How Can Music Bypass Impairment to Reach The Wholeness of a Person?

Introduction

In Poland, it is my babcia’s 80th birthday, but she did not know it herself because of how much her dementia had progressed. She sat at the head of the table with a confused pout on her face and her head down. Her head was down as she fumbled with a small napkin on her lap, its surface patterned with two colorful flowers. She would nervously fold the napkin and unfold it and fold it again with shaky hands as if she was trying to fix it. Then she would trace the flower’s shape with her finger as if it were the only thing that was real to her, the only thing she understood at a birthday table surrounded by her family.  She needed something to distract her as we spoke around her. Then, on the radio, an old 60’s Polish song starts playing, called “Mamo moja jada goscie,” a song she would sing all the time as a child growing up in the traditional part of Poland called Kurpie. She stops fiddling with the tiny paper and looks up and smiles, then rocking back and forth, she sings “la” along to the song. Her voice followed the song as if it never left her, and she tapped her hand to the beat. She finally seemed present, and the whole family joined alongside her. After being isolated the whole dinner, we found a way to show my babcia how much love surrounded her on her special day. By the end of the song, her sister goes to hug her, and she hugs back and kisses her on the cheek. She knew it was her.

These experiences with my grandmother inspired me to learn more about her impairment. Cognitive impairment can take away a skill and take away a person’s sense of who they are. However, such impairment should not have to mean being isolated or socially disappeared. Because music operates through subcortical circuits that remain functional, even when explicit language, motor, or memory processing is damaged or overridden, music can bypass that impairment and reach the parts of a person’s brain that are still intact, restoring not only function but also personhood. Understanding this function on paper was not enough for me — I needed to see it for myself.  This particular power led me to explore this possibility during my internship at Mount Sinai’s Louis Armstrong Center for Music & Medicine, as I worked alongside music therapists like Kristen and Dr. Rossetti, and researchers like Tammy.

The Power of Music, Broadly Defined

Music profoundly influences us. It has lived with and within us for as long as humans have existed. Music serves many different purposes, including emotional, physical, symbolic, and social ones, for a diverse range of groups of people.

The power of music is shown in how it can physically reshape your brain. When music interacts with the brain, all parts of the brain are active. Perception, movement, memory, and emotion are all being exercised in a way an isolated task never would. That whole-network engagement is what builds plasticity, and plasticity is what eventually allows music to do something no other stimulus reliably can: reach around damage instead of through it. This is monumental because the brain is connected to the body, and the body functions through the signals it sends. So ultimately, when exercising a part of the brain to improve it, the bodily function that part of the brain controls will also improve, which is exactly what opens the door to bypassing impairment in the first place. Hallam and Himonides state that “music has a multiplicity of functions which operate at several levels: that of the individual, the social group and society in general” (Hallam and Himonides 4), showing that music can not be reduced to a singular function and its power is plural, plasticity only being the first piece of it.

A person’s emotions are among the most complex concepts a person holds, and the hardest part of a person to access directly. You can be the most articulate person, but states like grief, love, longing, and fear can be hard to put into words fully. However, music does not have that limitation. It can carry the shape of an emotion in a way language cannot. That is why someone can hear a song and break into tears without knowing why. The emotional power of music lies in the fact that it is not just a sound to enjoy, but an access point. Music serves as “a vehicle for emotional expression, conveying ideas and emotions which might be difficult to communicate in ordinary verbal interchanges” (Hallam and Himonides 5), reaching feelings that language cannot form. This concept will be important later in this paper because I will address how it influences a person who loses language altogether.

