Barry Bittman, MD is the CEO and President of the Yamaha Music & Wellness Institute. His peer-reviewed published scientific research focuses on stress reduction from psychosocial to genomic levels utilizing novel creative music expression strategies.
He is a neurologist, author, international speaker and researcher. As Director - Care Coordination Strategies for the Allegheny Health Network (AHN), Dr. Bittman has pioneered a new paradigm for comprehensive integrative strategies that engage patients and communities in the active pursuit of health and well-being.
Based on his conviction that Recreational Music-making is an effective therapeutic strategy in various medical settings, Dr. Bittman led a team of researchers who investigated the biological effects of the HealthRHYTHMS group drumming protocol he co-developed. This foundational study correlated group drumming with increased activity of Natural Killer cells, specialized white blood cells that seek out and destroy cancer cells and virally-infected cells. Along with Karl T. Bruhn, acknowledged as “Father of Music Making and Wellness,” his research team also demonstrated substantial reductions in burnout and mood disturbances in long-term care workers, as well as significant cost savings using a Recreational Music-making protocol . A similar approach was also shown to benefit nursing students.
With a focus on the aging continuum, Dr. Bittman led a team of researchers to document the impact of Recreational Music-making in the long-term care continuum. His extensive compilation of data from two long-term care centers documented multiple psychosocial benefits across the aging spectrum).
Dr. Bittman demonstrated for the first time that playing a musical instrument reverses multiple elements of the human stress response on the genomic level. Stress-reduction was far greater for individuals participating in their first group keyboard lesson (Yamaha's Clavinova Connection) than for subjects who simply relaxed and read newspapers and magazines. In addition, the researchers introduced the concept of individualized genomic stress induction signatures, which uniquely demonstrate biological diversity in action.
His latest published genomic research demonstrated statistically significant changes in complex biological pathways in cardiac patients participating in the Clavinova Connection.
Wolf: I do a lot of work with traditional drumming and drum circles. When I did the Health Rhythms training, you provided background on the things that you attempted first that did not produce the results that you were looking for. I’m interested in what you tried that did not work, why you think those things did not work, and what you think created the success of the protocol that evolved through the course of your testing?
Bittman: Our initial inclination to test group drumming was based on the fact that we had performed research on laughter and the immune system. I had the opportunity to participate in a regular drum circle a few years prior to beginning the research, and I intuitively thought that there was likely to be some benefit from the activity. We basically established a research program that was funded initially by Remo with a focus on immune system modulation (changes in natural killer cell activity and cytokines), which are orchestrators of the immune system. We tested a one-hour group drumming protocol, and included a number of control groups.
Our team set up the experiment in a scientific fashion. We established a control group of individuals sitting in a circle listening to music and another group of individuals who actually participated in group drumming. The circles were led by an extraordinary drum circle facilitator. In order to avoid bias from prior experience, we did not include people who had participated in drumming in the past.
When we reviewed our first series of experiments, we noted no statistically significant differences between the group that drummed and the control group. There were no meaningful differences between the two groups. Our initial assumption was that perhaps our approach did not include enough drumming.
So I approached the facilitator and asked, “Could we drum more and explain less, and see what happens?” These results as well showed no statistically significant differences between the experimental and control group. In fact, the subjects’ biology was farther from the expected targets. We assumed that perhaps we were exceeding our subjects’ exercise thresholds.
The third effort included another extraordinarily gifted facilitator, who approached this with more of a spiritual focus. We replicated the experiment—the same time of the day, the same day of the week, the same room, same temperature, same group of nurses drawing the blood—and after we completed that arm of the study, once again no statistically significant differences surfaced between our test and our control group.
At this point we were challenged to say the least. Our team was concerned by the fact that despite three iterations of the experiment, we had not achieved positive results.
And then it dawned on us that our group of research volunteers would not have actually been inclined to join a drum circle. I finally realized that few people actually consider themselves “musical.” We were likely intimidating people and increasing their stress levels. From a psychoneuroimmunology perspective, we decided not to conduct the drum circle in the typical manner. We decided to incorporate some of the characteristic elements used in other fields, such as relaxation techniques, breathing, a focus on movement and guided imagery. We essentially focused on establishing a level of comfort and camaraderie.
Thereafter wee were able to demonstrate our first statistically significant results which were subsequently replicated.
