I Heard There Was a Secret Chord: Music as Medicine
When rigorous neuroscience confronts ineffable experience, what gets lost in translation from mystery to mechanism?
PART 1: CHAPTER-BY-CHAPTER LOGICAL MAPPING
Chapter 1: A Musical Species
Core Claim:
Music is a biological phenomenon with measurable therapeutic effects on brain function, physiology, and health outcomes—not merely cultural entertainment or subjective experience.
Supporting Evidence:
Levitin establishes dual framework: “Science seeks to find truth in the natural world. Art seeks to find truth in the emotional world”
Documents historical medical uses: Ancient Greek physicians prescribed specific musical modes for ailments (Dorian for mourning, Lydian for digestive problems)
Cites contemporary research: Music affects specialized neural pathways, synchronizes neural firing patterns, modulates neurotransmitters and hormones
Provides specific examples: LeBron James uses music for athletic performance; Parkinson’s patients use it for mobility; Alzheimer’s patients reconnect through it
Logical Method:
Levitin uses analogical reasoning throughout—comparing medicine to art (both deal with uncertainty and improvisation), shamanism to modern therapy (both use sound for healing), and establishing music as bridge between “evidence and scientific truths” (medicine) and emotional truth (art).
Logical Gaps:
Mozart Effect Critique: Levitin correctly debunks the claim that Mozart makes you smarter, but his explanation that “sitting in a dark room doing nothing made them dumber” lacks the precision he demands elsewhere. What specific cognitive mechanisms explain the control group’s impairment? Is it sensory deprivation? Attentional fatigue? The critique is sound but the counter-explanation is incomplete.
Frequency Hypothesis Rejection: Claims “there is no scientific evidence that music’s ability to heal... derives primarily from the specific frequencies of tones used” and that this “doesn’t make logical sense” because shamans couldn’t calibrate frequencies. This commits a category error—the inability of shamans to measure frequencies doesn’t prove frequencies are irrelevant, only that frequency-specificity wasn’t the mechanism for their practices. The actual refutation should rest on controlled experiments varying only frequency while holding other musical elements constant—which he doesn’t cite.
Personalized Playlist Future: Describes algorithmic curation that knows “you’re headed toward your parents’ home and... your blood pressure usually goes up” as beneficial personalization. But this surveillance architecture raises unexamined questions: Who owns this data? What prevents manipulation? The technological determinism here (”soon... becoming essentially invisible to you”) assumes benign implementation without addressing power dynamics.
Methodological Soundness:
Mixed. The chapter establishes important framework (music affects biology, individual differences matter, rigorous evidence is needed) but occasionally asserts mechanisms without fully unpacking them. The critique of poor research (Mozart Effect, Georgia governor funding) is excellent. The leap from “music affects neurotransmitters” to specific therapeutic protocols remains underspecified—how music modulates dopamine versus that it does are different claims.
Chapter 2: If I Only Had a Brain—The Neuroanatomy of Music
Core Claim:
Musical processing is anatomically distributed across virtually every brain region, with component features (pitch, rhythm, timbre) analyzed separately before integration—making music uniquely positioned to access multiple neural pathways simultaneously.
Supporting Evidence:
Maps auditory processing pathway: eardrum → brainstem → cerebellum → inferior colliculus → auditory cortex → specialized circuits for pitch/duration/loudness
Documents dissociations from patient studies: pitch perception can be lost while rhythm remains intact, and vice versa
Cites Singh study (National Brain Research Center, India): Musicians show greater white matter connectivity across “nearly every important computational and emotional center”
Describes multimodal integration: Music activates visual cortex (reading music, watching performers), motor cortex (preparation for movement), memory systems, emotion circuits
Logical Method:
Reductive analysis: Levitin deconstructs music perception into atomic components (frequency/amplitude/duration → pitch/loudness/rhythm → melody/harmony/timbre) to show how distributed processing creates unified experience. Uses patient case studies as natural experiments to demonstrate functional independence of musical subsystems.
Logical Gaps:
The Homunculus Problem: Levitin writes, “our subjective experience is that we simply hear the melody... The coherence of the signal... is effectively an illusion, but an adaptive one.” This raises the binding problem: what creates the illusion of unity from distributed processing? He describes aggregation circuits but doesn’t explain the mechanism by which separate pitch/rhythm/timbre analyses become phenomenologically unified. Saying it’s “adaptive” explains the evolutionary why but not the mechanistic how.
Individual Differences Paradox: Claims “there is no one song that everybody likes and no one song that everybody hates” yet also describes universal processing mechanisms (inferior colliculus, auditory cortex pathways). If the anatomy is universal, what explains the taste variation? He gestures toward “robust individual differences” from “genetics... environment... culture... random events” but doesn’t specify which of these factors accounts for how much variance. This is the classic nature/nurture dodge disguised as comprehensiveness.
Correlation/Causation Slippage: “Musical experience... changes the very structure and wiring of the brain” based on Singh’s connectivity study. But this is correlational data—we don’t know if musicality causes increased connectivity or if pre-existing connectivity predisposes toward musicality. Levitin is aware of this distinction (he critiques it explicitly in Chapter 13) but doesn’t apply the same rigor here.
Neurochemical Handwaving: Acknowledges “we have tools to track only about 10 of them [100 neurochemicals] in the human brain” and their influence is “likely to be region and circuit specific.” This undermines earlier confident claims about music “modulating key neurotransmitters and hormones.” If we can only measure 10%, how confident can we be about mechanisms?
Methodological Soundness:
Strong on neuroanatomical mapping (dissociations, pathway tracing), weak on mechanistic explanation of integration and individual differences. The tension: Levitin wants music to be both universal (everyone processes it through similar pathways) and individualized (therapeutic effectiveness requires personal taste). He documents both phenomena but doesn’t resolve the apparent contradiction.
Chapter 3: Oh the Shark Bites—Musical Memory
Core Claim:
Musical memory is exceptionally robust, preserved even in severe dementia, because music’s structural redundancy creates multiple retrieval pathways—melody, rhythm, lyrics, timbre can each independently trigger recall of the whole.