As strong as music is for its effect on the individual listener, it also holds tremendous social power. When music shifts from an individual personal experience to a shared experience, it takes on new meaning. Making music together creates a synchronized experience that’s built in real time. This synchrony does not just feel like connection — it becomes connection, at the level of brain chemistry, because it “creates and strengthens social bonds amongst interacting group members through endorphins, which are released during synchronized exertive movements in singing or playing together” (Hallam and Himonides 6). Shared music-making requires something of people that listening alone does not. It forces people to be vulnerable with their voice, timing, and imperfect participation. For someone with a cognitive impairment or mental illness, shared music experiences can offer a comfortable way to be seen without judgment and to stop being isolated and engage in the present moment. This is why “music fosters prosocial behavior, a shared sense of success, physical coordination, shared attention, shared motivation and group identity” (Hallam and Himonides 6) because it gives people a reason to lower their guard together. When music is shared, it does not just shape an individual and their emotions; it also shapes who “we” are and forms a group’s identity. This is similar to what sociologist Émile Durkheim calls “collective effervescence,” the heightened, almost electric sense of unity that arises when a group moves and feels something together, dissolving the boundary between individual and collective in the process. Durkheim was describing religious ritual, but the mechanism he described is the same one at work when a room full of strangers finds the same beat.

Beyond its power to connect people, music does something even more fundamental. Music does not just go through one ear and out the other; it physically alters your brain. Hallam and Himonides state that making music “draws on many brain functions, including those related to perception, action, cognition, emotion, learning and memory” (Hallam and Himonides 16). In other words, it moves through the whole system at once and is not confined to a single narrow pathway, as most single tasks are. This engagement with music is not short-lived. Over time, “extensive active engagement with music induces cortical reorganization, producing functional changes in how the brain processes information” (Hallam and Himonides 18). The brain is altering itself in a way that lasts and not just responding to music. Some clinical research suggests that music’s neurological power does not stop at the level of conscious thought.

According to Stephen Porges, the neuroscientist behind Polyvagal Theory, music also communicates directly with the autonomic nervous system, the part of the nervous system that regulates safety and threat, and operates completely outside conscious control. Andrew Rossetti, a music therapist who directs oncology music therapy at Mount Sinai, draws directly on Porges’ work. He explains that music “supports connectedness and co-regulation” and “communicates cues of safety to our nervous system,” which “down-regulate defense and optimize homeostatic processes” (Rossetti, ‘Environmental Music Therapy’ 135). This is not just theoretical and actually holds up under clinical testing. In a randomized clinical trial testing this mechanism in a radiation oncology waiting room, patients who received live, therapeutic music showed a significant drop in anxiety. Their anxiety had a median decrease of 16.6 points on a standard anxiety scale, compared to an increase in the control group (Rossetti et al., 2023, ‘A Clinical Pilot Study’ 58). If Porges’ theory explains why music can calm a nervous system that it never consciously reaches, this trial proves that it actually does. Music has been shown to interact with the brain on a whole other, unconscious level.

This unconscious quality of music is not a new revelation either; it is something researchers have speculated about for over a century. The philosopher Friedrich Nietzsche, who devoted himself to music and philosophy, put it, “we listen to music with our muscles” — a line the neurologist Oliver Sacks returns to in his own writing on music and the brain (qtd. in Sacks 2528). Kristen, another music therapist I worked alongside during my internship at Mount Sinai, echoed the same idea, saying, “music moves the muscles.” With Porges’ theory and Rossetti’s data, we can see that this is not just speculation. Music actually engages the body and brain as a single system, which is what makes listening to music such a distinct experience. 

If music’s neurological power lies in its ability to engage the brain and body as a connected system, then its critical significance lies in what happens when part of that system is damaged. For example, language relies heavily on specific and fragile brain regions responsible for grammar, word retrieval, and speech production, concentrated mostly in the left hemisphere. Music, on the other hand, draws on a much wider, more redundant network involving rhythm, pitch, and melody, which is processed in both the right and left hemispheres, in areas associated with movement, memory, and emotion. The two systems intersect at points, but they are not built on the same foundation, which means an injury precise enough to knock out language can still leave music’s broader network largely intact. Hallam and Himonides second this, saying, “clinical studies of those with brain damage revealed separate deficits in music and language” (Hallam and Himonides 46). In other words, a person can lose the ability to comprehend speech or to speak while their capacity for music remains completely untouched, and vice versa. This is what allows music to reach certain pathways and reach a person when language cannot, or they are impaired.

