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All right. Hi again. Today, we're going to talk about another tool, which many of you may be using already intuitively, but again, I'm going to teach you a little bit more about understanding why maybe it's working for you, and then you might be able to use it with a little bit more nuance, a little bit more flexibility.

We're going to study music listening as a tool for anxiety management. And music listening is interesting because it is a tool which can interfere at more than one point in that emotion generation process model that we talked about before in several episodes. So remember with emotion generation it is a cycle that iterates. Anyway, This basic cycle has the four points. The first one is the situation. We have a situation that is filtered through our attention. Situations the first point, attention is the second point. The third point is the appraisal. So the situation filters through the attention, appraised by the appraising brain for its bearing on our wellbeing. And then the fourth point is the emotional response which is generated. And when we want to regulate our emotions, Then we need to interfere in one or more of these four points. We need to either modify the situation, modify the way you were using our attention, modify our appraisal of the situation or work directly on modifying our emotional response.

Now music listening is interesting because it interferes in multiple points in this emotion generation process. It can change your situation, it also can change the way that you're using your attention, the type of information that is getting through your attention, on which your brain is going to base its appraisals. So it can focus your attention on certain things and bring it away from other things. So it can manipulate how you use your attention. And it can also work directly on your physical bodily response. It's one of those strategies that can physically calm you. That can work from the bottom up when you are very upset. So it's interesting because it works at all of these points.

We're going to study several different reviews of studies. I like to use reviews and meta analyses of studies because these, this type of study has gathered many different studies together for us and has analyzed them and has looked at all of the different things that these studies are showing. And tries to show overall what it is that we can learn from all of these different studies that have been done. And so today we're going to focus on music listening. As I said, there's other ways to utilize music as an anxiety management tool, you have music therapy, which involves having a trained therapist. There's also a music making, which is also an interesting tool that we'll talk about later. But today we're going to focus on music listening, which is especially useful because it doesn't require any specialist knowledge or skills or equipment really, or even special ability. And you don't need a trained facilitator. You don't need a therapist. This can be self administered. So for that reason, it's a very accessible tool. And so I want to talk about it first, before we talk about the other uses of music in the future.

So first, we're going to talk about the findings of a particular systematic review and meta analysis of many different studies that look, this particular review looks at the effect of music listening, how it affects anxiety, if it is effective at reducing anxiety. So this review looked at 24 different studies. All of these studies were published in peer review journals. So they were all peer reviewed. They were all with adult samples. They did not look at its effect on children. This was the effect on adults. All of the studies in this review, investigated music listening's effect on naturally occurring anxiety. There are some types of studies that try to manipulate anxiety in the participants. So during the actual experiment, The participants are manipulated in some ways so that they will experience anxiety and then it, and then it tests music listening and its effect on that type of anxiety. But these researchers that did this review wanting to look at those studies that all test music listening's effect on naturally produced state anxiety. Anxiety that arose naturally in the people,, in their situation, in their lives and it wasn't manipulated. Because they really wanted to provide useful information for people who experience anxiety generally, and not as a result of some kind of manipulation. So it's, it's especially interesting and pertinent for our purposes, this particular study. What they found in analyzing and reviewing these 24 studies, peer reviewed, published studies, was that yes, music listening had a very significant and large effect on anxiety outcomes overall. There was not a significant difference that related to the setting. So it didn't seem to matter that much if the person, if the participants were listening in a health care setting or not, for example. It also didn't seem to matter very much the dosage, whether they're listening to less than 30 minutes of music or more than 30 minutes of music. That didn't seem to matter very much. It mattered a little bit, whether or not the participants chose their own music or sort of cooperated with the experimenter in choosing the music. So it was slightly more powerful, more effective if the participant had either chosen or cooperatively participated in choosing the music that they were going to listen to. But it was not a huge difference. Just a small difference. This review was especially interesting because it included studies that looked at a wide range of populations, including some populations that you would expect to be experiencing heightened anxiety, like prison populations, and those with significant health concerns and people with dementia. And so it seems that music listening uh, appears to be widely effective, offers benefits over a diverse variety of groups. But it's especially interesting and pertinent that it helps to decrease anxiety even in those groups that are experiencing heightened levels of anxiety. But this particular review did not look at comparing the effectiveness of different types of music, different genres of music. And it also didn't really try and look at the reasons why maybe music listening has this effect.

So we're going to go on to a couple of other reviews that help us that try and explore a little bit those reasons why this connection between music listening and anxiety reduction so that we can understand a little bit more of the reasons, the mechanisms behind why music listening might be helpful.

