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The Benefits of Singing - Classical Music Magazine March 2018
Our Director and Lead Singing for Health Practitioner Emily was invited to write a feature on the benefits of singing for Classical Music Magazine. This was part of a special edition about singing, put together by Sing Up. Here is the article which was published in March 2018. It is a summary of some of the research Emily carried out for her PGcert in Vocal Pedagogy and Professional Practice. Full references are included here.
Feeling the benefits of singing
What would you think if instead of a prescription for drugs, your GP encourages to join a singing group? This is emerging across the country as part of the Government’s ‘Social Prescribing’ initiative. It enables primary care services to refer patients with social, emotional or practical needs to a range of local, non-clinical services, often provided by the voluntary and community sector (www.opm.co.uk).
A study of nearly 2,000 singers found that perceived benefits include; improved physical condition, cognitive stimulation, positive mental health, social connection and improved sense of well-being (Lynch and O’Donoghue, 2017). This echoes similar studies. With mounting evidence, it is no wonder that there are an estimated 400,000 choirs in the UK (Voices Now, 2017) with more than 2m people regularly singing. Along with a growth in community choirs, there are singing initiatives specifically targeting health conditions. The British Lung Foundation has supported and trained more than 50 singing leaders to kick-start groups across the UK (www.blf.org.uk/support-for-you/singing-for-lung-health/join-a-group) . Singing can help symptoms of breathlessness (Amadi et al, 2015 and Bott et al, 2016). The encouragement of deeper breathing and extension of exhalation helps to improve lung function and reduce feelings of anxiety, often linked with lung disease (Baldwin et al, 2006).
Singing for people with Dementia has shown improvements in general feelings of well-being as well as stimulating memory responses and promoting sense of belonging and social bonding (Eldirdiry Osman et al, 2014). Songs can stimulate memories, induce feelings of nostalgia and provoke emotional responses (Buchanan, 2007).
A commonly cited response to singing is the release of endorphins (Smith et al, 2010). This is an opiate-like chemical producing feelings of euphoria and is a natural pain-killer. Small-scale studies suggest that singing can support people with the management of chronic pain – something affecting between a third and half of the population (Croft et al, 2016).
Since the 1960s there have been significant advances in the understanding of neuroplasticity (Doidge, 2016). Singing can help to rebuild neural pathways (Norton et al, 2009). Singing for Parkinson’s Disease has been found to improve symptoms including speech loss and dysphagia (difficulty with swallowing) as well as promote improved posture and breathing (Hibbing et al, 2016).
Singing for all ages can promote feelings of well-being and decrease symptoms of depression and anxiety (Clift et al, 2008). Singing with others can have implications on overall well-being and depression (Alexander Haslam et al, 2015). The social element is prominent and important, enhancing other benefits of singing (Clift et al, 2008). The release of oxytocin, the ‘happy or love hormone’, associated with trust and bonding, is commonly cited as an outcome when we sing (Seltzer et al, 2010). Overriding stresses and worries (Smith et al, 2010), we may find ourselves in ‘flow’ or ‘in the zone’ (Csikszentmihalyi, 2008).
Whilst much research is recent, singing for health is no new concept. It can be evidenced to prehistoric times, when the melodious voice was used before there was a developed language (Mithen, 2006).
Roman Philosopher Porphyry wrote about the life of Pythagoras (born approximately 570 BC) describing ‘rhythms, melodies and incantations (healing songs) being used to charm away psychic and somatic afflictions.’ (Horden (editor), 2000).
With the health and well-being benefits of singing becoming increasingly recognised, there is a need for a new type of singing leader or expert. Singing with the primary aim of improving health requires a different skill-set than a traditional choir leader or singing teacher. It calls for knowledge and understanding of health conditions, a deep understanding of a holistic approach to singing and voice care and health.
Building on the Government’s recent publication recognising the role that arts can play in health and well-being (McGlynn et al, 2017), there is still some way to go. Singing for health and well-being must be taken seriously by health commissioners as a cost effective intervention. Currently the funding picture is patchy. Some CCGs (Clinical Commissioning Groups) are funding singing for health provision (eg in Gloucestershire where Singing for Lung Health is supported), whilst for others it is a lower priority, especially when dealing with deficits. Singing for Health practitioners must gather robust evidence which health commissioners will take note of. A relatively small investment in singing for health activity could save higher costs further down the line. People may have less need for medication, inhalers, GP visits and may lose less working days (back pain alone costs the UK £5b a year (www.britishpainsociety.org)). Social Prescribing is a sound concept, but relies heavily on voluntary sector organisations to provide activities where funding is often short-term. An ideal Social Prescribing initiative would be one which works more collaboratively with providers; commissioning and sourcing funding as a longer term strategy.