The Bypass Mechanism

This is exactly what happened to my babcia at our own dinner table. She sat in a wordless state due to her dementia, taking almost all speech away– until the melody of  “Mamo moja jada goscie” reached her.   Something inside her answered back. Looking at this mechanism more closely, I see that this separation between music and language is not something I noticed by chance. It has a name and a direct clinical application: melodic intonation therapy. For example, rather than asking a patient to speak, therapists sing sentences to them in an exaggerated, musical version of normal speech until it resembles a song. As Hallam and Himonides explain, this technique, developed by “Sparks and colleagues (1974)”, works by using “sung intonation of propositional sentences in such a way that the intoned pattern is similar to the natural prosodic pattern of the sentence when it is spoken” (74). The patients Sparks studied were not easy fixes. They were “eight severely, but not globally, impaired right-handed aphasic subjects with left hemisphere damage,” each of whom “had shown no improvement in verbal expression for at least six months” of standard language therapy (Hallam and Himonides 74-75).

This is the idea behind bypassing cognitive impairment: the therapy works not by forcing language back in through the original damaged pathway, but by rerouting it through music instead. My babcia was never enrolled in a clinical trial, but she is living proof of the same mechanism at work. Why is music able to bypass so many different types of damage, such as those affecting language, hearing, or memory? Part of the explanation goes deeper than any single neural pathway, reaching into the brain’s most ancient reward systems. The pleasure we get from music stimulates what neuroscientist Stefan Koelsch describes as “a phylogenetically old reward network that functions to ensure the survival of the individual and the species” (Koelsch 170). In other words, music does not depend on the same evolutionarily more recent circuits that language relies on. Instead, it has its own much older route into the brain, one that can remain intact even when more recent systems break down.

Kristen shared something a woman with Alzheimer’s said to her during a session: “I feel like I have forgotten more than I have ever known.” This is what daily pain is like with Alzheimer’s. It is not one dramatic loss but a subtle, contrasting awareness of disappearing until it has all gone. That is what a disease like dementia takes away from someone: not just words, but the certainty of who you were before you lost them. Music therapy cannot bring back everything that is gone, but it can reach and bring out the person that is underneath all that forgetting.

This idea of neurological bypassing can apply to any compromised system, and the effectiveness of music therapy in accomplishing this is supported by Hallam and Himonides, who summarize a study by Good and colleagues (2017) on children with cochlear implants. The children who received music training showed improved discrimination of melodic contour and rhythm, incidental memory for melodies, and emotional speech prosody perception, whereas a matched group given painting lessons showed no such improvements (Hallam and Himonides 74). This means the benefit was specific to music, not simply structured attention or care.

Work like this is also implemented in the Newborn Intensive Care Unit for premature infants. During my volunteer work at Mount Sinai, I observed music therapy in the Level IV neonatal intensive care unit, the Jo Carol and Ronald S. Lauder NICU. My mentor, Tammy, was studying how entrainment — matching the tempo of live singing to a baby’s breathing and heartbeat — affects oxygen and respiratory stability in infants born with conditions like Respiratory Distress Syndrome (RDS). While we do not yet have research findings, I observed it in practice at the hospital. I observed a baby with a small adhesive sensor strip on his forehead, connected to a near-infrared spectroscopy (NIRS) machine that tracked his fractional tissue oxygen extraction — a measure of how well the brain is receiving oxygen. As Tammy sang a soft jazz tune, matching her tempo to his breathing, he drifted off to sleep, and his vital signs remained stable throughout. This mirrors what Virtala and Partanen found in older infants: that ‘music-making and parental singing prompted infants’ early language development and auditory neural processing’ (Hallam and Himonides 74). Here, “bypass” is not the right word because there is not yet a damaged language pathway for music to route around. Instead, music arrives first to stabilize the nervous system before language has even begun to form, so that when language does emerge, it has a steadier foundation to build on.

