Why Some People Get the Chills While Listening to Music

A conversation with Concetta Tomaino—Spiritune Music Therapy Advisor—for International Women in Music Day.

Concetta Tomaino has worked at the intersection of music and health for nearly fifty years. Along the way, she’s co-authored numerous studies, co-founded the Institute for Music and Neurologic Function alongside leading neurologist Dr. Oliver Sacks, and, perhaps most importantly, helped patients with severe illness find their voice through sound.

Spiritune is honored to call Tomaino our Music Therapy Advisor. As Founder and CEO Jamie Pabst shares, “Connie’s decades of work in music therapy have laid the scientific and clinical foundation that makes what we’re building at Spiritune possible. Having her as an advisor helps us understand what’s been built in the past so we can more thoughtfully build toward the future—and I feel incredibly lucky to have her guiding us. I feel a deep sense of responsibility to carry her legacy forward by bringing music-based care to more people, more accessibly than ever before.”

This International Women in Music Day (March 28), we’re tracing Tomaino’s time in the field—from her childhood as a trumpet player to her early research in New York nursing homes to her modern goal to bring the power of music therapy to the masses.  

How did you get started in the music therapy field?

I wanted to be a medical doctor since I was two years old. But I’ve also been involved in music my whole life. I sang in the choir at church, and in high school, I picked up the trumpet and played in the band. 

I was really a science geek, and in college, I became a pre-med student in chemistry and biology. I wanted to keep up with trumpet lessons in college, but in order to do that, I had to become a music major. So I was double-majoring in music and sciences.

By my junior year, I had a dilemma: Do I pursue music or medicine? 

It was just by accident that one day I saw an ad that said ‘Career in music therapy.’ And I thought, ‘Oh my God, what is music therapy?’

It just so happened—again, by luck—that the band director at my college at the time was also the band director at NYU. And two years before, NYU had just started a master's program in music therapy. And so I graduated in June of 1976 and started attending my first music therapy course that July. My first internship was at a nursing home in Brooklyn, New York.

What was it like to work as a music therapist in nursing homes at that time? 

Not much was known about Alzheimer's and dementia back then. Patients were overmedicated, tube-fed, and tied to wheelchairs so they wouldn't scream and pull out their nasogastric feeding tubes. They were written off as being non-responsive and not aware of themselves. 

But when I sang a familiar song to them, they came back to life. 

They not only participated, but they also seemed less agitated. They obviously knew the words to the songs. I’m wondering: ‘How can they process sound if they supposedly have no cognition left?’ That really started my search to understand how music affects the brain, and why music is preserved in people who have severe brain injuries and damage.

What was the public perception of music therapy back then?

It was a fairly new field, and nobody really knew about it. When Dr. Sacks and I went to see neuroscientists, they would say, “‘You can't study music. There's no way, it's too complex, and there’s no scientific way to study it.’”

But he and I were seeing that music was really helping people change and improve. People who’d had strokes and couldn't speak were able to speak again. People with movement disorders were able to walk better. 

One of the reasons we started the Institute for Music and Neurologic Function was to raise funding for basic neuroscience research. We got some early grants that allowed us to look at the cause and effect of what was working and why.  

How were you able to study music’s impact on patients before modern brain imaging devices?

That was the interesting thing. In my first study with Dr. Oliver Sacks, he was still using his 8-channel paper EEG [editor’s note: This type of ‘analog EEG’ recorded spontaneous electrical activity onto paper]. PET scans and other types of functional imaging were just starting—they were so limited in what they could do. 

So, we had to look more at clinical applications in real time. We studied the effects that music had on people using other types of tools, such as psychological measurements and neuropsychological assessments. We had to learn as we went and try to find applications that made sense within the context of caring for these individuals with a variety of neurologic impairments.

Do any patient success stories stick out to you?

I worked with one woman who was being treated with medication for a pituitary tumor, I believe. Because of the medication, she had something called Tardive dyskinesia (TD)—her tongue was constantly moving in and out of her mouth. Because she couldn't speak well, the staff treated her as if she had severe cognitive impairment.

But I noticed that if I got her to sing, her TD shut off. It was an example of auditory-triggered motor activity actually canceling out involuntary movements. When she was in this state, she was able to talk and have full conversations. And she was 100% cognitively intact.

We were able to show the staff that somebody who seemed to be incapacitated was fully aware and alive and functioning. It was just because of her medication that she’d had this side effect.

What has been the most memorable or meaningful moment of your career so far?

We've been working all this time to build up an argument for supporting music-based interventions in clinical music therapy.

I think a big win for the field of music therapy happened about ten years ago when Renee Fleming got involved with the NIH [to fund and standardize music and health clinical research for brain disorders].

Having the NIH recognize that there's real promise in music and brain research and that money and research efforts should be put behind this… that was amazing.

How have your past experiences shaped the work you do at Spiritune?

Throughout my career and with the Institute, I've been really involved in engaging with scientists and trying to understand the specific elements of music that can affect our function. 