So one review that examined the effects of music listening on stress-related outcomes found a link between music listening and decreasing certain physiological indicators, indicators of anxiety, like heart rate and blood pressure. That it decreased, those, it brought those down. And so here we see a little bit of maybe the mechanism behind the music listening than it actually has this physical effect on our bodies. It's one of these physically calming strategies that we can use without much thinking, that will calm us from the body up, that it actually has a physiological effect on stress. Another systematic review and I'll put links to all of these different reviews in the show notes so you can look at them. They're quite interesting to be able to read completely. But this particular review looked at the biological impact of listening to music in clinical and non clinical settings. And so they were specifically looking for certain biomarkers that would show, show the impact that music listening had on people's biology, on their physiology. They found, uh, many studies that showed music listening causing a reduction in cortisol, which is an important stress hormone. So reducing the amount of cortisol. They also found studies showing that music, listening. Reduced blood glucose. And many of the other biomarkers that the studies analyzed we're part of the biological stress pathways, suggesting that the primary way that music listening affects us, biologically is through modulating the stress response. So again, here we see physiological bodily calming strategy that can calm us down.

So we talked a couple episodes ago about how we have certain situations in which certain types of tools are appropriate. We have tools that are thinking heavy, that are going to require a lot of brain power. And then we have other tools that are don't require a lot of thinking. They're just, they work on the body, they're behavioral strategies, and they can help us calm our brains down from the bottom up using our bodies. And apparently music listening is one of these strategies, that it physically calms the body. So just remember that, that this is something that you can use in those moments when you are already upset, when you're already very anxious and already high levels of emotional distress. And music listening can help calm you down without having to think much calm everything down to the point where you can have some. Mental functioning again. Because remember when we're really upset, we get reduced blood flow to our brains. And so then we can't use thinking strategies. So just remember music listening is one of those things that you can have in your emergency toolkit when you're already really upset and you need something that can calm you down quickly without having to depend on a lot of cognitive power. Studies talk about how music listening can be used for emotion, regulation, different types of emotion regulation. And how, when self-regulation through music listening is done in a positive way that it can support coping and reduce and even prevent different symptoms of anxiety. So it's, so it's definitely being shown in research to be a very powerful and effective tool for reducing anxiety in all different types of populations. And an even in those who are ex under extreme stress, like prisoners and like people with dementia.

Another aspect of music, listening that I wanted now to teach you about stems from work by neuroscientist Stephen Porges. And he made a study of certain features of music that trigger safety response or a threat response just kind of automatically in us, that we're not really aware of necessarily, but it's a very automatic, sort of hard wired response to certain types of music in our nervous systems. So he talks about how a threat or defense response is something that was present in ancient reptiles. It was important for their survival. Reptiles have a certain type of middle ear structure, which is different than ours. It is only sensitive to lower frequencies. Because it is dependent on bone conduction for the aural stimulus. And so they can sense the rumble of low frequency sounds and that alerts the animal to possible dangers in the environment, triggers a defense response. Now mammals also have this sensitivity to low frequency sounds, but, different than reptiles, we developed a sensitivity also to higher frequencies because of a special adaptation in our middle ear. We have a detached middle ear bone structure that under the right circumstances can actually dampen low-frequency sounds and help us to be able to hear the range of the human voice. So this evolutionary step was especially important for mammals because it allowed us to communicate in a range in which reptiles couldn't perceive, and it also allowed for social interactions between us that are related to nursing and reproduction, to interactive play and to being able to be calm in the presence of each other. And these are pro social behaviors. Porges calls them. These are cues that we give each other that the environment is safe. They are associated with a state where we don't need to be hypervigilant for danger and where it's safe for us to focus on social and cooperative interactions. So Dr. Pores is talks about how these hardwired associations, hardwired reactions that we have to different ranges of sound, meaning that the low range tends to be associated with threat and the range of the human voice associated with safety, that this, these hardwired reactions end up influencing our experience when we listen to music. So there is a particular type of human vocalization that we find especially calming. Porges talks about how mothers have an instinctive way of, of talking to their infants, which you've probably noticed, they have this sort of sing song, soothing voice that they just instinctively use with babies. And this is called vocal prosody.

So Porges talks about how music that is composed of melodies, that in a sense, imitate this type of sing song prosodic speech that mothers use will be especially calming to us, automatically, sort of unconsciously, because that is something that we associate with the safety of being in the mother in a mother's arms. Especially if that music has limited contribution from instruments that produce low frequency sounds because those low frequency sounds in our nervous systems are associated with threat. So listening to music that highlights sort of melodic imitations of the female vocal prosody and limt's contributions from low frequency sounds, will trigger feelings of safety because we will associate that with the absence of present predators, and the safety of being in the mother's arms.

So based on these principles Porges has developed a therapy regimen, which he calls the Safe and Sound Protocol. And the participant in this regimen listens to computer altered vocal music for 45 minutes to an hour a day for five consecutive days. And the way that the music is altered is it's basically filtered to minimize low frequency sounds and very high frequency sounds, and emphasizes sounds in the range of the human voice, especially the female human voice. And Porges uses this protocol to help sort of exercise that middle ear capacity to hear the range of the human voice. It exercises those middle ear muscles that when they are engaged and they're functioning properly, they will actually dampen the low frequency sounds, and they will emphasize the sounds, they will tune into the sounds of the human voice. And so in developing this protocol, Porges's theory was that when you exercise these middle ear, Muscles, the middle ears capacity to tune into the human voice and tune out low frequencies, that this also exercises the subjects capacity to regulate for social engagement, because the capacity to hear these sounds is related to social functions.