The bypass also extends to motor impairment. Earlier this year, I heard this principle explained directly by David Leventhal, founding teacher of Dance for PD, in a talk at a conference on music and medicine called “Mechanism of Pain and Music.” Leventhal described the patients who arrived rigid, frozen, sometimes barely able to initiate a single step, and the patients who left moving with fluidity and grace once music and rhythm entered the room — the same body transformed by an external beat. There is a real mechanism behind this happening. Parkinson’s disease damages the brain’s internal timing system, the one responsible for cueing smooth, sequenced movement. Researchers explain “PD is associated with a loss of internal cueing systems, affecting rhythmic motor tasks such as walking,” but that “music and dance encourage spontaneous rhythmic coupling between sensory and motor systems” (Krotinger and Loui). The mechanism, they argue, works because rhythmic training can strengthen “neural pathways involved in motor control, auditory-motor entrainment, action observation, and/or kinesthetic or proprioceptive feedback mechanisms that could then be utilized as an alternative to impaired motor areas” (Krotinger and Loui). This means that rhythmic training builds alternative neural pathways that can substitute for the internal timing system the disease has damaged.

Leventhal described people in his dance classes learning to forget that movements are commands sent from their brains to their bodies, and to use music and rhythm to shift what they do from a common action to something they create. I think of it like this: instead of thinking of walking as moving your feet in front of each other, one at a time, you use the rhythm of the music to make it an action of moving from stone to stone across a calm river. Then, soon after creating these new scenarios, people who could take a step learn to create these full dances. The body is not relearning how to move. It is borrowing a rhythm it can no longer generate on its own.

What struck me most, though, was not the mechanism – it was what Leventhal said about identity. Parkinson’s, he explained, “affects every aspect of a person’s sense of self.” But in his classes, patients are given “a new identity — that of dancer, instead of just patient” (“David Leventhal”). That distinction is not small. It is, in miniature, the entire argument of this paper: the bypass is not just of a damaged motor pathway, but of an erased identity.

So far, every population in this section has had a body or brain system that was physically compromised. PTSD complicates that picture — the injury is not structural, but the isolation it produces looks remarkably similar. Combat-related PTSD often produces ‘feelings of loneliness and isolation from society, intrusive memories, outbursts of anger and generalized feelings of helplessness’ (Bensimon, Amir, and Wolf 34). Traumatic memories resist the kind of verbal processing ordinary memories allow — they are stored as raw sensory fragments, leaving many survivors unable to translate what happened into words at all. This is often called “the unspeakable,” however, I would push back slightly on where the block actually sits. It may also be that people around them cannot bear to listen to it, and that unwillingness closes a door that survivors might otherwise have tried to open. Music offers a route around that block: because music and trauma are both “sensory mediated,” music therapy can function “as a means of sensory approach to traumatic memories as a detour of linguistic and logical mediation” (Bensimon, Amir, and Wolf 40)—a way to reach a survivor without requiring either side of that broken exchange to work first.

In a study of six soldiers diagnosed with combat- or terror-related PTSD, group drumming produced measurable “increased sense of openness, togetherness, belonging, sharing, closeness, connectedness and intimacy” (Bensimon, Amir, and Wolf 34). One participant described the effect directly: “Once you beat the drum, although you don’t know anyone, it gives a feeling of togetherness which makes it possible for you to share everything with the group. It’s as if you’ll go naked in front of them. . . If something facilitated intimacy above all the instruments, it was the drums” (Bensimon, Amir, and Wolf 38). These soldiers were already receiving individual psychotherapy alongside the drumming session, yet it was the drumming, specifically, that participants pointed to when describing this particular kind of openness. That distinction matters. It shows that rhythm reached something in these men that conversation, on its own, had not yet reached.  

