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Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 51 – 60 Kreutz | Singing and Social Bonding Introduction


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Psychobiological effects of amateur choral singing were studied in a naturalistic controlled within-subjects trial. A mixed group of novice and experienced singers (N = 21) filled out brief ad hoc questionnaires of psychological wellbeing and gave samples of saliva for measuring levels of salivary oxytocin, cortisol, and dehydroepiandrosteron (DHEA) at the beginning of 2 rehearsal sessions and 30 minutes later. The singing condition included warm-up vocal exercises and repertoire pieces. In the chatting condition, dyads of participants talked to each other about recent positive life experiences. Within-subjects, repeated measures analysis of variance (ANOVA) on self-reported and physiological measures revealed significant Time X Condition interactions for psychological wellbeing and oxytocin. Comparisons of mean scores showed patterns of changes favouring singing over chatting. There were no significant interactions for cortisol, DHEA as well as for the cortisol-DHEA-ratio. These results suggest that singing enhances individual psychological wellbeing as well as induces a socio-biological bonding response.
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Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
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Why do people like gathering and singing together in groups?
Some evolutionary theorists suggest that singing may have
evolved as a means to facilitate social bonding [1], group
cohesion [2], or to enhance pro-social, cooperative behaviors
as well as empathy between individuals [3]. One implication
of these theories is that singing should provoke the release of
so-called social hormones such as, for example, oxytocin [4].
The present research was designed to test this assumption in a
naturalistic setting.
Recent studies suggest that singers even without any
formal training may experience flow (a psychological concept
related to perceived happiness) during group singing [5].
Members of amateur choral societies frequently report a range
of psychological, e.g., enhanced feelings of positive affect and
energy, and physical benefits, e.g. improved posture,
breathing, or physiological arousal, in response to singing [6]
(for a recent review see [7]). In fact, psychological benefits of
group singing have been affirmed in a systematic review as
one of the robust findings of a body of research [8], which is
otherwise characterized by lack of theory-building and
frequent methodological flaws [7]. Notably, chronic illness is
not uncommon among amateur choristers [9,10]. According
to qualitative self-reports, singing is often used as a means to
manage the psychological side-effects of a range of
psychosomatic and physical disorders including arthritis, lung
problems, chronic pain, or cancer [11].
Psychoneuroendocrine responses to music have been
studied in various naturalistic settings including music
listening and singing [12,13]. For example, Beck, Cesario,
Yousefi & Enamoto [14] reported differential effects of
rehearsing and singing in public on immune and stress
responses in semi-professional singers. Some participants
showed several-fold increases of salivary Immunoglobulin A
(s-IgA) after two hours of singing. S-IgA is a protein that is
released in the mucous tissues of the upper respiratory tract
and considered the first line of defense against bacterial and
viral infections [15]. By contrast, cortisol, a stress hormone
that is key to the hypothalamic-pituitary-adrenal-system
(HPA-axis; [16] was found to increase during public choral
performance [14]. Kreutz, Bongard, Rohrmann, Hodapp, &
Grebe [17] found that increases of S-IgA were present during
singing only, but not during listening to choral music. In the
same study, cortisol concentrations decreased during the latter
condition and remained constant during singing.
Oxytocin (OT) is a hormone that is associated with
procreation in animals [18] as well as with intimate
relationships and buffering stress in humans [19,20].
Accordingly, it is considered as a biological correlate of social
PRODUCTION NOTES: Address correspondence to:
Prof. Dr. Gunter Kreutz, Department of Music, Carl von
Ossietzky University Oldenburg, Ammerländer Heerstr. 114-118,
26129 Oldenburg, Germany. Email: gunter.kreutz@uni- | COI statement: The author declared that no
financial support was given for the writing of this article. The
author has no conflict of interest to declare.
Copyright © 2014 All rights reserved.
International Association for Music & Medicine (IAMM).
Full Length Article
Does Singing Facilitate Social Bonding?
Gunter Kreutz1
1Department of Music, Carl von Ossietzky University Oldenburg, Germany
Psychobiological effects of amateur choral singing were studied in a naturalistic controlled within-subjects trial. A mixed group
of novice and experienced singers (N = 21) filled out brief ad hoc questionnaires of psychological wellbeing and gave samples of
saliva for measuring levels of salivary oxytocin, cortisol, and dehydroepiandrosteron (DHEA) at the beginning of 2 rehearsal
sessions and 30 minutes later. The singing condition included warm-up vocal exercises and repertoire pieces. In the chatting
condition, dyads of participants talked to each other about recent positive life experiences. Within-subjects, repeated measures
analysis of variance (ANOVA) on self-reported and physiological measures revealed significant Time X Condition interactions
for psychological wellbeing and oxytocin. Comparisons of mean scores showed patterns of changes favouring singing over
chatting. There were no significant interactions for cortisol, DHEA as well as for the cortisol-DHEA-ratio. These results suggest
that singing enhances individual psychological wellbeing as well as induces a socio-biological bonding response.
Keywords: Amateur singing, Psychological wellbeing, Oxytocin, Cortisol,
multilingual abstract
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
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affiliation throughout life [21,22]. Increases of OT were found
in patients after open-heart surgery, when they listened to
soothing music [23]. In one study, which is most similar to the
present endeavor, Grape, Sandgren, Hansson, Ericson, &
Theorell [24] found that OT increased in both amateur and
professional singers after 30 minutes of a singing lesson. In the
same study, the amateur singers only reported increasing joy
and elatedness after singing.