Supporting Evidence:
Ella Fitzgerald’s “Mack the Knife” performance: Forgot lyrics but preserved melody, rhythm, rhyme scheme, song history—demonstrating componential memory
Multiple memory trace theory: Each listening creates a trace; repeated exposure strengthens invariant features (melody, tempo) while encoding variable ones (context, volume)
Cross-indexing mechanisms: Music memories accessible via unlimited cues (emotional, sensory, autobiographical, factual)
Clinical cases: Alzheimer’s patients (Henry Dreyer, Glenn Campbell, Tony Bennett) retain musical abilities while other memories fail
Logical Method:
Empirical triangulation: Uses performance analysis (Ella’s improvisation), patient studies (Alzheimer’s cases), experimental results (song recognition studies), and theoretical models (multiple trace theory) to converge on explanation.
Logical Gaps:
The Overlearning Problem: Levitin claims musical memory for well-known songs is “preserved... with great precision” due to “massive rehearsal” from hundreds of listenings. But this contradicts his own evidence—memory isn’t precise, as shown by Ella forgetting lyrics and subjects making “perfectly reasonable substitutions” in Beatles songs (”you should be glad” → “you can’t be sad”). He’s conflating gist preservation with precision. These are different phenomena requiring different explanations.
False Memory Asymmetry: Documents extensive false memories (9/11 plane footage, Beatles production details, Reagan confounding movie with reality) but claims musical perceptual components are “more accurate than other memories.” What mechanism explains this asymmetry? Why would pitch/tempo/timbre memory be privileged over other sensory memories? He asserts it without proving it.
State-Dependent Retrieval: Describes how “when our spirits are high, we retrieve joyful memories effortlessly” creating “discouraging cycle of escalating despair” in depression. But he provides no quantitative data on effect size. How much does mood affect retrieval? Is this clinically significant or a minor bias? The mechanism is plausible but the magnitude is unspecified.
Hippocampal Card Catalog Metaphor: Proposes hippocampus functions as “card catalog” not storage location. But patient H.M. lost hippocampus yet retained some procedural memories—suggesting the metaphor is incomplete. If hippocampus is only an index, how did H.M. improve on puzzles without conscious recall? Levitin doesn’t address this contradiction in his own framework.
Methodological Soundness:
The chapter excels at demonstrating that musical memory is robust and multi-featured. It’s weaker on explaining why music receives privileged status compared to other structured information (language, for instance, is also highly structured). The “structure enables scaffolding” argument is circular—why does musical structure scaffold better than linguistic structure?
Chapter 4: Look at Me Now—Attention
Core Claim:
Music recognition persists across radical transformations (transposition, tempo changes, timbral variations) because brains extract invariant relational patterns rather than absolute features—demonstrating attention operates through pattern-matching on multiple simultaneous dimensions.
Supporting Evidence:
Ben White experiments (1960): Songs recognizable after pitch/rhythm alterations, time reversals, complete melody/rhythm elimination
McGill rhythm/melody identification study: 50% of songs identifiable by rhythm alone, 50% by melody alone, with “cue validity” determining ease of recognition
Patient dissociations: Mateo (stroke patient) lost pitch processing but retained rhythm, loudness, timbre; Ms. T (stroke) could read pitches but not rhythms
Attention as “mechanism of selection, enhancement, and integration” (Posner definition)
Logical Method:
Systematic elimination: By removing musical components (rhythm-only, pitch-only, timbre-only conditions) and testing recognition, Levitin isolates which features carry identifying information. Uses convergent validation from experimental psychology and neurological case studies.
Logical Gaps:
The Cue Validity Circularity: Defines cue validity as “distinctive, not easily confused with other memory entries” then uses cue validity to explain why some songs are easily recognized. This is circular—you’re essentially saying “recognizable songs are recognizable because they’re distinctive.” What makes a musical feature become distinctive? He doesn’t specify the mechanism by which brains learn to weight certain features as high-validity cues.
Pattern Matching Black Box: Claims brains “performed what computer scientists call a pattern match” but doesn’t explain the algorithm. How does the brain compare a degraded input to memory traces? What similarity threshold triggers recognition? He describes the outcome (recognition despite distortion) without specifying the process (how similarity is computed across multiple dimensions simultaneously).
The Waldo Problem: Uses “Where’s Waldo” to illustrate attention but then asks “which part of the brain made the first part of the brain the boss over the second” and calls it “infinite regress.” This is intellectually honest but leaves the question unresolved. If attention requires one part of brain instructing another, and that creates infinite regress, how does voluntary attention work? He identifies the paradox without solving it.
Multitasking Myth vs. Musical Integration: Claims “multitasking is a myth” (attention switches rapidly) but earlier described music as integrating “nearly every region of the brain” simultaneously. How can the brain integrate distributed musical processing if attention is a “limited capacity resource” that can only focus on “four or five things”? Either music bypasses normal attentional limits or the “four or five things” are higher-order integrated chunks. He doesn’t clarify which.
Methodological Soundness:
Experimental design is rigorous (controlled stimuli, blind coding by professional musicians, proper control groups). But the theoretical framework has unresolved tensions between limited-capacity attention and whole-brain musical integration.
Chapter 5: Daydream Believer—The Brain’s Default Mode
Core Claim:
Music facilitates entry into the default mode network (DMN), a brain state associated with self-reflection, autobiographical memory, and creative problem-solving—providing therapeutic access to subconscious processing that conscious attention cannot reach.
Supporting Evidence:
Raichle/Schulman discovery: Brain regions consistently deactivate during goal-directed tasks, activate during rest
Menon/Greicius network analysis (2003): Mapped DMN components (medial prefrontal cortex, anterior/posterior cingulate cortex, precuneus, angular gyrus)
Levitin/Menon study (2007): Listening to music facilitates DMN entry
Insula as neuroanatomical switch (2008): Right insula controls toggle between executive mode and default mode
Flow state research (Limb study): Jazz improvisation shows deactivation in dorsolateral prefrontal cortex (self-consciousness) and activation in medial prefrontal cortex (autobiographical memory)
Logical Method:
Convergent neuroscience: Triangulates from multiple imaging studies, patient cases (Clive Wearing’s temporal disconnection), and phenomenological reports (musicians describing flow) to build model of attention states.
Logical Gaps:
The Flow State Paradox: Levitin describes flow as “neither” executive mode nor default mode—”allows us to rise up above both to enter a state that borrows from both.” But this violates the seesaw model he just established. If insula is a switch between two states, how can both be active simultaneously? He needs either: (a) flow is rapid oscillation between states, or (b) the switch metaphor is wrong and it’s a continuum. He doesn’t commit to either.