Mania presents a different kind of impairment altogether– not a damaged pathway, but a mind in crisis. A recent randomized study of 102 inpatients hospitalized for manic episodes found that those who received group therapy alongside routine nursing care showed significantly lower mania severity scores and significantly higher emotional stability scores than those who received routine care alone. This shows that the intervention “significantly enhances emotional stability and satisfaction among hospitalized manic patients” (“Effect of Group Music Therapy” e46082). Here, the damage was to the mind’s instability in general and not to a single damaged circuit that needs to be routed around. And still, music reached something that routine clinical care alone did not.

As I explain later in this paper, I would witness this effect firsthand in a room full of patients diagnosed with schizophrenia, bipolar disorder, and psychosis.

Wholeness as the Goal, Not Just Function

Bypassing impairment at the level of the brain is only half the picture. For many patients, the deeper impairment is not neurological at all but the isolation that the illness produces, and reaching a person there requires more than rerouting a damaged circuit. It requires community. Music therapy and community music are not quite the same thing, and the distinction matters here. As MacGlone and colleagues explain, “community music interventions are distinct as they may have positive therapeutic outcomes, but these are secondary to the realization of an enjoyable, sociable experience for participants” (MacGlone et al. 2). In other words, community music does not set out to fix anything. It sets out to include someone, and healing comes as a byproduct of that inclusion rather than the goal. This reframes the word “treatment” from correcting something to restoring someone’s wholeness.

That reframing matters because isolation is not a side effect of illness — it is often part of the injury itself. “Isolation due to social exclusion is a key contributing factor to such mental health impacts” (MacGlone et al. 2), and the reverse is just as true: reducing isolation can itself be a form of treatment, not just a pleasant side benefit of one. Nowhere is this clearer than in the case of Jack, a young man with a disability who took part in a community music program studied by researchers at the University of Edinburgh. In the year before the program began, his mother had watched him steadily withdraw, losing interest in things that once brought him joy. A month of medical investigation turned up no clear cause, though doctors suggested depression. Then the music workshops started. According to a staff member, Jack “came back to life,” joining with enthusiasm he had not shown in over a year, cracking jokes again, playing with expectations during the group’s songs the way he once had. His mother described it: “It’s like seeing the old Jack… they’ve just seen bits of him that’s like they used to see years ago, coming back.” (MacGlone et al. 8). What is striking about Jack’s case is what did not happen. Nothing about his underlying diagnosis changed. No pathway was repaired, no circuit rerouted. And yet something unmistakable had come back. That gap is the clearest possible illustration of what “wholeness” means in this paper. It is not the absence of impairment, but the presence of the person who was there all along, however hidden the impairment had made them.

This idea has a name, specifically in dementia care. Psychologist Tom Kitwood defined personhood as “a standing or status that is bestowed upon one human being, by others, in the context of relationship and social being,” adding that it “implies recognition, respect and trust” (qtd. in Tieu and Matthews). I keep coming back to that word “bestowed.” Kitwood is not saying that personhood is something a person has, locked safely away, no matter what happens to them. He is saying it is something given continuously by the people around them, which means it can also be withheld. A caregiver, doctor, or distracted family member can fail to bestow it through impatience, talking over someone instead of listening, and by treating a diagnosis as the whole of who that person is. Doing this can erode a personhood that no brain scan would ever show as damaged. This reframes what happened to Jack, and what happens every time my babcia sings. Neither the community music workshop nor my babcia’s song repaired anything measurable. But both moments gave back something that had quietly gone missing. For Jack, that was a sense of self his withdrawal had taken from him, and for my babcia, that was a place in her own family’s conversation, which her dementia had left her locked out of. What came back in both cases was not a restored function but recognition finally being offered again.

One of the researchers behind Jack’s program, Kirsty Brown, who has a disability herself and worked as a lay researcher on the study, gave this phenomenon the name “voice”. She defined voice as a form of self- expression that does not have to be verbal at all — participants could “sing, speak, play instruments,” but just as often, their voice showed up as “increased eye contact with others, bodily movement or gesture” (MacGlone et al. 6). Voice, in other words, is not the same thing as speech. It is whatever a person still has left to offer those around them, in whatever form it takes.