Dehydroepiandrosteron (DHEA) is an androgen
produced by the adrenal cortex affecting various bodily
functions. Recently, DHEA has been implicated as anti-ageing
[25,26]. Because DHEA functions as antagonistic to cortisol,
increase in the cortisol/DHEA ratio is associated with higher
infection risk in older adults [27]. Positive effects of exercise
on immunity using this measure have been observed in older
adults [28]. Music-related studies on DHEA have remained
inconclusive. Whereas DHEA was found unchanged,
decreased cortisol/DHEA ratios have been observed in at least
three studies [29-31].
In sum, these various strands of research converge in
suggesting positive psychological effects of amateur singing on
individual health. Therefore, it was hypothesized that singing
in groups leads to significant increases in individual self-
reported measures of wellbeing and in decreases of negative
affect. Moreover, it was expected that group singing would
induce significant increases of oxytocin. Finally, it was
expected that singing leads to significant decrease of the
cortisol-DHEA ratio, which is considered a biological marker
of psychophysiological wellbeing. Contrary to singing, it is
expected that talking to each other does not evoke similar
psychologically beneficial and/or hormonal effects as does
Materials and methods
Recruitment of Participants
Participants were recruited by advertisement via television
(Westdeutscher Rundfunk, WDR, Cologne). There were no
limitations as to which individuals might apply for
participation in terms of demographic variables, ethnicity,
health status, or the like. However, individuals with little or no
prior singing experience were particularly encouraged to be
interviewed for the study. The interviews were conducted in
small groups and involved informal questioning of the
prospective choristers about their motivations and prior
singing experiences. In addition, they were asked to reproduce
a musical scale played by the choir master by singing a few
tones, in order to see, if prospective participants would show a
minimum of motivation for singing at all. There were no
rejections on the basis of the interviews, because all applicants
met these requirements. However, the recruitment procedure
ceased with the inclusion of the 40th chorister for logistic
reasons as well as to ensure a sufficient sample for the
prospective research study. Participants attended a series of 10
rehearsals in which a pre-selected repertoire of pieces was
prepared for public performance at the end of the rehearsal
period. Participation was free of charge and subject to varying
numbers of attendees between rehearsals.
A total of 40 choristers originally took part in the study. 10
individuals dropped out over the rehearsal period, but gave no
reason for leaving the choir, except for a few individuals who
indicated a conflict with other obligations. The 2 experimental
sessions were attended by 24 and 25 individuals, respectively.
Within this cohort 21 participants (16 female, 5 male; age
groups: 18-24: 1; 25-49: 7; 50-65 years: 14) were identical in
both sessions. The arbitrarily selected age groups suggest a
median age of over 50 years in this cohort. 9 participants
reported no previous experience in choral singing at all. The
other 12 participants had been singing at least for one year
with a maximum of 40 years (Median = 5.5 years). None of
the singers were currently enrolled in any other chorus. 12
individuals reported to be taking pharmaceutical medication.
Of these, 9 were suffering from chronic illness, whereas 4
indicated other reasons for their prescriptions. To respect
individual integrity and privacy, participants were not
required to provide more detailed health information. Thus,
to explore the potential influences of these between-subjects
measures, choral experience and taking medication were
considered in the ANOVA model.
General questionnaires on basic demographics (sex, age
group), music and singing background as well as health status
and medication were administered. They were designed to
inform about previous experiences in instrumental and
singing lessons as well as the years of singing activities,
particularly memberships in choral societies.
To assess psychological changes during the different
conditions, an ad hoc questionnaire of subjective feelings was
developed. It consisted of four target items, two positive: (“I
am feeling well” [“Ich fühle mich wohl.”]; “I am in good
spirits.” [“Ich fühle mich guter Dinge.”]; and two negative: “I
am feeling tired” [“Ich fühle mich müde.”]; “I am feeling
bored.” [“Ich fühle mich gelangweilt.”]. In addition, four filler
items were included, which were not considered in the
analyses. Each item was rated on a 7-point Likert-type rating
scale, with 1=”not at all” [“trifft gar nicht zu”] and 7=”very
much so” [“trifft völlig zu”].
Design and Procedure
2 out of 10 subsequent rehearsal sessions (sessions 7 and 8)
were selected to implement the research protocol. Each
involved one baseline and one follow-up measurement after
30 minutes. At these points of time each participant filled out
the psychological feelings questionnaire and gave saliva. All
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
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participants provided informed consent individually before
the study began.
In the singing condition (session 7), which was led by the
choir master, every attempt was made to preserve the
naturalistic character of this intervention. Importantly, no
interruptions by the experimenter or changing tasks took
place in the 30-minute period between the baseline and
follow-up measurements. The rehearsal began with
approximately 10 minutes of warm-up exercises that was
followed by rehearsing sections of pre-selected repertoire
pieces. The rehearsed music was chosen by the television
producers as part of a preconceived programme for a public
performance of the choir in a philharmonic concert hall in
Cologne, which took place after the last session of the
rehearsal period had been completed. However, the television
crew documenting the development of the project in other
rehearsal sessions and at the concert was not present during
the data collection sessions. The programme included three
pieces in four-part choral arrangements for soprano, alto,
tenor, and bass. Indeed, the particular piece that was rehearsed
during the remaining approximately 20 minutes after the
warm-up was a four-part version of California Dreamin’, a
well-known pop song composed by John Phillips and first
performed by The Mamas and the Papas in 1965 (see
Appendix). The two pieces that were rehearsed at other
occasions were Irgendwo auf der Welt [Somewhere in this
world], composed by Werner Richard Heymann in 1932, and
Falling Slowly, composed by Glen Hansard and Markéta
Irglová in 2006.