Wolf: So what would you say are the most important behavioral markers you’re looking for in a circle, in a population, that might indicate to you that you are creating the correct vibe to get the biological and psychoneuroimmunological results you’re expecting?
Bittman: I believe that any trained facilitator can observe the group and gain a sense of whether or not it’s working.
Creating an environment that’s safe, secure and nurturing—rather than one that often occurs in the drum circle that becomes competitive—makes a significant difference. Giving people permission to play and engaging them on a level that enables them to express what’s in their heart, rather than trying to follow along with what often turns out to be rather complex polyrhythms, reduces stress and improves personal expression.
The crescendo portion of our program, Inspirational Beats, allows the group to really gel, come together, and truly develop a sense of mutual support on multiple levels. As opposed to a musical performance, which a drum circle often resembles, Health Rhythms levels the playing field, and that reduces the perception of stress, which I believe can help us move in a positive direction biologically.
Wolf: That profoundly addresses what I was interested in! At the end of one of the Health Rhythms training sessions I observed, after listening to all the research, that you haven’t really proven anything about drums. What is your response now to that?
Bittman: You have to realize it’s very difficult to divide these elements into respective compartments, so I’ve often referred to Health Rhythms as a compound-complex intervention. I do not believe that simply the act of playing a drum itself, for the general population, is going to provide a generalizable biological benefit. I do believe that if we introduce the drum within a rational protocol, it can be extraordinarily effective.
Bittman: After more than 15 years, I believe that playing the drum and being part of a circle that’s conducted in a caring, compassionate way, can serve as a rather effective catalyst for the depth of verbal disclosure that would not occur otherwise. It’s not just playing the drum, but being able express oneself rhythmically, feeling nurtured and part of a group, that facilitates reflection through discussion.
Wolf: Nice. That perfectly addresses that question. Is there anything new and exciting coming up in further research?
Bittman: Over the years I’ve been profoundly moved by the fact that for seniors, kids at risk, nursing students and even patients facing the challenges of serious diseases, creative musical expression through Health Rhythms can be transformative.
Wolf: I’ve been fascinated by the styles of therapy that are grouped together under the heading of Memory Reconsolidation. In that paradigm they discuss the possibility of “rewriting” limbic or emotional memory—the possibility of being able to rescript at a deep level. This might be way out of left field, but is that an area where you would see a parallel or even potential application of group empowerment drumming?
Bittman: As a scientist and a neurologist, I’m not certain that we can literally rewrite memories. I am certain that we can change our beliefs and our perceptions. Undoubtedly since the most valued events in our lives are often attached to music, I have no doubt that if we can engage people musically or rhythmically, certain memories can be triggered that can enable introspection.
Wolf: So in these forms of therapy I’m interested in, they are working to simultaneously bring into awareness both a symptom-generating belief and to bring that into awareness with “disconfirming knowledge” that allows that belief to change. So I’m wondering if you think that Empowerment drumming might have a place in being able to generate that kind of empowering experience in the present that might be able to allow one to interact with deep-seated beliefs and scripts from the past and be able to transform those?
Bittman: The answer is both yes and no. No in terms of the average Health Rhythms facilitator. Yes with a trained behavioral clinician, who is capable of working with a person through cognitive behavioral therapy and other strategies. However, I must emphasize that it has to be in the right hands. I wouldn’t suggest that any Health Rhythms facilitator try to bring forth negative self-beliefs from the past and attempt to change them with drumming. On the other hand, a skilled counselor or psychologist could integrate this strategy effectively along with other tools.
Wolf: We’re in agreement. Thank you so much for taking the time to talk with me. I’ve been really seeking clarity about my perceptions about drum circle work versus Health Rhythms work, and trying to find a way to communicate what that difference is. There is a tendency for everybody who does any kind of work with the drum to quote the Health Rhythms research in support of whatever they are doing. I frequently think that what they are doing is not similar enough to anticipate that it’s going to create the same kind of environment and have the same biological results.
Bittman: I can assure you it won’t.
Wolf: And ironically, some of the most beautiful music I have heard, as a professional musician, as someone who plays in many contexts, some of the most beautiful music I’ve heard has been at some of the Health Rhythms circles I’ve facilitated or attended.
Bittman: Not surprising at all! My goal was to bring people together who really didn’t believe they were musical, and see if we could utilize a delightfully engaging non-threatening musical experience to change their minds and their biology. That’s what we’re after—creative musical expression as a catalyst for healing.
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