My babcia’s voice, that night at the dinner table, was a single syllable repeated in place of words she could no longer find: “la, la, la,” pitched exactly where the lyrics should have been. It was enough to bring her back.

None of this is merely an observation, and it does not apply only to dementia and disabilities. A ten-year follow-up study of people living with first-episode psychosis found that rates of “personal recovery,” “life satisfaction,” and “pleasure” were all higher than rates of “clinical recovery” — the disappearance of symptoms (Simonsen et al. 2112). In fact, “personal recovery overlapped more with emotional wellbeing than with clinical recovery” (Simonsen et al. 2118). Sixty-eight percent of participants had achieved at least one positive outcome after ten years, leading the researchers to conclude that a “good life with psychosis” was possible (Simonsen et al. 2112). This is the finding, stated in the language of psychiatric research rather than music therapy, that this entire paper has been circling. Wholeness was never the same as the absence of impairment and does not require a cure; it requires only what Kitwood said it does: constant recognition, respect, and trust. Sometimes that comes through a clinical trial. Sometimes it comes through a drum circle, a dance class, or a single syllable, sung at a dinner table, by a woman who lost the words but not the voice. Comprehending all of this can be done through reading, but watching it happen in front of your eyes in a room is so much more than an article can convey.

“It Brings Me Life”

I entered the “inpatient adult and geriatric psychiatric service unit” on the hospital’s fourth floor. The space is intimidating because people roam freely, and this section of the hospital is where patients with serious mental illness reside. . . It is my first time working with patients in these conditions, so I don’t know how to act. Not because I don’t want to be there, but because I can be standing two feet away from someone and have no clue what is going through their mind or what’s real and what’s not for them.

Patients carry their droopy faces as they drift, pace, and prowl around freely without reason. One person approached and stood closely behind me. In the common area, sets of eyes stare blankly at a TV playing. The eyes are not even watching the screen; they are just fixed there, not blinking or moving away.

The therapy room is different from the hallways. It’s clean and simple with a little bookshelf in the corner for patients to use. The chairs are arranged in a circle, with tables in the center, creating a sense of both distance and connection. Patients trickle in slowly, and I watch them carefully as each of their eyes darts around the room, trying to find the chair in the circle they feel the safest in. A guy on my left aggressively scratches his head and fixates on things around the room while the girls across from him look down rapidly tapping their feet. Then there is an older man at the end, and he is sitting back in his chair with his hands under the table, folded in his lap, his attention on the instruments placed down the middle of the circle. Kristen told me he rarely stays for the full sessions, trying to remain in his comfort zone. The feeling in the room feels uncertain until Kristen, the facilitator, asks a simple question. “What do you like about music?” People around the circle answer one at a time, and the old man at the end says, “It brings me life.” Kristen slowly starts playing her guitar and singing “Waiting on the World to Change” softly, almost under her breath. The soft strums allow everyone to drift into the shared experience comfortably. The instruments laid out are simple, nothing too sharp-sounding or jarring, like maracas, shakers, and small hand drums. Most people start reaching for instruments to play, whether it’s just to have something to hold or to add to the sound. The room, once filled with silence, drifts into a mix of different sounds, so softly played together, and the instruments disappear to the beat of the song Kristen is now singing.

Kristen stops singing at some point, and more questions about change and pushing people out of their comfort zones follow. I have previously learned some of their diagnoses, like schizophrenia, psychosis, and bipolar disorder, but as they play together and answer Kristen’s questions, their diagnoses disappear, and they turn into more complex humans. The older man finally grabs a small drum and a stick and plays so softly under all the other music that you can barely make it out. But as the bridge comes, he smiles and starts to sing along with Kristen. He stays for the full session.