The rehearsal was conducted in sections from individual
as well as combinations of parts of the song such that with
some intermission in which the choir master gave instructions
on technical and expressive aspects of the performance all
choristers were engaged in singing for at least 10 minutes
before the second measurement took place.
By contrast, in the chatting condition (session 8), the
participants were instructed to have a chat with their neighbor
sitting next to them about recent positive life events for 10
minutes. To model the exposure to the choir master’s verbal
instructions at the time of the singing rehearsal, a short
paragraph on the origins of singing were read aloud to the
participants, before they swapped seats with their neighbors in
order to form new pairs to continue chatting about recent
positive life events for another period of ten minutes. Then
again, a short paragraph was read aloud about the origins of
singing. The whole procedure was repeated a third time such
that for each ten-minute pairwise chats, novel pairs of chatters
were formed.
Participants were asked to remain seated throughout in
the singing and chatting conditions. The conductor ensured
by appropriate gestures that the loudness level during chatting
should not exceed a certain limit. Participants reported no
complaints or difficulties while chatting to each other.
Hormone collection and analysis
Saliva was collected by Salivetts® (Sarstedt, Germany).
Participants were asked to spit into the tubes until filled with
about 10-15mm of saliva from the bottom. Salivettes were
kept ice-chilled and sent to the lab1 via express mail. Saliva
samples were centrifuged at 4 °C at 1500g for 15 min, and the
liquid samples stored at 20 °C until assayed. The dry samples
were reconstructed in the assay buffer immediately before
analysis. Trained medical personnel conducted all
preparations and processing of the saliva samples in strict
accordance to the instruction manuals of the respective ELISA
kits (see below). In particular, routines to guard against
potential inference effects were installed where appropriate
and multiple measurements were performed and the
concentrations of samples were calculated according to
relevant standard curves.
Determination of Hormone concentrations
Determination of hormones was performed using commercial
ELISA kits (DRG Instruments GmbH, Marburg, Germany).
The use of the specific kits (Oxytocin: EIA-3117; cortisol:
SLV-2930, Dehydroepiandrosterone: SLV-3012) was
consistent with previous research (e.g., [19]). Details
concerning the assay procedures, norms, and quality control
measures are presented in the respective user’s manuals.
Data analysis
The IBM SPSS Statistics® package 20.0 was used for all
descriptive and inferential statistics. A series of 2 x 2 repeated
measures analyses of variance (ANOVAs) were run with
condition (singing/chatting) as the within-subjects and time
(baseline/30 minutes later) as the repeated measure. With a
given minimum sample of n=21 and an expected effect size
f=.4 (“large effect”) the critical F-value required to detect
significant interactions was determined at F(1,20)=3.861.
Table 1 shows the mean scores of the self-reported positive
and negative feelings at the beginning of each session and 30
minutes later. A significant Time X Condition interaction
emerged for positive feelings [F(1,20)=9.655, p<0.01,
η2=.326], and this effect was robust after the inclusion of
either taking medication or choral experience as a between-
subjects factors. Subsequent comparisons of means show that
positive feelings increased significantly after both singing
[t(21)=5.593, p<.01] and chatting [t(20)=2.400, p<.01]. A
significant interaction was also observed for negative feelings
[F(1,20)=4.735, p<.05, η2=.191]. This interaction dropped to
a trend (p<.1) after the inclusion of either taking medication
1HIB Blutanalyselabor UG, Postfach 24 24, 38014 Braunschweig
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
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or choral experience as a between-subjects factor. Subsequent
comparisons of means show that negative feelings decreased
significantly after singing [t(21)=3.0448, p<.01], but not after
chatting [t(20)=.336, p=.741].
Table 2 shows the mean scores of the biological markers
at the beginning of each session and 30 minutes later. A
significant Time X Condition interaction emerged for
oxytocin (OT) [F(1,21)=7.988, p<0.05, η2=0.276], and this
interaction was unchanged by the inclusion of taking
medication and choral experience as between-subject factors.
Subsequent comparisons of means show that OT increased
significantly after singing [t(21)=12.300, p<.001], but not after
chatting [t(21)=1.289, p=.21]. The median of oxytocin
concentration increases was 39.46 % (SD=29.13) with the
lowest at 15.97 and highest individual increase at 142.62 %. It
should be noted, however, that high relative increases do not
necessarily reflect high absolute levels of concentrations. In
other words, although no single decrease of OT
concentrations was observed across subjects in the singing
condition, the absolute levels varied considerably from
individual to individual.
A final set of ANOVAs was run for cortisol, DHEA, and
for the cortisol/DHEA ratio. No significant interactions
emerged in any of these analysis. The direction of changes of
mean cortisol/DHEA values, which were of greatest interest in
the present study, was contradictory to the hypothesis being
tested. However, these differences did not even mark a trend.
These findings remained unaffected by logarithmic
transformation of the hormone measures.
It was hypothesized that singing in groups leads to significant
increases of behavioral as well as of biological indicators of
psychophysiological wellbeing. In particular, we expected
higher values in these measures after singing as compared to
chatting. These hypotheses were confirmed for self-reported
positive and negative feelings as well as for oxytocin, a
hormone that is associated with stress reduction as well as
social bonding [3,4]. No changes were found with respect to
the cortisol/DHEA ratio. The implications of these findings
will be discussed below.