And so his theory was that exercising the capacity to hear these sounds helps us to regulate for social engagement or in other words, to regulate out of a threat response and toward a safety response. Or in other words, the response where we feel that we can approach, where we can connect with the environment.

This safe and sound protocol has been tested on patients with autism spectrum disorders. And interestingly enough, it has shown to be effective in reducing. Hypersensitivities that. Autism patients frequently experience. They are frequently hypersensitive to auditory and visual and tactile, and even digestive stimuli. They get easily overstimulated. They get, they get easily overstimulated and are hypersensitive to these stimuli. But doing this protocol of listening to this music and exercising these middle ear muscles reduced their sensitivity, their hypersensitivity to these different stimuli.
And it also has been shown to increase their spontaneous social behaviors. So it did seem to effectively regulate them, help them to shift out of this defense. Uh, state where they feel that they have to defend themselves, they feel overstimulated, they feel that they have to protect, and they don't feel like connecting to people. Instead, it helped them to increase their social behaviors, their efforts to reach out and connect socially.

Now what pertinence does this have to anxiety? Well, it's pertinent because it's showing the effect on autistic patients, of getting them out of a threat or a protection state and into a state where they are willing to connect. And as you remember, when we talked about the different appraisals that our brains can make of stress we highlighted two different responses. We highlighted a threat response and a challenge response. And a threat response was where we feel like avoiding and defending ourselves from the stressor. And as we've talked about many times, it triggers changes in our bodies, which make it difficult for us to think properly. And it makes us feel like we want to avoid the stressor, we want to defend ourselves. Whereas the challenge response motivates a different type of behavior. It motivates approach behavior. We feel like approaching the stressor because we feel like we can meet it. It's a different kind of appraisal where our brain decides that we have the resources for the demands in question. And so we can meet the stressor. And it triggers our bodies to be able to rise to the occasion and meet the stressor at hand. And it helps actually facilitate our performance, our thinking, our cognitive performance. So the fact that these autistic patients showed greater social engagement after this listening protocol shows that they were shifted from threat, from defense, and from avoidance toward connection. So they were effectively shifted out of a threat and protection state toward a connecting state. Which could mean either a challenge response, where they feel they still feel a stress in the situation, but they feel that they can meet the stressor. Or it could just mean that they feel completely safe, and there are no threats, and they are simply free and safe to connect with the environment. Either way this is positive. It shows the effectiveness on the physiological response of people with autism, and has interesting implications for those of us who, who suffer from anxiety.

So it's worth thinking about making a collection, a playlist of music for yourself, which de-emphasizes the bass and highlights melody, especially melody in the range of the female human voice. That can help trigger feelings of safety when you're especially upset. So, this is not something that you'll want to do when you're upset. It's going to be too difficult to go out and look for this music. But if you already have a folder of music, which fits this description, which has deemphasized low frequency sounds and really emphasizes the range of the human voice, it doesn't have to necessarily be vocal music, there's a lot of instrumental music, which also tries to imitate this vocal style and vocal range. But anyway, making a collection of music that fits this description for you to use when you're especially upset. And then it's already there. You don't have to think about it. You can just put it on. And maybe even have a habit of listening to it for 45 minutes or an hour a day, like the safe and sound protocol asks for, and use it to regulate when you're feeling especially upset.

Now of course, this is a response oriented strategy. If you're going to use it in this way, it's focused on physical response. And so going back once again to our idea of the process model and these different points where we're interfering in the emotion generation process. We can change our situation when we are listening to music, because it changes the stimulus in the environment that our brain is appraising. It can focus our attention on that music and away from other things which may be giving us anxiety. And it can physically calm us with its physiologically soothing properties, as it interferes in directly in that emotional response once, once it has already been generated. So in all of these points, we will be indirectly influencing our emotions. It will not be a direct way to regulate. It will be an indirect way to regulate because as we've gone over many times, The appraisal is what determines, which is what organizes our emotion. The appraisal is the central part, the central organizing component of emotion generation. But other things can influence our appraisal. So when we use music listening, Whether it's changing our situation, changing our attention, changing our emotional response or all three, it will exercise indirect influence to help us to change our appraisals and change our emotion, regulate our emotions. So I just want to emphasize that this is again, this is an indirect tool, but it can be very effective. It can help us, can make it easier, much easier for our brains to change their appraisal and get us out of an anxiety appraisal and into a safety appraisal.

Now of course, using the safe and sound protocol type music where we're minimizing bass and we're emphasizing vocal range is not the only way to use music to regulate our emotions. And in fact, there are studies that propose at least seven different strategies for using music for emotion regulation. They suggest these seven different categories of entertainment, revival, strong sensation, diversion, discharge, mental work, and solace. So there's many different ways that we can use music listening to regulate our emotions. But specifically when, when we're talking about anxiety it's good to keep in mind these principles of the safe and sound protocol. And how there's a certain type of music that will trigger a sense of safety especially powerfully because of our hardwired settings in our nervous system, which respond in hardwired ways to certain types of sounds in the environment. So I wanted to make sure that you knew about that information for you to use in a way that works best for you. But that's it for today. Thanks again for listening and see you next week.