I'm very interested in auditory entrainment and how the frequency of sound or the rhythm patterns of sound affect motor function and physiological states.

I think it was my scientific background and my experience working directly with patients that led Jamie to ask me to be part of the Spiritune team. My contribution has really been, with Dr. Daniel Bowling at Stanford, looking at the sounds that seem to affect emotional responses in very specific ways.

What do you hope is next for the field of music and medicine? 

We’ve come a long way since I started in the field: Medication and surgery aren’t always the end-all healthcare treatments anymore. Physicians are more open to alternative practices and other methods of healing. This has allowed the discussion of music therapy and its benefits to expand throughout the healthcare system. You no longer have to prove that music therapy is important.

But I still see room for improvement in two areas. One: Participation in music and creative arts should be an essential right for all children. Opportunities to access music should be available from birth until death.

Two: There has been some great research to show that personalized music can help people with Alzheimer's disease and dementia overcome behavioral issues. Music therapy reduces the need for psychotropic drugs. Yet still, many nursing homes use a schizophrenia diagnosis in order to give inappropriate psychotropic medications to people with dementia. 

One of my goals is to make a case that music therapy should be the first ‘prescription’ given to somebody with dementia, before psychotropic medication. I would love to see that happen. 

This interview has been edited and condensed for clarity.

When Spotify released its 2025 year-in-review report, Spotify Wrapped, one feature in particular got the internet talking: Listening Age. 

Suddenly, people of all biological ages couldn’t stop posting about their musical listening ages. There were the twenty-four-year-olds bemoaning their 62-year-old listening habits and the 40-somethings owning up to having the taste of a teenager. Thought articles couldn’t decide if the new feature was spot-on, far off, or somewhere in between—but one thing was for certain: it struck a nerve. 

What was intended as a fun marketing tool got people asking themselves: How do musical tastes shift, or stay the same, as we get older?

It turns out this question has intrigued researchers for a long time, before Spotify was even a blip. Here’s what science has revealed about how musical preferences evolve, and the ages at which they tend to be the most malleable.  

Finding the most formative music years

Back in 1989, a foundational study came out declaring that people’s penchant for popular music seems to follow a U-shaped curve. That is, their preference for the music of the moment grows until they reach the age of 24, and then starts to wane. Many interpreted this study to mean that the music we listen to in early adulthood has the strongest influence on our lifelong music habits. 

Subsequent studies have come to the same basic conclusion: What we are exposed to when we’re relatively young tends to shape our preferences for the rest of our lives—in music, but also in fashion, television, etc. However, the exact age at which musical preferences develop is still up for debate. More recently, researchers have argued that the golden age probably happens earlier in life, when we’re closer to 14 years old or 17 years old instead of twenty four. However, most agree that the decade between 15 and 25 seems to be an important one. 

Interestingly, people seem to resonate with the music they listened to when they fell in this age window and the music that their parents listened to at this age. This suggests that musical preference is, to a certain extent, passed along through generations. 

A lifelong evolution

While musical taste seems to firm up when we’re in our teens and 20s, it doesn’t completely solidify. Changes can still happen throughout our lives, for many reasons. 

To investigate how, one study aptly titled Music through the ages tracked over 250,000 people to see how their musical attitudes and preferences evolved from adolescence through middle age. Researchers found that as people got older, they tended to start liking some genres of music more and others less, and these shifts were largely shaped by personality. For example, having a more ‘open’ personality was associated with an increasing preference for classical and jazz music in middle adulthood. 

Others posit that our taste for certain music evolves naturally once we have more years under our belt. Some genres, like classical and jazz, tend to be more complex, and so enjoying them might take more musical knowledge and listening experience, which can come with age. The memories we form around certain songs or genres of music also likely shape how we perceive those songs over the years. 

Maybe you’re born with it

While your response to music is partially the result of age and lived experience, there also seems to be a genetic component at play. Based on research on twins, the ability to elicit pleasure from music is partially heritable. Musical talent is also thought to be genetically determined, at least in part. 

The latest research on this topic finds that, in general, people tend to have a more “omnivorous” musical diet and enjoy hearing different genres and styles when they’re young. After analyzing over two billion listening sessions on Last.fm from 2005-2020, researchers found that young people listened to a wider variety of songs, favoring new releases but also exploring older music. This listening pattern persisted until the age of 40 or so, when people’s preferences tended to become more focused, narrowing in on the music they liked when they were young. “Beyond 40, current music consumption declines, and nostalgia-driven listening dominates,” researchers write. 

Your musical companion through the ages

Spiritune is designed to appeal to every type of music lover—no matter if you’re a disco-crazy 60’s baby or a millennial with a penchant for pop-punk. Instead of focusing on a particular style, it’s built with the intention of “making music accessible for everyone,” says Daniel Bowling, Ph.D., Spiritune’s Scientific Co-founder. 

Spiritune music tracks use principles of music therapy and neuroscience to lead listeners through noticeable changes in mood and energy in just a few minutes. Composed with genre-agnostic instruments and beats, they’re made to be therapeutic for everyone—no matter their listening age.