A voice is something we all (or most of us) have. You don’t need to be able to be worthy of an X-Factor win to enjoy the benefits. Whether it is the fun of a community choir, humming to steady your nerves before an exam, singing lullabies to a baby or chanting in a Yoga class, the versatility and power of the voice is vast. The human voice has the ability to elicit cognitive arousal more than any other form of music (Bachorik at al, 2013).
Alexander Haslam S, Cruwys T, Desdemona Chong E.M, Dingle G.A, Hornsey M.J, Jetten J, Oei T.P (2014) Feeling Connected Again: Interventions that increase social identification and reduce depression symptoms in community and clinic settings. Journal of Affective Disorders.
Amadi C, Joshi A, Panigrahi A, Sohani S (2014) Role of Music and the management of Chronic Obstructive Pulmonary Disease (COPD): A literature review, Journal Technology and Health Care archive, Volume 22 Issue 1
Bachorik J P, Li H C, Loui P, Schlaug G (2013) Effects of Voice on Emotional Arousal, Frontiers in Psychology
Baldwin R C, Connolly M J, Yohannes A M (2006) Depression and Anxiety in Elderly Patients with Chronic Obstructive Disease, Age and Ageing, Volume 35, Issue 5
Bott J, Cave P, Clift S, Doyle A, Hopkinson N.S, Lewis A, McKee H, Russell A, Russell J, Stern M, Taylor K, Welch L (2016) Singing for Lung Health: A Systematic Review of the Literature and Consensus Statement, NPJ Primary Care Respiratory Medicine
Buchanan T W (2007) Retrieval of Emotional Memories, Psychology Bulletin
Clift S, Hancox G, Staricoff R, Whitmore C (2008) Singing and Health: A Systematic Mapping and Review of Non-Clinical Research, Sidney De Haan Research Centre for Arts and Health
Croft P, Donaldson L.J, Fayaz A, Langford R.M, Jones G.T (2016) Prevalence of Chronic Pain in the UK: A systematic review and meta-analysis of population studies. British Medical Journal, volume 6, issue 6.
Csikszentmihalyi M (2008) Flow: The psychology of optimal experience. New York Harper and Row.
Doidge N (2016) The Brain’s Way of Healing, Penguin Books
Eldirdiry Osman S, Tischler V, Schneider J (2014) Singing for the Brain: A Qualitative Study Exploring the Health and Well-being Benefits of Singing for People with Dementia and their Carers, Sage Press
Hibbing P, Rading H, Sapienza C, Stegmoller E L, Wingate J (2016) Effects of singing on voice, respiratory control and quality of life in persons with Parkinson’s Disease, Journal of Disability and Rehabilitation, Volume 39
Horden P (editor) (2000) Music as Medicine: The History of Music Therapy Sincne Antiquity. 1st Edition, Aldershot: Brookfield, USA; Routledge
Lynch J, Moss H, O’Donoghue J (2017) Exploring the perceived health benefits of singing in a choir: an international cross-sectional mixed methods study. Sage Journals.
McGlynn et al (2017) Creative Health: The Arts for Health and Wellbeing, All Party Parliamentary Group publication, APPG http://www.artshealthandwellbeing.org.uk/appg-inquiry/
Mithen, S (2006) The Singing Neanderthals: The Origins of Music, Language, Mind and Body, New Edited Edition, London: W&N
Norton A, Marchina S, Schlaug G (2009) Evidence for Plasticity in White Matter Tracks for Chronic Aphasic Patients Undergoing Intense Intonation-Based Speech Therapy. Neurosciences and music III Disorders and Plasticity: Annals of the New York Academy of Sciences
Seltzer L.J, Pollak S.D, Zeigler T.E (2010) Social Vocalisations can release Oxytocin in Humans, Proceedings of the Royal Society B: Biological Sciences 297, number 1694
Smith G, Sprouse-Blum A S, Sugai D, Parsa F D (2010) Understanding Endorphins and their importance in pain management Hawaii Medical Journal