Why music really CAN be the best medicine
Whether the problem is shortness of breath, acute pain or even mental health issues, breathing like an opera singer or a listening to a good melody may help, as RUSSELL HIGHAM finds out
DOES Lady Gaga get you out of bed in the morning? Or perhaps a bit of Beethoven eases you into the land of nod. Whatever your taste in music, its ability to both lift your spirits and help you relax is something you’ve probably always taken for granted. Lately, though, scientists and medical professionals have begun using music in all kinds of new and unexpected ways to reduce physical pain, help manage respiratory problems and even improve the lives of people with extreme psychiatric conditions.
Now, I can’t sing to save my life. I’ve got the kind of singing voice that makes dogs howl with pain. But I’ve been told that trilling a few tunes could be the answer to my own particular health problem – dyspnea or shortness of breath. Ever since contracting Covid last year I have suffered from bouts of breathlessness. It’s one of the hallmark symptoms of coronavirus.
Which is how I came to find myself standing on the stage of the largest theatre in the West End belting out a duet with one of Britain’s top operatic voice coaches.
Anybody, like me, who’s ever had an asthma attack will know how frightening “air hunger” can be.
But for sufferers of long Covid – which affects 1.3 million people in Britain – it can be devastating. In severe cases, the condition can progress to Acute Respiratory Distress Syndrome and is potentially fatal.
As Britain’s only full-time repertory opera company, the singers at English National Opera (ENO) are well aware of the importance of healthy breathing.They need plenty of puff to make their voices reach right to the back of the 2,359-seater London Coliseum, their home on St Martin’s Lane in Covent Garden. With an ethos of making opera accessible to all, ENO has always fostered connections between arts and the community and has worked with Imperial College Healthcare NHS Trust throughout the pandemic. The costume department were making scrubs for medics during lockdown when theatres were closed.
Now, together, they have come up with the idea of ENO Breathe, an online course of group workshops that brings together long Covid sufferers from all over the country to help them manage their breathlessness, and the anxiety it causes. The participants, most of them non-singers, meet up on weekly Zoom calls where they learn breathing and vocal tools usually employed by professional opera stars.
ICAUGHT up with Suzi Zumpe, a renowned singing specialist and the Creative Director of ENO Breathe, at the London Coliseum to get an idea of how these tools can help me tackle my own breathing problems.
Behind us, stagehands were getting things ready for ENO’s operatic version of Margaret Atwood’s The Handmaid’s Tale (from April 8 to 14; with free tickets for under-21s) as Suzi explained: “When we feel out of control of our breathing, we feel out of control of our life. And that’s been exacerbated by Covid. Lots of people have been isolated for a long time so our initial conversation with them is about re-establishing a human connection.
“There’s then a course of six one-hour sessions which, after being assessed individually by a medical professional, the same group goes through together. Some of the sessions are about the mind-body connection – being ‘in your body’ and listening to physical cues. Then we learn the tools and techniques which are mostly about extending exhalation relative to inhalation.”
To demonstrate, we practised a set of exercises not dissimilar to those you might do in a yoga class.
“Breathlessness and anxiety are inextricably linked,” Suzi told me as we stretched. “If your in-breath is longer and more pronounced than your out-breath, you can breathe yourself into an anxious state.That is exactly how you breathe when you are anxious. Once you’re in that state, you can’t think your way out of it because your body has perceived that you’re in danger, even if you’re not. But you can breathe your way out of it.
“When we breathe with a longer exhalation than inhalation, we send signals to our autonomic nervous system [which regulates involuntary processes such as blood flow, blood pressure, breathing and digestion] that we’re safe – so our bodies can return to functioning normally because we know we’re not in danger.”
Bev Place is one of the nearly 1,000 participants who have completed the programme since it was rolled out nationally last year.
The 47-year-old from Rochdale in Greater Manchester told me: “My GP referred me to ENO Breathe last August as I’d been diagnosed with a breathing pattern disorder caused by long Covid.
“Apparently it’s usual to take about 12 breaths a minute but I was taking 38. I was struggling to even speak.”
She found the breathing exercises as well as the lullabies, which the group sang together during the online sessions, especially helpful at combating the anxiety caused by her breathlessness. Lullabies are used, Suzi explained, because, as well as being easy to learn, even for non-native English speakers, their very purpose is to calm us down – and that works as well for adults as it does for babies.
