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Trading fours

By Blanaid Coveney Metaphor and language 16 Mar 2016

One of life’s greatest pleasures

Watching music being created live is, for me, one of life’s greatest pleasures. Maybe it is the intensity of the emotion that it generates, or the hypnotic effect that it can wield, or perhaps it just plays into the love of art being created in front of us. As an observer, it can still feel like a collaboration – the emotions of the audience and musicians colliding over and over creating a pure “in the moment” feeling that is utterly unique.

Being present at a recent performance of “The Gloaming” was one such moment. Highly regarded performers each in their own right, together this group of musicians have created a magical re-interpretation of Irish Traditional music, which has bewitched many. Listening to The Gloaming is like hearing music anew, as they create something entirely different and spellbinding each and every time.


The interaction between the two fiddle players always brings to mind a conversation of the best kind – deep in thought, leaning in towards the other, attentive listening, and space to speak and be heard. A kind of musical empathy, if you will. To watch these musicians make music live is exhilarating. To borrow the words of Seamus Heaney, like all great art it can

“Catch the heart off guard and blow it open.”

All that Jazz

But of course, the genre best known for its “in the moment” creation would probably be Jazz, bringing the music of John Coltrane, Myles Davis and Thelonious Monk to mind. The extraordinary Jazz pianist Keith Jarrett is famous for improvising entire concerts on the spot, to the delirium of his fans. But improvising is not just a solo experience; it can be a collaborative process too. Just listen to the live recording of Ella Fitzgerald and Duke Ellington singing  “It don’t mean a thing”, an exuberant version which has Fitzgerald scatting (vocal improvising) for four bars of song with the saxophone player scatting back, complementing her phrase with his own interpretation.  Back and forth they go for an entire chorus culminating in a frenzied climax to the delight of the audience. It is impossible to listen to and not to smile

Can we visualize creativity?

What’s happening inside the brains of a Fitzgerald, Davis, or Coltrane when they create this music? Scientists have long been fascinated by the question of creativity and what it involves, and with the advent of fMRI (functional Magnetic Resonance Imaging) scanners, we have been given a glimpse of the brain in action. While we may not be able to see creativity, we can observe the brain when the creative process is in action – a sort of proxy perhaps?

Dr Charles Limb and colleagues, at Johns Hopkins University, has been at the forefront of researching creativity through music. As an accomplished jazz composer and musician himself, Limb felt that observing the brains of Jazz musicians while improvising (inside the fMRI scanner), could give us some answers about the creative process.

Trading fours 

In an engaging TED talk, Limb describes how they looked at the brains of expert jazz musicians when they played memorised musical tasks and when they were improvising.

[ted id=1046]

On a specially devised un-magnetised piano keyboard, an expert jazz musician played a pre-learned scale up and down, an original piece which they had memorised, an improvised scale and finally they ‘traded fours’, with another jazz musician, outside the scanner.

Trading fours is a well-known back and forth improvisational exchange where a pair of musicians alternates four bars apiece, feeding off each other – you don’t know what’s coming musically, but you need to react instantaneously – and so it goes, back and forth, between musicians.

The results showed strikingly similar patterns of brain activity when improvising the scales and trading fours. The part of the Frontal lobe known as the Medial Prefrontal Cortex (MPFC) was active while the Lateral Prefrontal Cortex (LPFC) was deactivated. This is interesting because the active MPFC is involved in self-expression while the deactivated LPFC is involved in self-monitoring and self-observation. Limb and colleagues described it thus….

“The brain deactivates the area involved in self-censoring, while cranking up the region linked with self-expression.

Effectively, the musician shuts down their inhibitions and lets their inner voice shine through”

It appears that one area turns on and another turns off to allow you to take risks musically, and be willing to make mistakes without fear of self-judgment.

A kind of conversation

Additional studies on jazz improvisation have suggested that the areas of the brain associated with speech and language are active during improvising music – but in quite different ways. The parts of the brain associated with interpreting the structure of language and phrases (syntactic regions) is robustly active, but the part which processes the meaning of language (the semantic regions) is quiet.

“I figured we would have the involvement of language areas during spontaneous musical conversation, but I did not really anticipate the semantic area would be deactivated the way it was.”

“Syntax has more to do with grammar and the structure of language — basically the rules of language,” Limb explained. “Semantics has more to do with the meaning of words. So, if music has semantics, it’s not processed in the way that is traditionally used for language.”

Lost in the music

Watching performers such as The Gloaming weave their musical spells the idea of being ‘lost in the music’ easily comes to mind But as they close their eyes and seemingly enter a trance state, they are not just waiting their turn – further research from Limb and colleagues suggest that musicians enter states of creative, heightened awareness with all of their senses acutely tuned to the flow of music and allowing them to follow and respond

“even though a performing musician may lose track of her actions, she is at the same time in a heightened state of awareness—tasting, smelling, feeling the air around her.”

In a lovely illustration of the brain’s wondrous abilities, the same brain patterns that are present during deep REM sleep and dreaming can be seen when improvising, leading the researchers to suggest that the musicians may in fact be in a kind of waking dream.

Are we not all improvising?

While the lure of a “waking dream”, induced by reaching the heights of musical mastery, may seem out of reach for most of us, creative improvisation may not be the exclusive domain of jazz musicians, rappers or slam poets.  Are we not all improvising in a way, in our movement and our speech, in our telling a story, arguing a point or when we are engaged fully in a conversation?

Maybe our ability to improvise is a key part of the back-and-forth nature of our interactions with each other? In using our creative and improvisational skills when we interact with the patients, in trying to make sense of new information?