The finding that psychological measures of wellbeing
increased during singing is in line with previous research
using different measurement instruments such as the Positive
and Negative Affect Schedule (PANAS; [17]), the Profile of
Mood States (POMS; [34]), or visual analogue scales [24].
Thus the present findings corroborate the view that half an
hour of singing is sufficient to enhance perceived
psychological wellbeing. It is of note that in our study chatting
in dyads also led to relatively smaller amounts but still
significant increases in positive feelings. Chatting, however,
was not associated with reduced negative feelings as
represented in a combined measure of tiredness and boredom,
whereas singing did show such a significant decrease at group
Positive feelings
Before session
30 minutes later
Negative feelings
Before session
30 minutes later
Table 1: Positive and negative feelings before and after singing and chatting; M = Mean; SEM = Standard Error of Mean.
Oxytocin (pg/mL)
Before session
30 minutes later
Cortisol (ng/mL)
Before session
30 minutes later
DHEA (pg/mL)
Before session
30 minutes later
Before session
30 minutes later
Table 2: Oxytocin, cortisol, dehydroepiandrosteron (DHEA) and cortisol/DHEA ratios before and after singing and chatting; M = Mean; SEM
= Standard Error of Mean; ng/mL were converted to pg/mL for cortisol before calculating the cortisol/DHEA ratio.
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
MMD | 2014 | 6 | 2 | Page 55
level. Note that baseline values in both conditions were
already in a more positive range for positive feelings and in a
more negative range for negative feelings. This means that
participants showed little indication of irritation or stress at
the beginning of each session. In a previous study, in which
singing was compared to listening to choral music, a quite
different pattern of psychological changes was found. In
particular, positive affect was unchanged after listening,
whereas negative affect increased [17]. Therefore, listening to
music may not always be superior to induce positive affect as
compared to other vocal interventions such as chatting about
pleasant life events.
To our knowledge, this is the first study to reveal that
concentrations of salivary oxytocin (OT) increased during
singing but not during chatting in the same group of
individuals. A previous study also has shown increases of OT
after singing [24]. However, that study looked at singers
receiving individual singing lessons and did not include a
control condition. The present findings thus confirm the main
hypothesis that singing induces a sociobiological bonding
response that is similar to those elicited during intimate social
relationships [22]. Interestingly, such social bonding
responses are not evoked by verbal communication, even
when positive topics during conversations are encouraged.
These patterns of findings thus offer support to evolutionary
theories suggesting that singing and music emerged to
enhance social bonding and mutual attachment in larger
groups of individuals. Informal follow-up questioning of the
choristers in this study indicated a high interest in sustaining
the choral activities in the same group. In fact, a previous
survey among 3145 choristers [35] revealed an average
experience of 19.5 years of singing. This means that since the
first commencement in singing activities (mostly during
childhood and adolescence), singing was absent for only 4 to 5
years in the choristers’ lives as adults. In other words, amateur
choristers often ascribe high priority to singing as their main
long-standing leisure activity in adulthood. In light of the
present finding, such strong attachment to group singing may
be explained, at least in part, by sociobiological bonding
responses as observed in the present study.
An important facet of OT responses in social relationship
is so-called affect synchrony. According to one study, the
”temporal coordination between the parent and infant’s
affective behavior is an important component of sensitive
parenting that contributes to infant development” (p. 753)
[38]. In fact, these authors observed that OT accounted for a
significant amount of variance in predicting parental affect
synchrony with their infants. However, affect synchrony also
occurs in intimate relationships among adults with the
implication of reducing attachment anxieties and buffering
Finally, there was no effect observed with respect to
changes of the cortisol/DHEA ratio. Determination of this
ratio is considered an improvement over measuring these
hormones in isolation. Previous research has shown this ratio
to decrease in response to music, while DHEA was unchanged
(see [36] for a summary). The change of means in the present
study did not point into this direction. Clearly, further
research is needed that should include extensive baseline
measurements and a longer intervention period to uncover
patterns of changes of this ratio in a more systematic fashion.
One obvious limitation of the present study arises from the 2
conditions, in which singing in a group was compared to
chatting in dyads only. Although an attempt was made to
model the choirmaster’s instructions in the singing condition
as short oral presentations in the chatting condition, there
cannot be certainty whether the collaborative use of the
singing voice is the only remaining difference between the two
conditions. For example, the song lyrics could have induced
more positive feelings than the verbal exchange of positive life
With respect to the ad hoc measures of positive and
negative feelings in this study, it is of interest that both
quantitative and qualitative responses of different kinds have
produced converging evidence by showing that positive
emotions might increase after singing [6]. For example,
reduction of tiredness after both singing and listening to
music occurred in another study on group singing [34]. The
present findings confirm that singing is effective in inducing
positive changes in these psychological variables.
Although positive feelings were assessed, there were no
direct behavioural measures taken with respect to social
bonding. In fact, it seems feasible to ask about the degree of
enjoyment of participating in the respective activities.
However, an even stronger indicator of attachment obviously
is commitment. A large proportion of members of the chorus
subscribed to continue singing with their choirmaster beyond
the official termination of the choir. This continued interest in
singing with the same group of people suggests that social
bonding was successfully evoked during the sequence of 10
rehearsal sessions.