So was Bev nervous or embarrassed about singing in front of the group? “No, we all had our microphones on mute so we couldn’t hear each other,” she laughed. “Although I don’t think my husband enjoyed me warbling away upstairs!”
She came to the sessions with no knowledge of opera either, she reveals. “The only time I’d ever seen opera before was watching Pavarotti on the TV singing ‘Nessun Dorma’ at the World Cup.”
Bev, who helps run a charity called Rochdale Connections Trust, is now using what she’s learnt from ENO Breathe to help others. She explains: “We’re a charity that works primarily with people affected by domestic abuse, so there’s a lot of mental health issues created by those experiences. “I’ve now introduced singing as a way of helping
with that and building relationships. We’ve invited the local church choir to come in and sing with us. I’m really keen to explore that further.”
But music, it appears, has more to offer medicine than alleviating anxiety and breathlessness.
City of London Sinfonia (CLS) is an English chamber orchestra founded more than 50 years ago. It has been using music to improve the lives of thousands of people each year in schools, hospitals, hospices and care homes since the 1990s.
Fiona Lambert, Director of Participation, explained to me that the benefit comes from the orchestra playing music with people, rather than just to them. Specially trained CLS musicians go into psychiatric intensive care units in hospitals such as Bethlem and Maudsley, London. They work with patients who have mental health conditions ranging from eating disorders to severe psychosis.
“These are very unwell young people who find it very difficult to connect,” Fiona says. She then explains how CLS musicians use a range of traditional and non-traditional instruments, such as iPads, to make music that, however rudimentary or discordant, the patients can take pride in having created themselves.
“We’re not looking for artistic excellence here. The big challenge is trying to get them just to engage with us and each other. We might think we’ve failed because we haven’t made a harmonious sound. But then we’ll speak to their carer who’ll tell us ‘actually, what you did was incredible – they’ve never sat in a room for so long before’.
“So this is really a success. These young people go into hospital and it’s all about what’s wrong with them; it’s all about being treated for the thing that’s not working properly. What we do is work with the bit that is working, the part that represents who they are. And, through creating even the most basic sounds, they get to express that.
“It’s about bringing a small moment of joy that they can reflect upon at a really, really hard time in their lives.And you never know where that little spark, that moment of joy, is going to take that person.”
CLAIRE Howlin, a postdoctoral researcher at Queen Mary University of London, agrees about the importance of connection when it comes to music. Her area of expertise is the impact of the creative arts on our health and wellbeing.
Last year, with funding from the makers of Nurofen, she helped create a piece of music that can actually reduce physical pain. Instead of swallowing a pill, you listen to the song (called “All of Us” and available to stream on Spotify) which works, Claire explains, “by distracting the listener’s brain and convincing it to release dopamine, a chemical which makes us feel happy”.
She adds: “It’s basically a ‘psychological attention pain management strategy’ and that’s where music comes in. The area of your brain that processes music overlaps with the area of your brain where pain is experienced. So, by flooding that area with music, you’re making it very difficult for your brain to process pain.”
She explains that the track, which she created with a trained musician called Anatole, combines orchestral elements of classical music with the melodic structure of a pop song. This makes it appealing to a broad range of tastes.
Claire says her research showed “people find much stronger benefits when they are engaged with their own personally-chosen favourite music”.
When this process works well, she adds, “it can decrease the amount of time you spend in hospital when you’re recovering from an operation”.
That’s why music “is increasingly being used as a pain management strategy in hospitals and clinical settings, instead of taking a tablet”.
Martin Ledwick, Head Information Nurse at Cancer Research UK, concurs. “Studies in recent years have suggested that music therapy can help with pain relief and other physical symptoms in some patients,” he says.
A study cited by the charity involved trials with a total of 1,891 cancer patients. While further research is needed, it suggests that, as well as helping with anxiety, breathing and pain relief, music therapy could also lower heart rate and blood pressure.
As musicians and scientists continue to work together in this exciting new field of medicine, they’ll surely discover even more ways that music can comfort and heal us. In the meantime, I’m happy to report that my ENO singing lessons are helping with my post-Covid breathlessness. Just like me, there are many people – whether they prefer Albinoni or ABBA – who will be singing, however badly, a very sincere “thank you for the music”.
●For more information about ENO’s Breathe programme, or to book opera tickets (free for under 21s), visit eno.org
●For information about CLS, their concerts and work in the community, visit cityoflondonsinfonia.co.uk