Prof Nigel Osborne: Science is catching up with ‘medical music’

The internationally recognised composer, peace worker and musical therapy pioneer tells pharmaphorum how his emerging field stands at an important threshold.

History provides a wealth of commentary on the emotional value of music. One of the earliest came from Plato, who concluded that “rhythm and harmony find their way into the inward places of the soul”.

But translating such a widely acknowledged emotional impact into physiological improvements has been slow in coming, with medical authorities disdaining to back any sort of music therapy until fairly recently.

One of those hoping to advance the field is Professor Nigel Osborne. As well as being an internationally recognised composer, peace worker and adviser to the charity War Child, he’s also a pioneer of musical therapy.

Over the summer he supported Notes from the Frontline: A Celebration and Appreciation of NHS Key Workers, an event that celebrated the music made by NHS workers as part of a therapeutic path to heal the trauma caused by being at the frontline of the country’s response to COVID-19.

Prof Osborne spoke to pharmaphorum about the therapy areas that could most benefit from medical music, how health services are now approaching the area and his own work on technology that predicts how music make us feel.

How open are health authorities to the idea of ‘medical music’?

The atmosphere has changed very much over the last years. When I began being interested in medicine, I met a lot of closed doors with scepticism, from not just the medical professional, but from the musical profession too. That's changed radically. One of the reasons is that, in the late part of the 20th century, coming into our current century, science caught up with music in terms of the body and medicine.

From the beginning of human civilization, there's been the idea that music might have some role in helping people get better. Every society has it, and it's so pervasive. There had to be, of course, something there, our ancestors were not stupid for 250,000 years to practice this for no purpose. What happened was, of course, there came a point where science could not explain the effects of music and therefore didn't really want to have to deal with it.

Now that science has started to catch up with some of these ideas, what magnitude of change do you see it having?

[With] Music medicine, there was nothing dramatic, and it's very important we don't people don't expect dramatic things. These are small effect, but they're worthwhile effects. For example, we're trying at the moment to help children with night time epileptic seizures have fewer of those. If we can reduce into that and direct to the directive form these charges in children by a small percent, that will be a great benefit for children.

It could be a great benefit, and certainly is more effective than the medications available, which tend to have rather unfortunate side effects for children. We've got small little things that can help people developing along the way.

Where is your field today in terms of its development?

On a very important and interesting threshold. I think that there is the opportunity now to move research forward in very interesting ways. I think that we have to be careful about it, because I don't want it to become a fad, an enthusiasm, that incinerates overnight. I would like it to be a long-term project where certainly on the point where things can happen.

What's holding us up, on the other hand, would be, I think it will be quite some time before health services are prepared to pay the small amounts of money that are needed for this. For example, the system I developed, that enables the playlist, everybody wants it for free. During the pandemic, we have offered it for free [but] we have to pay our engineers.

Are you currently in discussions with health services or the pharma sector about this?

We've been actively in discussions [with health services] and trying to move that forward. It's difficult because it's obviously in a time of great need and demand for all sorts of things. It's not an easy moment, even though we have proven success in what's needed in the present.

The other way of moving forward which with pharma. I have the privilege of being involved in various pharma networks in the US. There is a consciousness, as you probably know in pharma, but there is a need for some fresh thinking and, obviously, we can provide that. That's a place for music medicine [and] it's in collaboration in pharma.

What aspects of medical music do you think pharma should pay most attention to?

The ones that I would point to immediately are those dealing with stress, helping people to relax. Which can be a great acumen to various interventions that pharma may wish to make and conversely helping people to rely on them. We could do that, and make them be more active, and stimulate them. Those are two very, very basic things. Then we go on to, we have much more subtle things where we can be producing things that can affect secretion, hormones, neurotransmission, autonomic levels, that we are able to predict those things.

There are more subtle things to be looked at. Right away down the line, for example, epilepsy intervention developing at the moment where we are on the fence as you know medication for epilepsy in children is not great. We will be able to radically reduce that in a new partnership hopefully as the research develops. We could make that more acceptable and better for the children.

How does your music/health technology X-System work?

It models the basic parts and organs of the brain involved in processing music. We model the patient's primary motor cortex and aspects of the limbic system, which receives that information and then becomes part of [the] effects on autonomic nervous system and endocrine systems, and so on.

The main work is done by the models. That means that we can have predictions of the effects of music on the mind and body, for example what's likely to happen to your heart rate. How are you going to feel more cheerful, how it's going to affect the movement. We can predict all of those things. One of the reasons the medical profession like working with us is that there are numbers … so it's accountable.

Does the type of music used matter?

It is really important. People respond best to the kind of music they like. That's important, but on the other hand, there is a real [musical genome] that address different aspects of the human mind, and body. Different music, different places and times have addressed different questions in human life. For example, if you want to dance go for west African music. If you want to explore your emotions go to Indian music.

On the other hand, there are music, many kinds of music, that'll be of help to people that [they] don't necessarily have to like. Music tends to have its effect anyway.

That's what we work on … the most universal interpretation. That means we can work in different parts of the world. We've done many trials in India, for example, and epilepsy trials are taking place in Croatia.

How did you apply medical music in your humanitarian work?

Where I unintentionally got started was when I was working in the war in Bosnia. I was working on human rights and I visited very early during the war. Those were dreadful situations for children. We knew fellow artists in the city and said, 'Look, what are we going to do about this?' We decided we would have a creative programme for children.

We began musical work with children and found extraordinary responses, very strong responses in children, but didn't decide to give it a label, as far as we were concerned we were distracting the children from the war’s horror.

The work began in 1993. I began understanding it in '94, '95. The [music therapy] principles work well so that we developed projects, also in Kosovo, Chechnya, the Middle East, East Africa.

Children with trauma are either very sluggish or hyperactive. Music can directly help motivate them, it can help regulate breathing which I think is very important, and then the body's chemistry can help regulate the trauma.

What do you think is the future for music medicine?

I very much hope that in Britain, the NHS and others will realise the power which has to help, with no side effects or little money. I would expect it possibly to be led by trauma-informed care. I think that's the part of the NHS most sensitised to it. I will very much hope we can continue our discussion with anaesthetics, with psychiatric trauma, with perinatal care and of course the treatment of epilepsy.

About the interviewee

Prof Nigel Osbourne, MBE, is a composer, peace worker and musical therapy pioneer. He served as University of Edinburgh’s Reid Professor of Music and has also taught at the Hochschule für Musik, Theater und Medien in Hannover. He now works internationally as a freelance composer, arranger and aid worker, and is the co-inventor - with the late Prof Paul Robertson - of the music therapy technology X-System.

About the author

Dominic Tyer is a journalist and editor specialising in the pharmaceutical and healthcare industries. He is currently pharmaphorum’s interim managing editor and is also creative and editorial director at the company’s specialist healthcare content consultancy pharmaphorum connect. Connect with Dominic on LinkedIn, Twitter or Instagram.