Another limitation arises from the fact that in the
previous study on oxytocin-increasing effects of singing, OT
was measured in plasma while the present study used saliva
samples instead. However, previous studies suggest significant
correlations between plasma and salivary OT at the level of
r=.46 ([37], p. 673), and r=.41 ([38], p. 756). Since both
measures were also associated with behavioural variables in
each of the cited studies, they appear to reflect relevant
biological activity of this hormone.
The present study shows that group singing may lead to
increases in positive feelings, decreases in negative feelings as
well as to increases in the release of the hormone oxytocin,
which has previously been implicated in intimate social
bonding [32,33,38]. By contrast, the cortisol-DHEA ratio
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
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remained unaffected. Taken together, these findings support
the theory that singing facilitates social bonding.
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31. le Roux FH, Bouic PJD, Bester MM.The effect of Bach's Magnificat on
emotions, immune, and endocrine parameters during physiotherapy
treatment of patients with infectious lung conditions. J Mus Ther.
32. Feldman R, Gordon I, Schneiderman I, Weisman O, Zagoory-Sharon O.
Natural variations in maternal and paternal care are associated with
systematic changes in oxytocin following parent-infant contact.
Psychoneuroendocrinology. 2010;35(8):1133-1141.
33. Gordon I, Martin C, Feldman R, & Leckman JF. Oxytocin and social
motivation. Developmental Cognitive Neuroscience. 2011;1(4):471-493.
34. Unwin MM, Kenny DT, Davis PJ. The Effects of Group Singing on
Mood. Psychology of Music. 2002;30(2):175-185.
35. Kreutz G, Bruenger P. Musical and social Conditions of Singing: A
Study among German-language Choir Singers. Musicae Scientiae.
36. Koelsch S, Stegemeier T. In: MacDonald R, Kreutz G, Mitchell L, eds.
Music, Health and Wellbeing. Oxford: Oxford University Press.
37. Feldman R, Gordon I, Zagoory-Sharon O. The cross-generation
transmission of oxytocin in humans. Horm Behav. 2010;58(4):669-676.
38. Feldman R, Gordon I, & Zagoory-Sharon O. Maternal and paternal
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Biographical Statement
Gunter Kreutz, PhD, is professor for systematic musicology at the
Carl von Ossietzky University in Oldenburg, Germany. His research
interests include playing music, singing, dancing and listening to
music in every-day life.
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
MMD | 2014 | 6 | 2 | Page 57
All the leaves are brown -
All the leaves are brown and the sky is grey
All the leaves are brown -
and the sky is grey. I've been for a walk
I've been for a walk
and the sky is grey. I've been for a walk
on a win- ter's day.
on a win- ter's day, I'd been save and
on a win- ter's day.
I'd be safe and warm if I was in L. A.
wa - rm, if I was in L. A.
I'd be safe and warm if I was in L. A.
California Dreamin'
Singgemeinschaft Hard John Phillips/Michelle Phillips
Arr. Axel Girardelli
© Axel Girardelli
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
MMD | 2014 | 6 | 2 | Page 58
Ca - li - for nia,- Ca - li - for nia- dream - in
California Dreamin' Seite 2
on such a win- ter's
Ca - li - for nia- dream - - in' -
Ca - li - for nia- dream - in' -
day. Stepped in - to a church
get down on my knees
I passed a long-the way. Oh, I get down on my knees,
get down on my knees
Ipre- tend to pray.
and I pre - tend to pray, you know theprea-cher likes the
Ipre- tend to pray.
Prea - cher likes the cold - knows I'm gon- na stay
cold, he knows I'm gon- na stay,
Prea - cher likes the cold - knows I'm gon- na stay
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
MMD | 2014 | 6 | 2 | Page 59
Ca - li - for nia- Ca - li - for nia dream- -
California Dreamin' Seite 3
in' on such a win ter's-
Ca - li - for nia- dream - in' -
Ca - li - for nia- dream - in' -
day. 15
All the leaves are brown -
All the leaves are brown, and the sky is grey.
All the leaves are brown -
and the sky is grey - , I've been for a walk
I've been for a walk
and the sky is grey - I've been for a walk
- on a win- ter's day.
on a win-ter's day, If I di dn't-
- on a win- ter's day.
Music & Medicine | 2014 | Volume 6 | Issue 2 | Pages 5160 Kreutz | Singing and Social Bonding
MMD | 2014 | 6 | 2 | Page 60
If I did - n't tell her I
California Dreamin' Seite 4
could leave to - day
tell her I could leave to day.-
If I did - n't tell her I could leave to day-
Ca - li - for nia,- Ca - li for- nia- dream - in',
Ca - li - for nia- dream - in' on such a win - ter's
Ca - li - for nia,- Ca - li for- - nia dream - in',
Ca - li for- nia- dream - in', Ca - li for- nia- dream
day, on such a win ter's- day,
Ca - li for- nia- dream - in', Ca - li for- nia- dream
- in' day.
on such a win - ter's day.
- in' day.
... Music interventions in cancer care are therefore a pertinent avenue to explore as they fulfil all three components: they have the potential to help participants express their emotions, enable them to interact with music as a new hobby and are inherently social. There is also growing evidence of the impact of music-making on neuroendocrine and immune responses in other patient populations [7], with previous studies showing that singing in particular can reduce levels of stress hormones such as cortisol, cortisone and progesterone and increase social bonding including the release of oxytocin [8][9][10][11]. Finally, animal research has shown that music played to rodents reduces the suppressive immune effects of stress associated with cancer, enhances anti-tumour response and improves white blood cell function [12], further paving the way for biological studies in humans. Within service development, there are a growing number of organisations delivering singing programmes for people affected by cancer, including patients, carers and staff. ...