Meditation Taxonomy Without Integration: Lists three meditation types (focused attention, open monitoring, loving-kindness) with distinct neural signatures but doesn’t explain how they relate to music listening or DMN. Are these different pathways to DMN or different DMN substates? The taxonomy sits isolated from the main argument.
Precuneus Contradiction: Claims precuneus (self-awareness hub) “is only connected to the rest of the default mode network when we listen to music that we like. When we listen to music we dislike, the precuneus severs its ties.” This is mechanistically implausible—how does the brain know in advance whether you’ll like music in order to pre-configure network connectivity? More likely: the precuneus remains connected but shows different activation patterns. He’s describing correlation (disliked music = disconnected precuneus) as causation (disconnection explains aversion).
The Consciousness Dodge: Acknowledges Dennett/Kinzborn rejection of “Cartesian theater” and multiple conscious awarenesses, but then continues using unitary consciousness language throughout (”your consciousness tells you what it feels like to be you”). He knows the framework is philosophically suspect but uses it anyway for convenience—intellectually honest but conceptually muddy.
Methodological Soundness:
Network analysis is solid. The insula-as-switch finding is important. But the chapter overreaches on mechanistic claims. Saying “music facilitates DMN entry” is supported. Saying precuneus severs connections based on preference is not—that’s interpretive leap from correlation.
Chapter 6: Interlude
Core Claim:
Musical perception is a constructive process operating in two stages (fast/holistic and slow/analytical), paralleling Kahneman’s System 1/System 2 thinking—and therapeutic effectiveness depends on engaging the fast, intuitive system while the analytical system steps aside.
Supporting Evidence:
Neisser’s two-stage perception model (1967): “fast, crude, holistic and parallel” versus “deliberate, attentive, detailed and sequential”
Kahneman’s dual-process framework applied to music
“Family resemblance” concept (Wittgenstein): Brain recognizes “Summertime” across wildly different versions (Ella Fitzgerald, Janis Joplin, Miles Davis) not through Aristotelian rules but similarity to prototype
Stimulus generalization: Same process allowing us to recognize friend’s voice when angry/joyful/hoarse
Logical Method:
Conceptual synthesis: Levitin maps cognitive psychology frameworks (Neisser, Kahneman, Wittgenstein) onto music perception to explain why rigid definitions fail and contextual interpretation succeeds.
Logical Gaps:
System 1/DMN Mapping Admitted as Imperfect: “The mapping isn’t neat and tidy because these processes are not always mutually exclusive and they often interact dynamically.” This is honest but undermines the analogy’s explanatory power. If System 1 only “maps loosely to the default mode,” what’s the value of the comparison? It’s illustrative, not mechanistic.
The River Metaphor Problem: “When we take individual rhythms and pitches... out of the musical performance, all we are left with is a bucket full of notes. No movement, no flowing.” This is poetic but circular. Why does music lose meaning when decomposed? The river metaphor doesn’t explain—it just restates that wholes are more than sums of parts. He needs to specify what emergent properties arise from the combination.
Individual Differences Remain Unexplained: Acknowledges “no two musical tastes are exactly alike” and “only 0.002% of songs are widely loved” but still hasn’t provided a generative model. If family resemblance explains recognition, what explains preference? He keeps deferring this question.
The Therapeutic Leap: Claims “music therapy can work across a wide range of applications” because “brains process different features of music separately” but this is a non sequitur. Separate processing explains why rhythm-based and melody-based therapies might target different circuits, but not why this separation enables therapy rather than complicating it. The logic jumps from neuroanatomy to therapeutic effectiveness without establishing the connecting mechanism.
Methodological Soundness:
The conceptual frameworks are well-chosen and properly attributed. But this chapter functions more as theoretical positioning than empirical argument—it’s preparing the reader for what comes next rather than proving new claims.
Chapter 7-8: Movement Disorders & Parkinson’s Disease
Core Claim:
Rhythmic auditory stimulation (RAS) provides external timing cues that compensate for degraded internal timing circuits in movement disorders, with music proving more effective than metronomes because it engages emotion and reward systems simultaneously with motor pathways.
Supporting Evidence:
Tout’s RAS methodology: Synchronizing gait to auditory rhythm improves walking stability, reduces falls, decreases freezing episodes
Effectiveness across conditions: Parkinson’s, MS, Huntington’s, stuttering, Tourette’s (five of eight major movement disorders respond)
Bobby McFerrin case study: Parkinson’s symptoms ameliorated during performance (”suddenly filled with energy... felt 80% better after the show”)
Motor hierarchy explanation: Speech/music require pre-planned sequences; disruption at any level (storage, retrieval, implementation, timing) causes dysfunction
Logical Method:
Mechanistic decomposition: Breaks motor control into component requirements (sequence planning, timing precision, sensory feedback, error correction) then shows how each can fail independently, producing different symptom patterns.
Logical Gaps:
Mel Tillis Explanation Is Incomplete: Claims singers who stutter in speech but not singing do so because singing is “overlearned” and “rehearsed performances become deeply entrenched.” But Tillis could sing improvised lyrics in performances of new songs he’d never rehearsed—contradicting the overlearning explanation. The actual mechanism is likely hemispheric (singing recruits right hemisphere more than speech), which Levitin mentions briefly but doesn’t fully develop.
RAS Persistence Mechanism: States benefits “can last for up to six months” and hypothesizes this occurs because “RAS encourages the brain to bypass damaged circuits, relying instead on alternative routes.” But how does temporary external pacing create lasting rerouting? What consolidates the new pathways? He’s describing outcome without explaining process.
The Paradoxical Kinesia Mystery: Documents that intense emotion can temporarily restore movement in Parkinson’s patients (grandfather jumping up to save grandson from stairs) and suggests music’s “thrilling or intensely emotional” moments might trigger this. But provides zero evidence that musical chills actually produce paradoxical kinesia. This is speculation presented as logical possibility without empirical test.
Bobby vs. Linda Ronstadt Asymmetry: McFerrin channels musical energy for “symptomatic release”; Ronstadt “unable to do so.” Levitin says “every case is different” but doesn’t explain what differs. Disease severity? Neural pathway affected? Psychological factors? “Like aspirin, music can treat symptoms of some people in some situations, but not everyone” is true but not explanatory—it’s admitting we don’t know the boundary conditions.
Methodological Soundness:
The RAS research is well-documented with proper controls. Patient case studies are compelling but anecdotal. The mechanistic explanations (motor hierarchy, timing circuits) are plausible but underspecified. Levitin is better at describing what works than why it works.
