen to music, but more activity in emotion-processing areas like the amygdala. Their brain activation patterns when listening to music are also more spread out across different brain structures than people with neurotypical brains.
Levitin explains that music therapy works especially well for people with Williams syndrome because it builds on their natural musical strengths. For example, people with Williams syndrome who struggle with fine motor control can often play rhythm instruments with greater coordination when following musical cues, and participating in group singing activities helps them develop better turn-taking and social interaction skills.
Autism Spectrum Disorder
Autism spectrum disorder (ASD) often involves challenges with social communication and interaction. People with autism typically have restricted interests and may demonstrate repetitive behaviors, such as hand-flapping, rocking, or repeated phrases. They might also insist on sameness through strict routines or become intensely focused on specific topics or objects. Many people with autism struggle to recognize emotional cues in everyday situations, yet can show remarkable strengths in specific areas, including musical processing.
Music therapy works well for people with autism because it provides a safe, structured way to process emotions through patterns. Since many people with autism excel at pattern recognition, they can understand emotions in music more easily than in faces or voices. In this way, music acts as a kind of emotional translator. Studies show regular music therapy produces lasting benefits, including improved communication, emotional understanding, and social engagement.
The Future of Music as Medicine
According to Levitin, learning more about music’s effects on the brain and body have opened up new possibilities for the role of music in health care. Scientists are exploring how to use existing research and new technology to develop increasingly sophisticated approaches to music-based treatment.
Levitin argues that using digital technology could help health care providers develop more targeted music therapy treatments for a variety of conditions. He envisions AI systems connected to health trackers that monitor biometric data—including heart rate, breathing patterns, and muscle tension—to select the most therapeutic music for each individual patient. This personalized approach would offer greater precision than current standardized methods, potentially expanding music therapy’s effectiveness across a wider range of health conditions.
Exercise: Create Your Personal Music Medicine Cabinet
We often turn to music intuitively when we need emotional support or motivation. Let’s systematically identify the music that could help you in different situations, creating a personalized therapeutic playlist collection.
- Think of a time in the past month when you felt particularly stressed, anxious, or emotionally overwhelmed. What music, if any, did you listen to during this time? How did it affect your state of mind?
- Now identify a type of situation where you commonly experience stress or emotional challenges (e.g., before important meetings, during difficult conversations, while dealing with physical pain). What type of music do you think might help you cope better in that situation? Be specific about tempo, genre, or even particular songs.
- How would you implement a system to make this music readily available when you need it most? Consider creating dedicated playlists, setting specific times for music breaks, or using music as part of your daily routine.