... One hundred and ninety three participants took part in the study, with the majority being white women (Table 1). Participants across both groups were on average not symptomatic of having depression or anxiety and had average levels of wellbeing [8][9][10][11]. However, their social resilience scores were considerably lower than the general population (cf. ...
... The main finding from this study is that singing was associated with a decrease in cortisol and increase in cytokine activity, found generally consistently across all five choirs and among all four groups. Previous studies involving singing have demonstrated that singing can modulate cortisol levels [8, 10] . However, this is the first study to demonstrate that singing is associated with modulation of cytokines, receptors and neuropeptides involved in immune response. ...
Full-text available
There is growing evidence that psychosocial interventions can have psychological benefits for people affected by cancer, including improved symptoms of mental health and wellbeing and optimised immune responses. However, despite growing numbers of music interventions, particularly singing, in cancer care, there is less research into their impact. We carried out a multicentre single-arm preliminary study to assess the impact of singing on mood, stress and immune response in three populations affected by cancer: carers (n = 72), bereaved carers (n = 66) and patients (n = 55). Participants were excluded if pregnant or if they were currently being treated with chemotherapy, radiotherapy or oral immunosuppressive drugs. Participants were regular participants in five choirs across South Wales and took part in one hour of group singing. Before and after singing, visual analogue mood scales, stress scales and saliva samples testing for cortisol, beta-endorphin, oxytocin and ten cytokines were taken. Across all five centres and in all four participant groups, singing was associated with significant reductions in negative affect and increases in positive affect (p < .01) alongside significant increases in cytokines including GM-CSF, IL17, IL2, IL4 and sIL-2rα (all p < .01). In addition, singing was associated with reductions in cortisol, beta-endorphin and oxytocin levels. This study provides preliminary evidence that singing improves mood state and modulates components of the immune system. Further work is needed to ascertain how this differs for more specific patient groups and whether repeat exposure could lead to meaningful, longitudinal effects.
... As an intervention, it may be appealing and motivating given the different focus on use of the art form and thus encourage attendance and engagement [32,33]. The experience of making music provides a very different therapeutic encounter; music has an immediate impact (often positive) on mood [34] and within groups (especially singing) can promote social bonding [35]. A positive experience within a community-based group may then place the person in contact with their musical and psychological 'resources' [36], which-linking to wider theories of recovery in mental illness-may provide opportunities to build inner resources of coping, resilience and promote hope [37,38]. ...
... The intervention may be appealing and motivating encouraging attendance and engagement. Music has an immediate (often positive) impact upon mood [34] which may reduce symptom distress and within groups (especially singing), can promote social bonding [35]. Musical improvisation may support initial nonverbal communication of feeling states and aid patients in learning to name these [41]. ...
Full-text available
Background Despite effective treatments, one fifth of patients develop chronic depression. Music therapy may offer a different approach. This study aimed to assess feasibility and acceptability of a music therapy intervention and trial methodology. Methods A parallel two-arm randomised controlled trial with wait-list control, mixed feasibility/acceptability measures and nested process evaluation. Adults with long-term depression (symptom duration > 1 year) were recruited from community mental health services and computer randomised to 42 sessions of group music therapy with songwriting three times per week or wait-list control. Depression, social functioning, distress, quality of life, satisfaction and service use were assessed by blinded researchers at enrolment, 1 week and 3 and 6 months post-therapy. Outcomes were analysed descriptively, controlling for baseline covariates. Recruitment (number eligible, participation and retention rates) and intervention (fidelity, adherence) feasibility were assessed using pre-defined stop–go criteria. Attendance, adverse events, mood, relationship satisfaction and semi-structured interviews were analysed in a nested process evaluation. Results Recruitment processes were feasible with 421 eligible, 12.7% participation and 60% (18/30) retention. Thirty participants were randomised to intervention (N = 20) and control (N = 10). Session attendance was low (mean 10.5) with four withdrawals. Music therapist adherence was good but changes to session frequency were suggested. Outcomes were available for 10/20 treatment and 9/10 wait-list participants. Depression increased in both arms post-therapy. Treatment depression scores fell below baseline 3 and 6 months post-therapy indicating improvement. Wait-list depression scores increased from baseline 3 and 6 months post-therapy. At 3 months, the treatment arm improved from baseline on all measures except satisfaction and functioning. At 6 months, quality of life, distress and functioning improved with reduction in health service contacts. High-attending participants improved more than low-attending. Seven adverse events (one serious) were reported. Limitations As this was a feasibility study, clinical outcomes should be interpreted cautiously. Conclusion A randomised controlled trial of group music therapy using songwriting is feasible with inclusion criteria and session frequency modifications, but further intervention development is required. Trial registration ISRCTN18164037 on 26.09.2016.
... Interestingly, members of TG1 sang known songs together early in the process, while TG2 and WLG did not. Group singing quickly creates group cohesion and bonding (Kreutz, 2014) and early cohesion is linked to better treatment outcomes (Orfanos and Priebe, 2017;Tschuschke and Dies, 1994). Singing might be an important facilitator for songwriting and further shared vocal activities might have helped to build vocal confidence. ...