Chapter 9: Mental Health & Trauma
Core Claim:
Music provides non-pharmacological access to trauma reconsolidation by allowing emotional re-experiencing in aesthetically mediated context where feelings are less overwhelming—enabling recontextualization of traumatic memories before they re-store.
Supporting Evidence:
Collaborative songwriting for veterans: Reduces PTSD symptoms (avoidance, hyperarousal, hypervigilance) through “gentle and repeated exposure to artistic reinterpretation”
Group drumming bypasses language centers, facilitates default mode entry, increases feelings of “unity, togetherness, belonging”
Tracy Chapman’s “Fast Car” analysis: Demonstrates how bridge structure (present moment pain → transcendent memory → return to reality) allows dual processing of trauma and hope
Creative Forces program (DOD/VA/NEA): Three-phase approach (therapy → jam groups → community performance) shows measurable outcomes
Logical Method:
Narrative analysis: Close reading of song lyrics (Tracy Chapman, JD Beul’s “Unity” and “Motorland”) to demonstrate how musical metaphor enables expression of trauma that literal language cannot access. Uses case study method with veterans (Sam) and songwriter (JD Beul).
Logical Gaps:
Reconsolidation Mechanism Unspecified: Claims music allows “recontextualize [traumatic memories] in a more neutral, less fear-inducing light, before they become stored again” but doesn’t explain the neurobiology. Reconsolidation requires retrieval → modification → re-storage. At what stage does music intervene? Does listening to music during trauma recall weaken the fear conditioning? Levitin describes the goal (reconsolidation) without specifying the mechanism.
Aesthetic Distance Assumption: Assumes “immersing themselves in the emotional experience of music allows people to experience deep emotions aesthetically where they are less likely to be overpowering.” But what prevents musical trauma triggers? He notes veterans report music from combat can induce PTSD hypervigilance—so music doesn’t automatically create safe distance. The boundary between therapeutic re-experiencing and re-traumatizing is never precisely defined.
The Metaphor Magic Problem: Beautiful close reading of JD Beul’s songs showing how metaphor (life jacket = grandfather, Motorland = suburban facade) enabled expression of childhood sexual abuse. But why does metaphor enable expression? Levitin quotes Nick Cave: “writing a song... tells you something about yourself you didn’t know” but doesn’t explain the cognitive mechanism. Is it bypassing conscious defenses? Accessing different memory systems? The therapeutic value is documented; the mechanism is mysterious.
State-Dependent Memory Cycle: Describes how negative mood → retrieval of negative memories → reinforcement of negative mood creates “discouraging cycle.” But provides no data on intervention effectiveness. If music elevates mood, does that actually break the cycle or just temporarily mask it? The theory predicts music should enable access to positive memories when depressed—but he doesn’t test this prediction.
Methodological Soundness:
Case studies are powerful but not generalizable. The literary analysis is insightful but subjective (Levitin’s interpretation of “Unity” lyrics as sexual abuse metaphor—how do we know JD intended that reading?). The reconsolidation framework is borrowed from trauma therapy but not empirically tested with music specifically.
Chapter 10-11: Dementia, Alzheimer’s, Stroke & Pain
Core Claim:
Musical memory and motor pathways are phylogenetically older and more robust than language circuits, explaining why music remains accessible in severe dementia and can drive post-stroke language recovery through right-hemisphere compensation.
Supporting Evidence:
George (Alzheimer’s patient): Lost speaking voice but could “sing when music played as if he were 30 years old again”
Melodic intonation therapy: Gabby Giffords couldn’t speak single words but could sing “This Little Light of Mine” after 10 months
Keith Jarrett (stroke): Lost left-side paralysis, musical inspiration, but could still play with right hand
Joni Mitchell (aneurysm): Recovered walking/talking ability while nurses played personalized music selections
Pain studies: Music activates same neural mechanisms as propofol (anterior cingulate, GABA receptors, HIF-1α, vasopressin)
Logical Method:
Comparative case analysis: Uses different patient outcomes (George vs. Jarrett vs. Rollins) to isolate variables. Pharmaceutical parallels: Maps music’s mechanisms to known drug pathways to establish biological plausibility.
Logical Gaps:
The Jarrett Inspiration Mystery: Documents that Jarrett’s “well of inspiration was dry” after stroke even though his right hand could still play. Levitin speculates this is because Jarrett’s process required “feedback loop, from muscles to ear, to brain, and muscles again.” But Jarrett’s hearing was intact—so the feedback loop should work with one hand. The real variable might be embodied cognition (two-hand playing feels fundamentally different) or psychological (loss of mastery → loss of motivation). Levitin gestures toward this but doesn’t commit.
Joni Mitchell Recovery Attribution Problem: Lists possible causes (being home, passage of time, music, willpower) and says “my guess is that it was a combination of all of these, and that music was the catalyst.” This is admirably cautious but scientifically unsatisfying. Without controls, we can’t know if music was necessary, sufficient, or merely correlational. The recovery could have been entirely due to time + physical therapy.
Pain Relief Mechanism Remains “Feeble Beginning”: Levitin’s own words. Lists four possibilities (distraction, mood elevation, direct neurochemical modulation, placebo) and concludes “we couldn’t rule out or favor any of the four mechanisms.” Then continues making therapeutic recommendations anyway. This is honest about uncertainty but premature for clinical application.
The Scalability Paradox: Russo/Malik paper identifies “limiting factor in scalability... will be the time and effort required to personalize music” because licensed music therapists are scarce. Levitin’s solution: AI will automate selection. But this contradicts the book’s central thesis that “self-selected music is far more effective than music selected by someone else.” Can AI actually achieve what human therapists do, or is this technological optimism?
Methodological Soundness:
Patient case studies are moving but scientifically weak (n=1, no controls, multiple confounds). The pain experiments are properly controlled. The honesty about mechanistic uncertainty is refreshing but means the therapeutic protocols rest on shakier ground than Levitin’s confident tone suggests.
Chapter 12-13: Neurodevelopmental Disorders & Learning
Core Claim:
Williams syndrome demonstrates music is neurologically and genetically dissociable from general intelligence—preserved musical ability despite IQ 40-60 proves music is an independent cognitive faculty, not piggy-backing on g-factor.