Like what you're reading? Sign up for Spiritune’s newsletter to get a monthly music therapy download straight to your inbox. Haven’t tried Spiritune yet? Download it today with a free trial!

Here at Spiritune, we’re constantly exploring how therapeutic music can impact the brain (by improving mood, enhancing focus, and more) and body (by deepening sleep, providing pain relief, etc.). But what exactly is ‘therapeutic’ music, and how is it any different than a pop song you’d hear on the radio? 

Here’s an expert-led guide to the attributes of therapeutic music, how it differs from other forms of music, and how you can benefit from listening to it daily. 

What Is Therapeutic Music?

Simply put, therapeutic music is any music that helps the listener reach a certain therapeutic goal—be it managing stress, enhancing memory, or easing pain. 

Some genres and musical attributes are considered more therapeutic for certain goals than others. Listening to classical music, for example, is generally thought to have a calming effect. Fast-tempo music tends to rev up emotional and cognitive activity, while slower beats often lower heart rate and promote relaxation.

However, therapeutic music does not need to sound one particular way. And in fact, it will sound different from person to person. 

As Daniel Bowling, Ph.D., Spiritune’s neuroscience advisor, explains, personal preference plays a significant role in shaping the outcomes of any musical experience. “It's all about what you enjoy,” he says. “That's really going to be what moves your nervous system the most.” 

While some sounds evoke reactions that are near-universal (you’d be hard-pressed to find someone who isn’t energized by Beethoven's Symphony No. 5, for example), there is no one way for a song to be considered “therapeutic,” since an individual’s tastes, memories, and culture affect how they respond to different pieces of music.

How Is Therapeutic Music Different Than Music on the Radio?

Here’s where it gets a little complicated: Pop, rock, country, or any other type of music you hear on Spotify or the radio can absolutely be therapeutic in certain contexts, for certain people.

Let’s say you are feeling tired and want to perk up, so you play an up-tempo Taylor Swift song and immediately have more pep in your step. Congratulations, you just used music therapeutically. If you’re feeling defeated after a long day and put on your favorite hopeful song from childhood—the one that you know every word to by heart—and perk right up, that totally counts, too. 

Bowling explains that music you love and have a history with can even pack an extra strong therapeutic punch due to the way it builds anticipation in the brain. “It’s a constant unfolding of expectation and reward,” he says. 

That said, there are plenty of ways to engage with popular, familiar music that are not therapeutic at all—and may actually make you feel worse. Listening to fast-tempo songs with complex lyrics while you’re trying to focus at work can be really annoying and distracting, for example. And if you’re in a bad mood, putting on a low-pitch song with sad lyrics that remind you of a low point in your life will likely make it worse. 

So, as a neuroscientist, Bowling doesn’t consider therapeutic music its own genre or category. “Whether it's therapeutic or not depends on the composer and on the listener,” he says.

What About Music Therapy? What Does That Entail?

Music therapy, as defined by the American Music Therapy Association, is the “clinical and evidence-based use of music interventions to accomplish individualized goals within a therapeutic relationship by a credentialed professional who has completed an approved music therapy program.” 

In other words, it involves listening to, engaging with, or creating music with a trained practitioner who can guide you towards your goals.

While you can definitely use music as a therapeutic tool on your own, as we covered in the last section, this wouldn’t be strictly considered music therapy. Using music as a therapeutic tool without the oversight of a practitioner is more often referred to as “music medicine.”

How Spiritune Makes Therapeutic Music More Accessible

Spiritune exists to democratize music medicine and bring the therapeutic power of music to the masses.

Each track is created with a specific goal in mind: be it to relax before bedtime, enhance focus, or adopt a more positive mindset. Professional composers will then use rhythm, tonality, harmonic progression, etc., to create tracks that fulfill this goal while being pleasing to the ear.

“Spiritune is music-forward,” says Bowling, adding that its tracks feature well-written compositions, versatile instruments, and smooth rhythms that are as universally appealing as possible. Most Spiritune tracks don’t have lyrics, which can be distracting, opting instead for instrumentals that make a wide variety of listeners feel good, he adds.

The app is designed to be easy and intuitive to use: Simply choose your current state (i.e., anxious or frustrated) and then your desired state (i.e., content or excited), and Spiritune will play tracks designed to get you there. 

You don’t need to consciously attune to the music; simply let it play in the background and wrap yourself in an “acoustic blanket.” Before you know it, you might find yourself feeling less restless, more positive, or more focused. Based on user surveys, 90% of listeners agree that Spiritune’s science-driven playlists help them reach their goals—often within just 10 minutes of listening.

While Spiritune isn’t designed to replace your favorite pop song (you’re safe, Taylor), it’s a helpful tool to add to your routine when you have a specific goal or outcome in mind and want a reliable, science-driven way to get there, fast. 

Like what you're reading? Sign up for Spiritune’s newsletter to get a monthly music therapy download straight to your inbox. Haven’t tried Spiritune yet? Download it today with a free trial!