Songwriting is widely used in individual music therapy but less often in groups. This article draws on the authors’ experience of facilitating music therapy groups for adults with severe depression using songwriting. This work was part of the SYNCHRONY study, funded by the National Institute for Health Research, to assess the feasibility of conducting a randomised controlled trial of group music therapy with a songwriting component for patients with long-term depression (1 year or longer) within the community. The authors (all music therapists in the study) describe their experiences and reflections on the group processes and use of songwriting, drawing on semi-structured interviews conducted as part of the study. Themes of the work included pre-composed songs as a more accessible way to talk about difficult experiences, musical improvisation enabling an environment for songwriting, the impact of difficulties in attendance on group cohesion and the songwriting process, building confidence through song development and recording, and considerations around the end process and creating the song album. These are illustrated with clinical vignettes. Some recommendations for practice are also offered. The authors hope to identify the potentials and challenges of a songwriting approach in a community mental health context.
... Studies of singing and songwriting suggest that group singing can most powerfully invoke positive emotions, feelings of connectedness to others and group bonding [49][50][51][52] and act as encouragement for people to return to and participate in groups [53]. Creating bespoke songs as a group has the added potential for participants to begin to find ways of verbally expressing their experiences and having this supported through active group music-making [44,[54][55][56]. ...
Full-text available
Background Depression is of significant global concern. Despite a range of effective treatment options it is estimated that around one in five diagnosed with an acute depressive episode continue to experience enduring symptoms for more than 2 years. There is evidence for effectiveness of individual music therapy for depression. However, no studies have as yet looked at a group intervention within an NHS context. This study aims to assess the feasibility of conducting a randomised controlled trial of group music therapy for patients with long-term depression (symptom durations of 1 year or longer) within the community. Methods This is a single-centre randomised controlled feasibility trial of group music therapy versus wait-list control with a nested process evaluation. Thirty participants will be randomised with unbalanced allocation (20 to receive the intervention immediately, 10 as wait-list controls). Group music therapy will be offered three times per week in a community centre with a focus on songwriting. Data will be collected post-intervention, 3 and 6 months after the intervention finishes. We will examine the feasibility of recruitment processes including identifying the number of eligible participants, participation and retention rates and the intervention in terms of testing components, measuring adherence and estimation of the likely intervention effect. A nested process evaluation will consist of treatment fidelity analysis, exploratory analysis of process measures and end-of-participation interviews with participants and referring staff. DiscussionWhilst group music therapy is an option in some community mental health settings, this will be the first study to examine group music therapy for this particular patient group. We will assess symptoms of depression, acceptability of the intervention and quality of life. We anticipate potential challenges in the recruitment and retention of participants. It is unclear whether offering the intervention three times per week will be acceptable to participants, particularly given participants? enduring symptoms and impact upon motivation. This study will provide data to inform both development of the intervention and to assess and inform the design of a full trial. Trial, ISRCTN18164037. Registered on 26 September 2016.
Full-text available
This chapter begins with an overview of non-clinical studies involving existing community choirs and singing groups or which have established singing groups for purposes of research. The focus then shifts to therapeutically oriented research investigating the value of singing for people with specific health or social care needs. The chapter concludes with a brief outline of the work of the Sidney De Haan Research Centre for Arts and Health, and its efforts to develop an integrated and progressive programme of research on singing, wellbeing, and health.
The book can be viewed as representing the birth of evolutionary biomusicology. What biological and cognitive forces have shaped humankind's musical behavior and the rich global repertoire of musical structures? What is music for, and why does every human culture have it? What are the universal features of music and musical behavior across cultures? In this groundbreaking book, musicologists, biologists, anthropologists, archaeologists, psychologists, neuroscientists, ethologists, and linguists come together for the first time to examine these and related issues. The book can be viewed as representing the birth of evolutionary biomusicology—the study of which will contribute greatly to our understanding of the evolutionary precursors of human music, the evolution of the hominid vocal tract, localization of brain function, the structure of acoustic-communication signals, symbolic gesture, emotional manipulation through sound, self-expression, creativity, the human affinity for the spiritual, and the human attachment to music itself. Contributors Simha Arom, Derek Bickerton, Steven Brown, Ellen Dissanayake, Dean Falk, David W. Frayer, Walter Freeman, Thomas Geissmann, Marc D. Hauser, Michel Imberty, Harry Jerison, Drago Kunej, François-Bernard Mâche, Peter Marler, Björn Merker, Geoffrey Miller, Jean Molino, Bruno Nettl, Chris Nicolay, Katharine Payne, Bruce Richman, Peter J.B. Slater, Peter Todd, Sandra Trehub, Ivan Turk, Maria Ujhelyi, Nils L. Wallin, Carol Whaling Bradford Books imprint
This chapter examines the influences of musical activities such as listening, singing, or dancing on the endocrine system. The underlying assumption is that psychological processes associated with musical experiences lead to changes in the hormonal systems of brain and body. It begins with a brief introduction to general questions of psychoneuroendocrinology as well as to relevant hormonal systems, followed by an overview of empirical studies, which have begun to investigate hormonal responses to musical stimulation and musical activities. The chapter concludes with suggestions for future work that will be derived from initial evidence showing that music can be seen as a psychoactive stimulant inducing physiological effects that are sometime similar to those produced by pharmacological substances.
