Summary: In a creative shift for psychiatric research, a study suggests that songwriting and group music-making can help people with psychosis re-connect with reality. The research explores the concept of predictive coding, the brain\u2019s ability to anticipate what happens next.<\/p>\n
By engaging in the rhythmic and melodic expectations of music, participants with schizophrenia and auditory hallucinations reported reduced paranoia and a significant shift away from social isolation.<\/p>\n
Key Findings:<\/p>\n
Reduced Paranoia: While hallucinations didn\u2019t disappear for everyone, those with less severe symptoms reported a measurable drop in paranoia after the weekly two-hour group songwriting sessions.The \u201cWe\u201d Shift: Researchers tracked a significant change in language. People with psychosis often use first-person pronouns (I, me, mine) due to distress and isolation. Following the sessions, there was a marked increase in plural pronouns (we, us, ours), signaling a return to social connectivity.Beyond Medication: Unlike antipsychotic drugs, which can cause lethargy and \u201cbrain fog,\u201d the music therapy had no negative side effects. Participants \u201ccame alive,\u201d expressing emotions and creativity that traditional medicine often struggles to reach.Permanent Rewiring: Dr. Corlett suspects that consistent music-making may permanently alter brain circuitry, essentially \u201cretraining\u201d the dysfunctional prediction systems of the brain.<\/p>\n
Source: Yale<\/p>\n
Our brains anticipate sensory signals, such as sight, sound, smell, or touch, by relying on past experiences. When we bite into an apple, for example, we expect a sweet crunch because of all the other times we have eaten one.<\/p>\n
Some neuroscientists believe that this neural processing, known as predictive coding, helps ease the brain\u2019s cognitive load and facilitate faster learning. But at times, these expectations or predictions can go wrong, resulting in the hallucinations and delusions that can come with psychosis, a mental state where the mind loses touch with reality.<\/p>\n
In a new study published April 9 in the journal Psychosis, Yale scientists demonstrated a way to help those with psychosis re-engage with their surroundings through making music.<\/p>\n
\u201cMusic is a Golden Road for making predictions,\u201d says Philip Corlett, PhD, an associate professor of psychiatry at Yale School of Medicine and the senior author of the study. When one sings the lyric, \u201cSweet Caroline \u2026,\u201d for example, the mind conjures the ensuing melody: \u201cBab, bab, baa \u2026\u201d<\/p>\n
Because of this strong link between music and prediction, Corlett\u2019s research group at the Belief, Learning, and Memory Lab set out to assess the impact of song-making on psychotic illnesses, particularly hallucinations.<\/p>\n
\u201cPeople have hallucinations because their predictions are too strong, and that makes them see and hear things that other people don\u2019t see or hear,\u201d Corlett says. Making music might be an avenue to help dysfunctional brains regain their ability to make good predictions, he says.<\/p>\n
\u201cLike a roller coaster, music is a safe way of having our expectations violated whilst not having to experience any kind of dangerous and unsafe things.\u201d<\/p>\n
For the project, Corlett partnered with Adam Christoferson, a music facilitator, a member of the Citizens Community Collaborative at the Yale Program for Recovery and Community Health, and founder of Musical Intervention, an organization that uses music-making for rehabilitation and community building in New Haven.<\/p>\n
Corlett became interested in music therapy for psychosis after observing its effect on patients he met at the Connecticut Mental Health Center.<\/p>\n
\u201cI saw some people who I\u2019d seen for the past 10 years or so, coming in and out of the center, not really improving very much,\u201d Corlett says. \u201cAnd then they sat with Adam for an hour, and they seemed to come alive; they weren\u2019t as negative or finding it hard to express their emotions or connect with others. And I just thought I wanted to be part of this by exploring the science behind it.\u201d<\/p>\n
Group music eases paranoia<\/p>\n
The researchers recruited 20 people between the ages of 18 and 65 in Connecticut to participate in a six-week longitudinal study. The individuals, who were either referred by their clinicians or self-registered, had schizophrenia or experienced distressing auditory hallucinations at least once per week.<\/p>\n