Supporting Evidence:
Williams rhythm study: Performed equal to neurotypical controls despite 95% Down syndrome comparison group scoring incorrect
Creative musical completions: Williams syndrome individuals 3x more likely (45% vs 15%) to produce improvisatory responses rather than rote mimicry
fMRI results: Williams syndrome brains showed “entire brain responding to music, not just so-called music areas” with highly variable activation patterns
Genetic specificity: 20-gene deletion on chromosome 7, with STX1A (syntaxin) possibly modulating serotonin transporter gene SLC6A4 and oxytocin expression
ASD music studies (Batara/Quintin): Individuals with ASD recognize musical emotions accurately despite impaired social-emotional processing in other domains
Logical Method:
Double dissociation logic: If intelligence and musicality were the same faculty, you couldn’t have one without the other. Williams syndrome (low IQ, high musicality) and existence of non-musical geniuses prove they’re separate.
Logical Gaps:
The Phenotype Definition Problem Levitin Himself Identifies: Spends pages documenting that “music is not one thing, it is a bunch of different things” (melody, harmony, rhythm, timbre, composition, performance, emotional response, etc.) then studies Williams syndrome as if musicality is unitary. He’s searching for “the music gene” while simultaneously arguing music is too multifactorial to have one. This is intellectually honest (he admits the phenotype is “poorly defined, diffuse”) but scientifically problematic.
Genetic Mechanism Is Speculation: The best hypothesis is STX1A affects SLC6A4 which affects mood which affects musical engagement. But this is a four-step indirect pathway with zero direct evidence. Levitin himself notes “some individuals with all behavioral markers of Williams lack this deletion. Others who have the deletion do not have Williams syndrome.” This undermines the genetic foundation. He’s describing correlation not causation.
The Gordon Test Failure: When Gordon musical ability test couldn’t distinguish LA Philharmonic musicians from UCLA engineering students, Levitin concludes the test is bad. But alternative explanation: there is no unitary musical ability to test. The test failure supports his phenotype skepticism but contradicts his search for musical faculty. He doesn’t resolve this tension.
Cognitive Transfer Question Dodge: Calls the question “offensive” because “it implies that music is somehow not worth doing in its own right.” This is a value judgment masquerading as scientific critique. The transfer question is empirically valid regardless of whether we like the framing. He then documents extensive transfer evidence (enhanced verbal ability, processing speed, executive function) while maintaining music doesn’t need justification. Can’t have it both ways.
Methodological Soundness:
The Williams syndrome rhythm study is well-designed (blind coding, proper controls, creative completion category). The genetic speculation is appropriately caveated. But the enterprise has an unresolved contradiction: searching for biological basis of musicality while documenting that musicality resists definition.
Chapter 14-16: Everyday Life, Empathy, Meaning
Core Claim:
Music’s therapeutic power derives from its unique position as (1) evolutionarily ancient (phylogenetically older than language), (2) physically grounded in universal overtone series, (3) pragmatically ambiguous (open to personal interpretation), creating a “secret language” between listener and music that enables healing through personalized meaning-making.
Supporting Evidence:
Lullaby universals: Slow tempo, 3/4 or 6/8 meter, stepwise melody, soft timbre—stimulate oxytocin and prolactin in both parent and infant
Home music study: Families listening to music spent 3.25 more hours together, sat 12% closer, had 67% more sex, cooked 33% more meals together, reported 13% reduction in negative emotions
Empathy experiment (Mogil/Martin): 20 minutes playing Rock Band together created empathy levels equivalent to three years of friendship (130 hours of prior interaction)
Neural synchronization (Levitin/Menon/Abrams): Brainwaves of people listening to same music synchronize across frontal, parietal, limbic, cingulate, and insular regions
Overtone series derivation: All musical scales worldwide derivable from physics of vibrating strings (2:1 octave, 3:2 fifth, major/minor triads fall out mathematically)
Logical Method:
Layered explanation: Physical universals (overtone series) → neurobiological universals (beat perception in newborns, rhythm tracking) → cultural variations (which overtones get used) → individual interpretation (pragmatics). Each layer constrains but doesn’t determine the next.
Logical Gaps:
The Correlation/Causation Catastrophe in Family Study: Reports families spent more time together and had more sex during music weeks. But direction of causation is completely ambiguous. Possible explanations:
Music causes togetherness
Being in good mood → playing music + spending time together (common cause)
Experimental demand characteristics (families knew they were being studied about music effects)
Selection bias (families who agreed to participate might already value music)
Levitin ran “controlled experiment” (music vs. no music weeks) but didn’t control for placebo effect (families knowing they’re in “music week” might behave differently). The 67% increase in sex could be entirely because couples thought that’s what researchers wanted to find.
Empathy Study Is Methodologically Flawed: Twenty minutes of Rock Band = three years of friendship in empathy measures. But:
No delayed post-test (how long does effect last?)
Single measure (empathy during pain observation—what about other empathy dimensions?)
Novelty confound (maybe any novel cooperative activity works, not music specifically)
Demand characteristics (participants knew experimenters predicted musical bonding)
This needs replication with non-musical cooperative games as control condition.
Overtone Series Universality Overstated: Claims “all music we hear... have their origin in the overtone series” but his own examples contradict this:
Arabic maqamat use quarter-tones between Western pitches
Javanese gamelan uses non-equal temperament tunings
Talking drums in West Africa prioritize tonal patterns that don’t map to Western scales
What’s universal is the octave (2:1 ratio) and possibly the fifth (3:2). The claim that all scales derive from overtone series is Western-centric overreach.
Pragmatics as Explanatory Escape Hatch: Levitin concludes musical meaning is “best understood at the level of pragmatics”—context-dependent, individually interpreted, resistant to fixed definitions. This is philosophically defensible but scientifically unfalsifiable. If meaning is purely pragmatic, we can’t make testable predictions about what music will mean to whom. He’s traded mechanistic explanation for hermeneutic interpretation.
Methodological Soundness:
The overtone series physics is correct but its universality is overstated. The empathy and family studies need replication with better controls. The pragmatics framework is conceptually rich but empirically slippery—makes music’s therapeutic power simultaneously undeniable (it works for people) and unexplainable (we can’t specify why).
PART 2: COMPREHENSIVE LITERARY REVIEW ESSAY
The Unbearable Lightness of Being Evidence-Based:
Levitin’s I Heard There Was a Secret Chord and the Paradox of Musical Medicine
The number is 80 billion. That’s how many neurons Levitin tells us populate the human brain, creating “more connections than particles in the known universe.” It’s a staggering figure, meant to humble us before the complexity of consciousness. But there’s another number that matters more: 0.002%. That’s the proportion of available songs (out of 100 million on streaming services) that people actually love and play repeatedly. One song out of 50,000.