In a naturalistic pre-post design, samples of saliva were collected from the members of a professional chorale during an early rehearsal (n = 31), a late rehearsal (n = 34) and a public performance (n = 32) of Beethoven's Missa Solemnis. As measures of immune system response, mean levels of secretory immunoglobulin A increased significantly, as a proportion of whole protein, 150% during rehearsals and 240% during the performance. Cortisol concentrations decreased significantly an average of 30% during rehearsals and increased 37% during performance. As measured through performance perception rating scales, a group of emotions and other experiential states that singers associated with professional singing were highly predictive of changes in level of secretory immunoglobulin A during the performance condition, but the results for the rehearsal conditions were not significant. The best multiple regression model for performance level of immunoglobulin A (p < .0015) included seven emotional, cognitive, and evaluative variables generally associated with choral singing, including levels of mood before and during singing, stress, relaxation, feeling "high," detachment/engagement, and specific satisfaction with the immediate performance.
There is considerable evidence to suggest that music has adaptive characteristics. Individuals use recorded music to transform the emotional landscape to coincide with transitory needs and desires. Also, music has frequently been reported to provoke uncommon emotional and physical reactions often referred to as peak experiences. In many cultures, that have limited industrial and technological development, active participation in musical activities is pervasive and all individuals are considered musical. In contrast, the musical elitism that has evolved in the Western world intimates that musical ability is specific to a talented minority. The elitist notion of musicality restricts the majority to procurers of rather than producers of music. However, experimental and theoretical sources indicate that music is an innate and universal ability and, therefore, active participation in music may have adaptive characteristics at many levels of proficiency. Positive life transformations that occurred for members of a choir for homeless men, since joining the choir, provided an opportunity to determine if group singing was a factor in promoting adaptive behaviour. A phenomenological approach utilizing a semi-structured interview wasemployed to explore the choristers' group singing experience. Analysis of the interviews indicated that group singing appears positively to influence emotional, social and cognitive processes. The choristers' perceptions of the adaptive characteristics of group singing fell within four principal categories: clinical-type benefits, benefits derived from audience-choir reciprocity, benefits associated with group process and benefits related tomental engagement. Active participation in singing may act to alleviate depression, increase self-esteem, improve social interaction skills and induce cognitive stimulation. The themes adhere to the tenets of flow theory which advocate the importance of mental stimulation and social interaction in increased life satisfaction. The emergent themes provide a preliminary basis for the development of a theory of the adaptive characteristics of group singing and also provide a framework for further investigation in this area.
Synchrony—a construct used across multiple fields to denote the temporal relationship between events—has been applied to the study of mother–infant interaction and is suggested here as a framework for the study of interpersonal relationships. Defined as the temporal coordination of micro-level social behavior, parent–infant synchrony is charted in its development across infancy from the initial consolidation of biological rhythms during pregnancy to the emergence of symbolic exchange between parent and child. Synchrony is shown to depend on physiological mechanisms supporting bond formation in mammals—particularly physiological oscillators and neuroendocrine systems such as those involving the hormone oxytocin. Developmental outcomes of the synchrony experience are observed in the domains of self-regulation, symbol use, and the capacity for empathy across childhood and adolescence. Specific disruptions to the parameters of synchrony that may be observed in various pathological conditions, such as prematurity or maternal affective disorder, are detailed. A time-based, micro-analytic behavioral approach to the study of human relationship may offer new insights on intersubjectivity across the lifespan.
Music is regarded in biological terms as originating in the brain, so that most explanations concentrate on the ways in which brains process information. Recent studies of the nonlinear dynamics of the primary sensory cortices have shown that the patterns that are constructed by chaotic nonlinear dynamics in cortical neuropil replace stimulus driven activity. This finding supports the concept that knowledge in brains is entirely constructed within them without direct transfer of information from outside. As knowledge increases by learning, brains of individuals grow progressively apart. The separation results from the uniqueness of the knowledge that is constructed within each brain. The resulting condition of isolation is known among philosophers as epistemologic al solipsism. This view is reinforced by the tenets of aesthetics, which emphasize the deeply personal experiences of individuals, not as active listeners but as passive recipients of beauty in music and other arts. Neither conventional neuroscience nor aesthetics can explain the deep emotional power of music to move humans to action. An alternative view is presented, in which human brains are seen to have evolved primarily in response to environmental pressures to bridge the solipsistic gulf between individuals, and to form integrated societies. An evolutionary origin is found in the neurohumoral mechanisms of parental bonding to altricial infants. A case is made that music together with dance have co-evolved biologically and culturally to serve as a technology of social bonding. Findings of anthropologis ts and psychiatrists are reviewed to show how the rhythmic behavioral activities that are induced by drum beats and music can lead to altered states of consciousness , through which mutual trust among members of societies is engendered. "All arts, we must remember, are phases of the social mind. We are so much in the habit of thinking of them in terms of art products that we forget that the arts themselves are groups of ideas and acquisitions of skill that exist only in the minds, muscles, and nerves of living men. " Giddings (1932):
Music is used to regulate mood and arousal in everyday life and to promote physical and psychological health and well-being in clinical settings. However, scientific inquiry into the neurochemical effects of music is still in its infancy. In this review, we evaluate the evidence that music improves health and well-being through the engagement of neurochemical systems for (i) reward, motivation, and pleasure; (ii) stress and arousal; (iii) immunity; and (iv) social affiliation. We discuss the limitations of these studies and outline novel approaches for integration of conceptual and technological advances from the fields of music cognition and social neuroscience into studies of the neurochemistry of music.