Why This Matters: The Cost of Calling Music Optional

Nothing in this article is new information. The evidence for music therapy’s power to bypass impairment and restore personhood is not new, not thin, and not controversial within the field. And yet music therapy remains, in practice, an afterthought. Music therapy is treated as something offered when there is room in the budget, rather than built into the structure of care itself. Part of the reason is that music therapy does not fit neatly into a healthcare system built around pharmaceuticals and procedures. These things can be billed, coded, and reimbursed on a predictable schedule. A pill has a price, and a scan has a code. A conversation between a music therapist and a patient, no matter how transforming, often does not have that role in the patient’s treatment plan. As one recent review of music therapy in healthcare puts it plainly, “in many healthcare facilities and community settings, music therapy remains inconsistently funded, often relying on charitable support or short-term grants” (Lan et al.). Charity and short-term grants are not what you build a system of care on. They are what you build a program on and can be cut when the budget needs to be tightened.

This is not a problem of ignorance. The same researchers note that even mainstream medicine has been forced to take non-pharmacological approaches seriously, precisely because of “the limited efficacy and certain adverse drug reactions (ADRs)” of the drugs doctors have relied on instead (Lan et al.). In other words, the medical system already knows the current model has real costs, measurable harm, and real limits. It has turned to music therapy anyway due to necessity and not out of conviction. Funding has not kept pace with the growing evidence.

The disparity is not evenly distributed, either. Music therapy “has been formally recognized as a professional field in numerous Western countries, such as the United States, Canada, the United Kingdom, and Australia; yet, in many low- and middle-income countries. . . There is a lack of standardized recognition and proper reimbursement mechanisms” (Lan et al.). Access to a person’s own personhood being restored should not have to depend on where that person happens to live and how much money goes into the healthcare system they are born into.

This concept is the most visible in long-term and nursing home care — the exact setting where Kitwood’s model of personhood was first developed, because it was in those settings that he saw personhood most routinely eroded. A resident in a facility built around cost containment is, structurally, a line item before they are a person — a bed to fill, a set of medications to administer on schedule, a body to keep alive as efficiently as possible. Bestowing personhood, Kitwood’s word (constant recognition, respect, trust), takes time, attention, and staff who are not stretched so thin they cannot give it. None of that shows up on a balance sheet as a cost saved. It shows up, if it shows up at all, as a resident who is easier to manage, calmer, and less likely to need intervention. These are all outcomes a spreadsheet can register, even when it cannot register the reason behind them.

The researchers behind this same review are unambiguous about what needs to change: “government, clinicians, insurers, and healthcare payers must recognize music therapy as a reimbursable health service. . . establishing reimbursement pathways or national funding frameworks would legitimize music therapy as a part of the formal, standard practice” (Lan et al.). This is not a radical claim, nor is it strictly about music. It is a claim about what a healthcare system chooses to count as a real treatment, and what it allows itself to treat as an option or just a nice, extra form of care. That extra form of care has reached people like no pill can.

My babcia is fortunate because she has family who can give her the music that she cares about. Not every patient with dementia, not every survivor of trauma, not every person losing themselves has that. Whether they do should not rely on what a hospital’s budget can absorb this year. It should depend on what we, as a system that claims to care for people and not just their symptoms, are willing to call essential.

Conclusion

I wanted to write a paper like this as soon as I saw my babcia reawakened from a 60-year-old song that found an opening into her being. I needed to know more about what I had witnessed. I found that what reached her was not a miracle, but a mechanism. Music and language are not the same communication modality, no matter how intertwined they are, and if one is damaged, the other is not. The same rerouting that allowed her to sing was the reason a man rigid with Parkinson’s moved again after hearing a rhythm his own brain could no longer generate, and why deaf children were able to learn to hear speech through rhythm. This bypass is more than strengthening an area of the brain to restore a daily function because it is actually able to reach people with issues that do not impact a function but take over their entire mental stability: people with trauma so severe they cannot put it into words have used music to overcome it. This is possible because music’s influence on the brain is older than language itself and foundational enough to remain after other parts of the brain have been compromised. However, on closer inspection, it is apparent that none of this is actually the point. A bypassed pathway is not the goal, but restoring the person is. What is actually happening when my babcia starts singing a song she once knew, when a shy man opens up to a group of strangers, every time Jack “comes back to life”, is closer to what Kitwood called bestowal. The quiet, repeated act of recognizing someone as a person, respecting them as one, and trusting that they are still there to be reached.

