The Psychoneuroimmunology of Music

“Every Illness is a Musical Problem, The Healing, a Musical Solution”

Cast your mind back thousands of years, and try to imagine living in pre-historic times. Your goal in life is to stay alive by hunting for food. Your survival instinct, known as the ‘fight or flight’ response, becomes activated when faced with an immediate danger, such as a wild beast. Adrenaline courses through your body, keeping your heart rate stable and temporarily shutting down your immune system. Miraculously, you overcome the threat and find your way back to safety. At this point, your body halts the release of adrenaline, instead focusing on the production of cortisol, which will re-activate your physiological systems and allow you to revert to normal functioning. Of course, whilst the likelihood of a stressful confrontation with a feral beast is slim in the modern world, humans are still faced with a vast array of experiences and situations which can be stressful through both acute and chronic pathways. The effects of stress are as relevant today as to our ancient ancestors, and the strategies available for regulation, prevention and treatment of stress are plentiful and creative. We have come leaps and bounds in our understanding of psychoneuroimmunology, (the field seeking to explore the effect of the mind on health and resistance to disease), but, of particular interest to students on the MSc Music, Mind & Brain (MMB) programme, is the relatively unexplored question: is there an inherent potential for music to act as such a healing power for the mind and body?

Despite continuous attempts throughout history, answering this question still remains a challenge. For example, the ancient Greeks believed that music was a type of magic that could vanquish evil spirits that caused illness, whilst the Mycenaean god Pajawo (2000 BC) believed that holy songs could cure disease (Fancourt, 2013). Given the advances of modern technology, it comes as no surprise that research on music and health is starting to grow rapidly within the scientific community. Nowadays, research has investigated the potential of musical treatments using cell counts, brain scans and psychological assessments. As one of the pioneering researchers in this field, Dr. Daisy Fancourt offered her insight into whether music can change our immune systems to the MMB research group at Goldsmiths, University of London on January 14th 2016.

When dealing with such a new area, Fancourt highlighted how important the concepts of consistency and replication are in designing and conducting good-quality research. In collaboration with colleagues, she proposed a new model, which can account more comprehensively for the different ways by which people are affected by music. These include musical components (e.g. rhythm and timbre), getting actively involved in music making and listening, bonding with others over music, and, developing that all-important personal tie to music (See fig. 1 from Fancourt et al., 2014).

Psychoneuroimmunology Model

Figure 1: A model of the system interactions involved in the psychoneuroimmunological response to music (Fancourt, Ockelford & Belai, 2014)

Furthermore, Fancourt suggested that each of these engagement mechanisms affect our physiology through different pathways. This has been demonstrated by Fancourt and her colleagues by examining change within identified biomarkers (specific cells, proteins, or hormones) in response to a musical intervention. In particular, her work has documented the responses of such biomarkers to group drumming and choral singing, with populations of mental health service users, professional singers, and cancer patients respectively. She has examined a change in stress hormones (adrenaline and cortisol) and sex hormones (testosterone and progesterone), along with other proteins called cytokines (involved in immune function) as a function of the musical interventions that have been delivered (Fancourt et al., 2016).

Inevitably, some of Fancourt’s work has attracted high-profile attention from outlets such as The Times, The Guardian and Classic FM including her study on the impact of singing on the endocrine system in low versus high stress situations (Fancourt, Aufegger & Williamon, 2015).

Classic fm article

Figure 2. Eric Whitacre and music as stress relief (Classic FM, March 2015).

Teaming up with composer Eric Whitacre, Fancourt and her colleagues collected saliva samples and psychological data from a group of professional singers on two consecutive evenings. On the first evening, they took part in an ordinary rehearsal (low-stress situation), but on the second, they performed a live concert to an audience of 610 people (high-stress situation). The comparative results showed a significant decrease in the stress hormones, cortisol and cortisone, across the low-stress condition, suggesting that singing in itself is a stress-reducing activity. However, the same stress hormones significantly increased across the high-stress condition, which highlighted that despite consistently being exposed to performance situations, professional singers have a preserved and important ‘fight or flight’ response, akin to that of our predecessors. This was the first study to show that singing can directly affect stress responses, and that this set of responses change depending on the performance conditions.

Given this, the evidence for music as a tool for potential health promotion has gained an increasing impetus. Fancourt then talked of how her research has also investigated the effectiveness of music in the physiological treatment of mental health. This work focused on observing a group of mental health service-users’ inflammatory responses (cytokine proteins) before and after a group-drumming intervention (Fancourt et al., 2015).

Rhythm for Life 435x290

Figure 3. Group drumming interventions

Previous research on depression has demonstrated that psychological symptoms are consistently accompanied by an excess of inflammation in the body. In an attempt to reduce both affected avenues, many alternative intervention programmes such as yoga or mindfulness have been developed, but Fancourt’s work with her colleagues has pioneered music in this domain. Taking the form of a control trial, service users were assigned to either group drumming or a different social activity for six weeks, in which saliva samples were collected pre- and post-sessions. For the first time, Fancourt and colleagues showed that a music-based intervention such as group drumming could enhance immunity and decrease stress over individual sessions, in addition to reducing inflammatory activity (i.e., cytokine activation) associated with poorer immune function. These results aligned nicely with reported improvements in scores on measures of depression, well-being and social resilience; again demonstrating the strong link between mind and body. Fancourt’s future work (in press) will expand upon this exciting finding by demonstrating the durable nature of this effect by following up service users’ physiological and psychological responses up to three months after their initial participation.

Providing scientific evidence supporting not only the effectiveness of music in achieving health outcomes, but sustaining these changes over time is something that could revolutionise modern approaches to healthcare, in terms of wellbeing promotion and alternative medicinal treatments. Fancourt is continuing to explore an array of such possibilities, as evident from her current involvement in research projects such as Music & Motherhood, which assesses the impact of creative interventions such as singing on the symptoms of postnatal depression, and Sing With Us, which will assess the effectiveness of choral singing as an intervention for cancer patients and their carers. Both studies will employ both psychological and physiological measures to further explore the fascinating relationship between mind, body and music; an enigma that has forever intrigued us as a species.

By Jessica Akkermans, Fiona Brien & Sarah Collin


Fancourt, D. (2013) Medicine musica: the eighteenth-century rationalization of music and medicine. Hektoen International Journal. Retrieved from:

Fancourt, D., Ockelford, A., Belai, A. (2014). The psychoneuroimmunological effects of music: a systematic review and a new model. Brain Behav Immun 36: 15–26.

Fancourt, D. (2015). An Introduction to the Psychoneuroimmunology of Music: History, Future Collaboration and a Research Agenda. Psychology of Music: 1-15.

Fancourt, D., Aufegger, L., and Williamon, A. (2015). Low-stress and high-stress singing have contrasting effects on glucocorticoid response. Front. Psychol. 6:1242. doi:10.3389/fpsyg.2015.01242

Fancourt, D., Perkins, R., Ascenso, S., Atkins, L., Kilfeather, S., Carvalho, L., Steptoe, A., & Williamon, A. (2015). Group Drumming Modulates Cytokine Response in Mental Health Services Users: A Preliminary Study. Psychotherapy and psychosomatics, 85(1), 53-55.

Fancourt, D., Williamon, A., Carvalho, L. A., Steptoe, A., Dow, R., & Lewis, I. (2016). Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity in cancer patients and carers. ecancermedicalscience, 10.


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