Perhaps it really is a kind of verbal trading fours!  Too far? Perhaps, but maybe not.


-Blanaid Coveney

Blanaid is a practicing physiotherapist in Dublin, Ireland. Her professional interests include epidemiology, pain and all things brain related.




NOI is taking EP, GMI and MONIS on tour around this great southern land, click on a location for details and course flyers

Townsville: EP & GMI April 29-May 1 

Canberra: MONIS at the Australian Institute of Sport May 3-4 

Canberra: EP& GMI at the Australian Institute of Sport May 6-8

Adelaide: Pain, Plasticity and Rehabilitation May 14-15 

Noosa: EP & GMI June 17-19

Perth: EP & GMI October 15-17


  1. Thank you Blanaid a beautiful piece x
    I do believe that we should all be aspiring, in our interaction with our fellow sufferers towards ” Trading fours”. Only then can we truly engage in a short term symbiotic relationship with our patient. The ultimate goal being the ability to trade fours with oneself……..
    London 🎷🎹🎤

    1. Hi David, Thanks for that. It is a constant challenge to be completely present in the moment, isnt it ? Something which these musicians seem to have mastered. That state of creative heightened awareness where all their senses are acutely tuned to the task must be an extaordinary place to inhabit in your daily job. Aspirational without doubt. I love your idea of trading fours with oneself by the way! Blánaid

  2. betsancorkhill

    I too like the idea of ‘trading fours’ with our patients.

    Coincidentally the theatre here in Bath is hosting an event called Hug which is described as an immersive choral sound. This involves being blindfolded as you enter the room. You are then hugged by a singer… the idea is that as you are ‘unable to gauge your surroundings, you experience the performance through sound, breath and the vibrations of the body as the choir of voices deliver their song.’

    I haven’t quite worked out what I think of this…it would certainly be an interesting new experience. First I need to get over those thoughts of ‘Hope the stranger who hugs me hasn’t got BO or bad breath!

    1. Hi Betsan, Perhaps you can let us know how you get on with the “Hug” event. It sounds really interesting. Blanaid

    1. davidbutler0noi

      Thanks Blanaid,

      I have read your beautiful piece of writing and listened to “The Gloaming” a number of times now. There is so much in it. I think “Trading fours” applies to our work so much. One thing that your writing made me reflect on is the power of equality in the musical/therapeutic relationship. I am not even quite sure what I mean by that, but I am working on articulating it.


    Hi Blanaid , Lovely piece of writing and reflection . The Gloaming are certainly making waves . I have Martin Hayes DVD his life story and influences ………he is my musical hero , a true genius and inspiration! I have been learning Irish music for a decade now and a good session will never be the gloaming but the effect personally is transformational! Its the pauses , rhythm, reflection , community , interaction the improvising but keeping to the bones of the thing and the sheer pleasure of the ever changing experience that is so relevant to life in general —all the things many persistent stressors rob people of. The paper I have linked may add to the discussion . Ian

  4. Hi Ian,

    I was delighted to hear from another Martin Hayes fan, he is truly the Jimi Hendrix of the trad music world! You have wonderfully described the joys of a “session” with all its transformative qualities. The pleasure of the ever changing experience and being in the moment. A true salve for the soul.

    The article on Jazz and the ‘Art’ of Medicine is a really fascinating one with so many parallels between the art of improvising and the interaction between patient and clinician. The notion of creating space is an interesting one. I particularly like when the author described the use of space musically, so when someone like Myles Davies played, his brilliance was all about what notes he didn’t play as much as those he did, but when they described the benefits of the clinician creating space for the patient the effects can be significant;

    “When practitioners effectively use space, paying attention to both communicative and narrative parameters in the conversation, patients do not feel pressured or forced to omit information from their story. Rather, they are freed up to describe their health concerns on their own terms”

    Of course the benefits of the ensemble in playing and making music are well documented but I like the thought that;

    “the essence of the ensemble whether in music or in medicine (clinician-patient) lies in looking beyond one’s own perspective to see, understand, and respond to the perspectives of others ”

    Thanks for sharing this Ian and the article. It made fascinating reading and gave me pause for thought. Happy playing.


  5. Blanaid, really glad you enjoyed the article which resonated with me . I find the jazz article and the interaction style this tends to cultivate are essential in our work . Have you read any of Iain McGilchrist ? One could argue about his ideas around the function of brain hemaspheres but his analysis of the culture we are in seems relevant to me . We need adaptability , flexibility and integrated knowledge in order to reduce threat and cultivate ‘growth’ /adaptation . The tunnel vision pathway mindset in health care tends to reduce the creativity needed to connect and put people at ease I find . Maybe not strictly on target but look at this young girl re creativity /adaptation/curiosity …genius !
    Yes , Martin is a genius and I really warm to his appraoch to life have you watched his tour of India on line —what is so good is his ability to connect musically to a completely different culture . Ian

  6. Hi Ian,
    That young girl is an extraordinary self-taught dancer but what is fascinating is how she learned by watching the dancers over and over for hundreds of hours before she tried them herself. Essentially learning and practicing by watching, and imagining!
    The Martin Hayes tour of India documentary you speak of was lovely and like you say the blending of musical genres and cultures was at times seamless. He seems as at ease playing jazz with Bill Frissel or classical with Brooklyn Rider as he is in his own traditional world. I have heard him say that he is not too concerned with genre, blues, jazz, traditional…its all music to him! I think it is his innate humility and ability to connect with others which allows him to do this.
    Regards Blánaid

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