During their initial visit, the participants completed a set of psychometric questionnaires to assess their tendencies toward hallucinations and paranoia. They also participated in an interview with the study facilitators.<\/p>\n
For the next four visits, the participants formed groups of five and met weekly for two hours to write songs with guidance from a professional musician. They received recording equipment, including a microphone, guitar, keyboard, and drums, and were encouraged to write their own lyrics.<\/p>\n
At the final visit, the participants filled out the same set of questionnaires and sat for a post-session interview.<\/p>\n
\u201cWe wanted to longitudinally assess people\u2019s changes objectively,\u201d says Deanna Greco, a PhD student in the Corlett lab and the first author of the study.<\/p>\n
The researchers did not find a decrease in hallucinations for all participants, but those with less severe hallucinations reported experiencing less paranoia after the sessions.<\/p>\n
The researchers also noted a change in the participants\u2019 language. Previous research has shown that people who experience severe psychosis use first-person pronouns (I, me, mine) more often than plural pronouns (we, us, ours), which can indicate social isolation and distress.<\/p>\n
After the participants\u2019 final interview, \u201cwe were seeing a decrease in their first-person pronoun usage and an increase in plural pronoun usage,\u201d Greco says.<\/p>\n
Individuals with psychosis often experience social isolation, paranoid thoughts, and stigma. While the participants came with varying levels of psychosis, they all benefited from the group music activities by gathering with the community and rekindling their creativity, Greco says.<\/p>\n
For Christoferson, the result was a validation of what he had seen in the field for the last 25 years of running similar groups.<\/p>\n
\u201cThe Yale study shows the validity of the Musical Intervention approach,\u201d he says. To him, the song-making activities offer the participants a sense of identity and a way to express their emotions and creativity, which in turn affects their livelihood.<\/p>\n
Treating psychosis with music therapy \u201cis a really exciting area of research,\u201d Corlett says.<\/p>\n
Individuals with psychosis are typically prescribed antipsychotics to reduce symptoms such as hallucinations and delusions. These medications can cause unpleasant side effects, including difficulty concentrating, lack of motivation, and lethargy.<\/p>\n
\u201cOur approach may be outside of the purview of clinical medicine,\u201d Corlett says.<\/p>\n
\u201cBut the study showed that we can do proper clinical scientific research on music therapy, and that it can do just as well as the more standard and traditional treatments, and perhaps better in some cases, because people come back, they want more, and they don\u2019t experience negative side effects.\u201d<\/p>\n
As a follow-up to this study, Corlett and his team are investigating how music as an intervention changes brain circuitry. \u201cI suspect that it does something permanently in the brain,\u201d he says. \u201cAnd we want to find out what that is.\u201d<\/p>\n
Key Questions Answered:Q: How does singing \u201cSweet Caroline\u201d help someone with schizophrenia?<\/p>\n
A: It\u2019s about the \u201cBa, Ba, Baa!\u201d Music forces the brain to make a prediction and then immediately confirms it. For a brain that is struggling to tell the difference between its own internal \u201cnoise\u201d and external reality, this rhythmic \u201ccall and response\u201d acts like a physical therapy for the mind\u2019s logic center.<\/p>\n
Q: Is this a replacement for antipsychotic medication?<\/p>\n
A: Not yet, but it\u2019s a powerful \u201cnon-clinical\u201d tool. The researchers found that music therapy does what meds can\u2019t: it reduces social isolation and sparks creativity without making the patient feel lethargic or unmotivated. It\u2019s a way to treat the person, not just the symptom.<\/p>\n
Q: Why did the participants\u2019 use of the word \u201cWe\u201d matter so much?<\/p>\n
A: Language is a window into the soul\u2019s isolation. Psychosis often traps people in a terrifyingly solitary world. Moving from \u201cI am hearing voices\u201d to \u201cWe are writing a song\u201d is a massive neurological leap from isolation back into the community.<\/p>\n
Editorial Notes:This article was edited by a Neuroscience News editor.Journal paper reviewed in full.Additional context added by our staff.About this music and mental health research news<\/p>\n
Author:\u00a0Colleen Moriarty<\/a>
Source:\u00a0Yale<\/a>
Contact:\u00a0Colleen Moriarty \u2013 Yale
Image:\u00a0The image is credited to Neuroscience News<\/p>\n