This ratio—boundless neural complexity producing ruthlessly selective taste—captures the central tension in Daniel Levitin’s I Heard There Was a Secret Chord: Music as Medicine. How can something so subjective, so resistant to prediction, so utterly dependent on individual taste, also be a reliable therapeutic intervention? How do we square the neuroscientist’s demand for mechanistic explanation with the mystic’s insistence that music’s power is ineffable?
Levitin, uniquely positioned as both cognitive neuroscientist and professional musician, attempts to hold this paradox in suspension. The result is a book that is simultaneously rigorous and rhapsodic, empirically grounded and phenomenologically expansive, committed to measurable outcomes and comfortable with mystery. It is also, inevitably, a book that sometimes collapses under the weight of its own ambitions.
The Architecture of Evidence
The book’s structure moves from foundations (neuroanatomy, memory, attention) through clinical applications (movement disorders, dementia, trauma, pain) to broader implications (learning, everyday life, meaning itself). This is pedagogically sound—we need to understand how music works in the brain before we can evaluate whether it works as medicine.
Levitin’s treatment of neuroanatomy (Chapters 2, 4, 5) represents the book’s strongest material. The mapping of auditory processing pathways from eardrum through brainstem to cerebellum to auditory cortex is precise and clearly explained. His use of patient case studies—Mateo losing pitch perception after stroke, Ms. T losing rhythmic reading ability, Mr. P losing timbre recognition—demonstrates the functional independence of musical subsystems in a way that abstract description cannot.
The default mode network discussion is particularly valuable. Levitin traces the discovery from Raichle and Schulman’s observation of consistent deactivations during goal-directed tasks, through Menon and Greicius’s 2003 network mapping, to his own 2007 finding that music facilitates DMN entry. The insula as neuroanatomical switch between executive mode and default mode is a genuine scientific contribution, replicated across multiple labs.
But even here, cracks appear. When Levitin describes the flow state as “neither” executive nor default mode but rather “allows us to rise up above both to enter a state that borrows from both,” he’s abandoned the mechanistic clarity he established. If the insula is a switch between two states, both can’t be active simultaneously. He needs to either revise the switch metaphor or explain flow as rapid oscillation. He does neither, leaving the reader with poetry where precision is required.
The Therapeutic Claims: What Do We Actually Know?
The clinical chapters (7-12) move from well-established interventions to speculative possibilities. The progression reveals an uncomfortable truth: the more rigorous the evidence standard, the narrower the claims we can make.
Strong Evidence (Levitin provides randomized controlled trials, meta-analyses, or extensive replications):
Rhythmic auditory stimulation (RAS) improves gait in Parkinson’s, MS, stroke patients
Music reduces anxiety and agitation in dementia patients
Melodic intonation therapy restores speech after left-hemisphere damage
Music reduces postoperative pain and anesthesia requirements
Group music therapy improves mood in depression (multiple studies)
Moderate Evidence (correlational studies, case series, small samples):
Collaborative songwriting reduces PTSD symptoms in veterans
Musical keyboard training improves hand function in MS patients
Singing interventions improve respiratory function in Parkinson’s
Music listening increases immunoglobulin A and NK cell activity
Weak Evidence (anecdotes, single cases, mechanistic speculation):
Music enables paradoxical kinesia in Parkinson’s (emotion temporarily restores movement)
Playing instruments reduces dementia risk (correlational, not causal)
Music during pregnancy shapes fetal brain development
Specific frequencies or modes have distinct therapeutic properties (ancient Greek medicine unsupported by modern research)
Levitin is generally honest about these evidence gradations, but his rhetorical structure obscures them. Patient testimonials (Bobby McFerrin, Linda Ronstadt, Rosanne Cash) receive as much space as controlled studies, creating false equivalence. When Bobby describes feeling “80% better after the show,” that’s a powerful anecdote. It’s not data. Levitin knows this—he explicitly critiques anecdotal evidence in Chapter 1’s Mozart Effect discussion—but he can’t resist the narrative seduction of individual stories.
The pain chapter (11) exemplifies both the book’s rigor and its limitations. Levitin’s own cold pressor experiment tested four mechanisms: distraction, mood elevation, direct neurochemical modulation, placebo. The finding: “we couldn’t rule out or favor any of the four mechanisms” and “those proportions were different for different people.” This is exemplary scientific honesty. But then he continues recommending music for pain management without specifying which patients, which pain types, which music, or which mechanisms to target. The gap between “we don’t know how this works” and “use this for therapy” is never adequately bridged.
The Individual Differences Problem That Won’t Go Away
The book’s most persistent tension: musical taste is radically individual, yet therapeutic protocols require some generalizability. Levitin returns to this problem obsessively:
“There is no one song that everybody likes and no one song that everybody hates”
“The right music is whatever music is right for us at any given time and place”
“Self-selected music is far more effective than music selected by someone else”
“Music therapy like any treatment needs to be individualized”
This creates a practical impossibility. If therapeutic effectiveness requires perfect personalization, and if taste is so idiosyncratic that we can’t predict who will like what, how do we scale music therapy beyond one-on-one sessions with licensed therapists?
Levitin’s proposed solution—AI curation based on listening history, biometrics, context—assumes the problem is information (we don’t know enough about the person) rather than principle (taste may be fundamentally unpredictable). But his own evidence suggests the latter. The Gordon musical ability test couldn’t distinguish LA Philharmonic musicians from engineering students. Collaborative filtering (people who like Drake also like Doja Cat) only works for people whose tastes conform to clusters. What about the 15-year-old whose favorite artists are Schoenberg, Snoop Dogg, and Appalachian murder ballads?
The deeper issue: Levitin wants music to be both universal (everyone processes it through similar brain pathways, making general claims possible) and radically particular (therapeutic effectiveness depends on idiosyncratic personal meaning). These aren’t necessarily contradictory—language works this way too—but he never constructs a coherent framework for how universals constrain but don’t determine individual responses.
The Williams syndrome research, meant to illuminate music’s biological basis, instead highlights the definition problem. Levitin documents that musicality involves “melody, harmony, rhythm, timbre, composition, performance, emotional response, improvisation, lyric writing, reading music, programming music, spotting talent, choreography, dancing, memory, and sensitivity to being moved.” If music is this multifactorial, what exactly got preserved in Williams syndrome? Everything? Specific components? He can’t say, because “we don’t have any way of measuring any of these components accurately.”
