On Superpowers,Oxytocin,and Sciences—Reflections on a Challenging Field

When I (Thomas) was young, in addition to my previously mentioned fondness for cassette recordings, ¹ there was another highlight: Superhero comics. These tell the stories of people who possess certain superpowers. Typically, superpowers develop through advanced technology (Batman and Iron Man), a biological transformation (Spider-Man and Fantastic Four), or an accident during an experiment (Hulk and The Flash). But they may also owe their powers to their extraterrestrial origins (Superman) or magic (Doctor Strange and Phantom Stranger). Such superhuman abilities often include superhuman strength, the ability to fly, heightened senses, or the ability to emit energy in various forms such as heat, light, or sound (see ² for a review).

This fascination with superpowers was unexpectedly reignited at the most recent conference of the International Society for Arts and Health. ³ There, my PhD student and coauthor of this editorial, Paula Kristin Busse, gave a presentation on the connection between oxytocin and the musical experience. ⁴ After the very successful presentation, Paula was spotted, and the words echoed down the hallway: “Look, there’s Oxy-Woman.” Probably this needs a bit more explanation from Paula to put it into context:

Oxytocin is a fascinating hormone with a wide range of neurobiological effects. It is commonly known as the “love hormone,” with typical release stimuli, including breastfeeding, labor, skin-to-skin contact, warm temperature, and food intake. ⁵

In recent years, there has been a growing body of scientific research into the role of oxytocin in a wide variety of areas, including psychiatric disorders,^6,7 nociception, ⁸ stress response, ⁹ and appetite regulation. ¹⁰

The idea here is that alterations in the oxytocinergic system are not only regarded as a (contributing) cause of various medical conditions but also offer diagnostic opportunities, represent a potential therapeutic target, and may be used to monitor the success of treatment.^11,12 Thus, the therapeutic benefits of oxytocin could lie in both the promoting of its endogenous release and in its exogenous administration.^13,14 Furthermore, oxytocin may serve as a biomarker for the development of interpersonal relationships and, consequently, as an indicator of therapeutic alliance and treatment success.^15–17 However, several questions regarding the oxytocinergic system remain unanswered at this stage, such as the significance of individual baseline oxytocin levels and the varying oxytocin concentrations in the body’s compartments—namely blood, saliva, urine, and cerebrospinal fluid.^18,19

In my work, I have taken a closer look at the significance of oxytocin in music-based interventions. Given the overlap between the effects of music and oxytocin, I investigated the hypothesis that the biology of oxytocin mirrors, at least in part, the diverse effects of music.^20,21 To this end, I reviewed primary studies that examined pre- and post-intervention oxytocin measurements in music-based interventions. The results showed equivocal findings in oxytocin levels before and after a music intervention. However, it should be noted that many feasibility and pilot studies were included and that there was also considerable heterogeneity among the studies. ⁴ A review published concurrently reaches similar conclusions. ²²

Now coming back to superheroes, so much is clear: Based on the current evidence, Oxy-Woman would not yet qualify as a superhero, since there is not yet sufficient evidence to support the effects of oxytocin. Nevertheless—or perhaps precisely for that reason—the translational approach to investigating the relevant mechanisms, pathways, and modes of action of such interventions is of enormous importance.

From a broader scientific point of view, superpowers are closely intertwined with human cultural history and mythology and describe the projection of human longings for power, freedom, and the overcoming of natural limitations.^23,24 Not surprisingly, over time, superheroes and their superpowers have evolved as a reflection of the current political and cultural landscape and, furthermore, differ across different cultural contexts.^25,26

Today, at a time when digitalization and climate are changing the nature of human interaction and our living environment, new superpowers are evolving on the horizon. They might, for example, include the ability to counter disinformation, influence local weather, alter collective consciousness, or influence chance. The ability to connect and integrate people, as mentioned earlier, could also become a sought-after superpower in the 21st century.

Interestingly, it is not only the superheroes and their powers that change over time, but the superpowers depicted can also prompt people to develop more prosocial intentions and behavior.^27,28

So perhaps it is no longer a matter of developing a specific skill as a superpower. Rather, the superpower lies in creating a framework within which the integration of different skills can succeed (allowing a new superpower of collective action to emerge).

So, what is the central message? Probably this one: Superpower emerges when people come together to jointly make a difference. But isn’t that precisely the purpose of integrative medicine?