The larger argument of this paper is that music can help heal and that neurological impairment does not have to mean disappearance. Music is one of the most powerful ways we have found to meet a person where they are. It should not be a luxury or a grant-funded extra but a requirement. We are born with one heart and one body, so if there is a way to prevent impairment from taking who we are away from the one life we have, there should be no discussion.

My babcia still goes through every day with dementia, and there is no cure. However, knowing that we can achieve those little moments where my babcia and others are not lost forever restores hope — not that the disease like this one will stop taking, but that what they take can still, sometimes, be given back.

References

Bensimon, Moshe, Dorit Amir, and Yuval Wolf. “Drumming through Trauma: Music Therapy with Post-Traumatic Soldiers.” The Arts in Psychotherapy, vol. 35, no. 1, 2008, pp. 34–48, https://doi.org/10.1016/j.aip.2007.09.002.

“David Leventhal.” Dance for PD, danceforparkinsons.org/about-us/staff-and-nyc-faculty/david-leventhal/.

“Effect of Group Music Therapy Combined with Routine Nursing on Emotional Stability, Symptom Severity, and Patient Satisfaction in Inpatients with Manic Episodes.” Medicine, vol. 104, no. 49, 2025, p. e46082, https://doi.org/10.1097/MD.0000000000046082.

Hallam, Susan, and Evangelos Himonides. The Power of Music: An Exploration of the Evidence. Open Book Publishers, 2022, https://doi.org/10.11647/OBP.0292.

Koelsch, Stefan. “Brain Correlates of Music-Evoked Emotions.” Nature Reviews Neuroscience, vol. 15, no. 3, 2014, pp. 170–180, https://doi.org/10.1038/nrn3666.

Krotinger, Anna, and Psyche Loui. “Rhythm and Groove as Cognitive Mechanisms of Dance Intervention in Parkinson’s Disease.” PLOS ONE, vol. 16, no. 5, 2021, e0249933, https://doi.org/10.1371/journal.pone.0249933.

Lan, Yung-Yi, et al. “Music Therapy in Health Care Practice: Promise, Pitfalls, and Policy Implications.” Frontiers in Human Neuroscience, vol. 20, 2026, article 1768102, https://doi.org/10.3389/fnhum.2026.1768102.

MacGlone, Una M., et al. “Understanding the Wellbeing Effects of a Community Music Program for People With Disabilities: A Mixed Methods, Person-Centered Study.” Frontiers in Psychology, vol. 11, 2020, article 588734, https://doi.org/10.3389/fpsyg.2020.588734.

Rossetti, Andrew. “Environmental Music Therapy (EMT): Music’s Contribution to Changing Hospital Atmospheres and Perceptions of Environments.” Music & Medicine, vol. 12, no. 2, 2020, pp. 130–141, https://doi.org/10.47513/mmd.v12i2.742.

Rossetti, Andrew, et al. “A Clinical Pilot Study on the Effects of Environmental Music Therapy on Anxiety and Waiting in Radiation Oncology: A Randomized Control Trial.” Music and Medicine, vol. 15, no. 1, 2023, pp. 52–62.

Sacks, Oliver. “The Power of Music.” Brain, vol. 129, no. 10, 2006, pp. 2528–2532, https://doi.org/10.1093/brain/awl234.

Simonsen, Carmen, et al. “A Good Life with Psychosis: Rate of Positive Outcomes in First-Episode Psychosis at 10-Year Follow-Up.” Psychological Medicine, vol. 54, no. 9, 2024, pp. 2112–2121, https://doi.org/10.1017/S0033291724000205.

Tieu, Matthew, and Steve Matthews. “The Relational Care Framework: Promoting Continuity or Maintenance of Selfhood in Person-Centered Care.” Journal of Medicine and Philosophy, 2023, https://doi.org/10.1093/jmp/jhad044.

---