This isn’t a failure of Levitin’s research. It’s the honest acknowledgment that we’re trying to study a phenomenon we can’t define precisely. But it means the genetic claims must be drastically scaled back. We can say: people with Williams syndrome show enhanced musical engagement. We cannot say: we’ve identified the genes for musicality.
The Mechanistic Gaps That Matter
Throughout the book, Levitin is far better at describing what happens than how it happens:
What: Music reduces pain
How: Maybe distraction, maybe mood, maybe neurochemicals, maybe placebo—”we couldn’t rule out or favor any”
What: RAS improves gait in Parkinson’s
How: Perhaps “bypassing damaged circuits” through “alternative routes”—but what consolidates the new pathway?
What: Musical memories survive Alzheimer’s
How: Music is “phylogenetically older” and has “multiple retrieval pathways”—but why does age of circuit predict preservation?
What: Collaborative songwriting reduces PTSD
How: “Gentle and repeated exposure” enables “reconsolidation”—but at what stage of retrieval/modification/re-storage does music intervene?
These aren’t trivial gaps. Clinical application requires mechanistic understanding. If we don’t know why music reduces pain, we can’t optimize dose, duration, or musical parameters. We’re back to shamanism—it works sometimes for some people, and we’ll keep trying things until something sticks.
Levitin is aware of this. His pain chapter concludes: “Maybe the answer lies somewhere else” in the “saliency matrix” theory (context determines whether pressure = massage or injury). This is a promising direction but underdeveloped. He raises the question without answering it.
The most honest mechanistic admission comes late: “Whatever it is in music that is engaging, emotional, or social... is not a building block. It is the end product of a number of different elements coming together... through an epiphenomenon, one that involves indeed requires you as part of the experience.”
This is correct. Music’s meaning is constructed by the listener, not contained in the sound waves. But it renders any simple stimulus-response model of music therapy impossible. We can’t prescribe music the way we prescribe antibiotics because the “active ingredient” isn’t in the music—it’s in the interaction between music, brain, memory, culture, and moment.
The Method Problem: When Rigor Demands Reductionism
The book’s deepest tension lies between scientific method and musical reality. Science proceeds by isolating variables. Levitin’s own pain experiment is exemplary: separate music listening from other conditions, control for placebo expectations, measure specific outcomes. This is how you build knowledge.
But music resists isolation. Remove it from temporal context (the song’s placement in a playlist matters), social context (same song played at a concert versus hospital room means differently), autobiographical context (your history with the song), and you’ve destroyed the phenomenon you’re trying to study. Levitin acknowledges this with the river metaphor: “When we take individual rhythms and pitches... out of the musical performance, all we are left with is a bucket full of notes.”
The problem is he does need to isolate variables to make scientific claims. So the book oscillates between:
Reductive experiments: Testing whether rhythm-only or pitch-only conditions enable song recognition (Chapter 4)
Holistic frameworks: “Music is a uniquely powerful combination of elements that coalesce” such that “trying to isolate their individual contributions is not just difficult, but misguided” (Chapter 16)
Both are true, but they pull in opposite directions. The reductive experiments generate publishable findings but miss what makes music therapeutically powerful. The holistic appreciation captures the phenomenon but can’t generate testable hypotheses.
Levitin’s solution is to embrace both, moving fluidly between empirical rigor and phenomenological description. This produces a readable, emotionally resonant book. It does not produce a coherent theory of music as medicine.
The Case Studies: Moving But Not Probative
The book’s emotional power comes from patient narratives:
Bobby McFerrin singing through Parkinson’s diagnosis
Rosanne Cash relearning piano after brain surgery
Joni Mitchell recovering from aneurysm while nurses play her favorite music
JD Beul encoding childhood sexual trauma in metaphorical lyrics
Gabby Giffords singing “This Little Light of Mine” when she couldn’t speak
These stories are genuinely moving. They’re also scientifically weak. Single cases with no controls, multiple confounding variables, and retrospective interpretation. When Levitin writes about Joni’s recovery, he lists possible causes (being home, time, music, willpower) and admits “I can’t say for sure what caused the transformation.” Then why include it in a book subtitled “Music as Medicine”?
The answer, I think, is that Levitin is doing two incompatible things simultaneously: writing a popular science book that persuades through narrative and a scientific argument that convinces through evidence. Popular science thrives on individual stories that illustrate general principles. Scientific argument requires statistical aggregation that washes out individual variation.
The case studies work as existence proofs: music can be therapeutic, at least sometimes, for at least some people, in at least some conditions. They fail as effectiveness proofs: music reliably produces therapeutic outcomes when properly applied. The gap between these is the entire field of clinical trials.
What Levitin Gets Right
Despite these criticisms, the book makes genuine contributions:
1. The Scalability Problem Is Real
“There simply aren’t enough music therapists to go around.” This is the key challenge for music medicine. Levitin is correct that personalization is crucial and AI might help, though he’s optimistic about solving the prediction problem.
2. Music Engages Multiple Systems Simultaneously
The evidence that music activates “nearly every region of the brain that has so far been mapped” is well-documented. This whole-brain engagement distinguishes music from other interventions and plausibly explains broad therapeutic effects.
3. Phylogenetic Age Matters
Musical circuits being evolutionarily older than language circuits predicts they’d be more robust to damage. The melodic intonation therapy success with Gabby Giffords supports this. Right-hemisphere musical processing can compensate for left-hemisphere language damage.
4. Self-Selected Music Is Crucial
The replicated finding that patient-chosen music outperforms researcher-chosen music is important for clinical practice. Locus of control isn’t just psychological comfort—it affects neurochemical response.
5. Honest About Uncertainty
When Levitin writes “this may only constitute a feeble beginning” about pain mechanisms or “we don’t know yet” about optimal musical characteristics, he’s modeling intellectual humility. Too many popular science books oversell certainty.
6. The Pragmatics Framework
Even though it’s empirically slippery, the claim that musical meaning operates at the level of pragmatics (context-dependent interpretation) rather than semantics (fixed meaning) is conceptually important. It explains why music can have therapeutic power through ambiguity rather than despite it.
The Unrealized Potential: What’s Missing
1. Cost-Effectiveness Analysis
Not once does Levitin compare music therapy costs to pharmaceutical alternatives. If music reduces pain “as effectively as” low-dose opioids, what’s the cost per quality-adjusted life year? Without this, healthcare systems won’t adopt music protocols regardless of efficacy.
2. Mechanism-Targeted Protocols
He documents four pain mechanisms (distraction, mood, neurochemical, placebo) but doesn’t develop differentiated interventions. If pain is primarily inflammatory, maybe music that modulates cortisol. If it’s neuropathic, maybe rhythm-based distraction. The mechanistic agnosticism prevents optimization.
3. Adverse Effects Section
Pharmaceuticals require reporting side effects and contraindications. Music therapy gets a free pass. But Levitin himself notes music can trigger PTSD, exacerbate tinnitus (implied by the “unwanted music in public spaces” discussion), and might be ineffective or counterproductive for some conditions. Where’s the systematic adverse effects profile?
4. Integration With Existing Treatments
Most chapters discuss music as alternative to drugs. But optimal use is likely complementary—music + medication might enable lower drug doses with fewer side effects. Levitin gestures toward this (Parkinson’s patients might reduce Levodopa if engaging with music regularly) but doesn’t pursue it systematically.
5. The Measurement Problem
Acknowledges “we don’t have any way of measuring [musicality components] accurately” but doesn’t propose solutions. What would valid measurement look like? Until we can reliably assess melodic ability, rhythmic sensitivity, emotional responsiveness to music, the genetic and therapeutic research remains hamstrung.
The Stylistic Paradox: Accessibility Versus Precision
Levitin writes beautifully. The opening—transported by Art Blakey at Keystone Corner into “experiential fusion,” the state where “you and the music have become one”—immediately establishes both his authority (he’s lived this) and his rhetorical approach (phenomenology first, mechanism second).
This creates a tonal problem. Scientific writing demands hedging, conditionality, explicit uncertainty. Literary writing demands confidence, narrative momentum, emotional resonance. Levitin tries to do both:
Scientific hedging: “It may be that music is just one of several psychological enzymes... but if there are others, they have not revealed themselves to us as clearly”
Literary confidence: “Music reduces pain, increases resilience and resolve, and can actually change our perception of time”
The oscillation between these modes produces whiplash. One paragraph meticulously catalogs what we don’t know; the next makes sweeping claims about music’s power. The reader finishes uncertain whether music therapy is (a) rigorously proven intervention ready for clinical deployment, or (b) promising area needing more research, or (c) useful framework for thinking about music even if mechanisms remain mysterious.
All three are partially true, but Levitin never clearly delineates which claims fall into which category.
The Philosophical Endgame: When Science Meets Mystery
The final chapters attempt to theorize musical meaning. Levitin proposes music operates through pragmatics (context-dependent interpretation) rather than semantics (fixed meaning). This is his answer to the question: how can different people listening to different music have the same emotional experience?
The framework is borrowed from linguistics (Grice’s implicatures, speech act theory) and applied to music. A F# doesn’t “mean” anything in isolation—its meaning depends on what came before, what comes after, what key we’re in, what the listener knows, what they’re feeling, what they remember.
This is conceptually rich but empirically empty. If meaning is purely pragmatic, we can’t predict what music will mean to any given person. We’re back to “the secret chord is you”—therapeutic effectiveness depends on unreproducible personal history.
Levitin seems aware of this. His conclusion acknowledges music may tap into “something primal, universal, and profoundly mysterious” and that “mystery is delivered by music’s inherent ambiguity.” He’s abandoned the mechanistic project for phenomenological appreciation.
This is defensible. Maybe music’s therapeutic power requires mystery, ambiguity, resistance to explanation. Maybe trying to specify the mechanism destroys the phenomenon, like explaining a joke kills the humor.
But if so, we’re not doing medicine. We’re doing art. And art doesn’t get covered by insurance.
The Verdict: Necessary But Insufficient
I Heard There Was a Secret Chord succeeds as:
Synthesis of neuroscience literature on musical processing (excellent)
Introduction to music therapy applications (comprehensive, if sometimes uncritical)
Philosophical meditation on music’s meaning (thoughtful, inconclusive)
Personal testament to music’s power in the author’s life (moving, if solipsistic)
It fails as:
Mechanistic explanation of therapeutic effectiveness (too many gaps, too much speculation)
Clinical implementation guide (lacks specificity on protocols, contraindications, optimization)
Resolution of universal/particular tension (documents both, doesn’t reconcile them)
The book’s central weakness is also its defining strength: Levitin is unwilling to simplify music into something science can fully grasp. He knows that musical experience exceeds our current explanatory frameworks. Rather than forcing music into reductive models, he lets the mystery stand.
This makes him a better phenomenologist than mechanist. He can describe what it feels like to be transported by music (”experiential fusion”), trace the neural correlates (DMN activation, precuneus engagement), and document therapeutic outcomes (pain reduction, gait improvement). He cannot—and perhaps should not—reduce this to simple cause-effect relationships.
The question is whether healthcare systems will accept “it works but we don’t know exactly how or for whom” as sufficient justification. Pharmaceuticals with that evidence profile don’t get approved. Should music therapy be held to the same standard or granted special status as a low-risk intervention?
Levitin doesn’t answer this because it’s not a scientific question. It’s a policy question, an economic question, a philosophical question about how we balance evidence demands against therapeutic potential.
The Question That Remains
If you walk away from this book convinced that music has therapeutic power, Levitin has succeeded. If you walk away knowing how to reliably deploy music as medicine, he has not.
The gap between these is the entire project of translational research—moving from “this works in the lab” to “this works in the clinic” to “this works at scale.” Levitin has done the first. The second and third remain open questions.
Perhaps that’s appropriate. Maybe the book’s real contribution is demonstrating that music’s resistance to full explanation is not a bug but a feature. That the ambiguity, the context-dependence, the individual interpretation—all the things that make music scientifically frustrating—are precisely what make it therapeutically powerful.
Music works, Levitin shows us, not despite being irreducible to mechanism, but because meaning-making happens in the listener’s construction, not the sound waves’ delivery. The secret chord is you. The medicine is in the meaning you make.
That’s a beautiful idea. It’s also unfalsifiable. And in the space between beauty and proof, the entire question of music as medicine remains suspended, unresolved, perpetually in motion—like the music itself.
Tags: Daniel Levitin, music neuroscience, therapeutic applications of music, default mode network, pragmatics of musical meaning