The Science of Music Therapy with Kathleen Howland, PHD

Hello, ladies and gentlemen, welcome to wellness talk. I am George Bautista as always your host and your wellness advocate. So glad you guys could join me each week. Today. We have a very, very special show. We're actually going to be doing a little bit of a continuation on the show. I did about a month ago called music as medicine there. I talked about some studies, uh, regarding how music was used to help people post, uh, post heart attack, people with a cognitive decline, all different types of things. Very, very powerful show. If you guys can get a chance to check that out, make sure you do. It was, it was some really, really compelling studies on there, but today we're going to be doing an even deeper dive today because we have a very special guest and we have Kathleen Howland on today. And, uh, we're going to be talking about Kath, uh, talking to Kathleen about music therapy and how music heals and the power of music. This is something, of course, you guys know near and dear to my heart because I've been a musician for well over 30 years. And, um, this is just something I love talking about. So let's talk, uh, let's talk a little bit about, uh, Kathleen, um, for the past 35 years, Kathleen has worked with a variety of clinical populations using music to enhance speech language, cognition and movement in habilitation and rehabilitation settings. She has also developed protocols to reduce stress anxiety for general wellness, surgical preparation, oncology treatments, and child birthing. Along with being a speech language pathologist, Kathleen teaches undergraduate and graduate courses at Berkeley College of Music and the Boston Conservatory in Music Therapy, Music Education and Liberal Arts. She also lectures locally and internationally about the neurological foundations for music perception and performance and the power of music as a therapeutic intervention. I am so excited to have this conversation with her today. So thank you so much, Kathleen, for being on the show with me today. Thank you so much for having me and choosing such a exciting topic. Absolutely. Absolutely. This is, you know, and again, those folks who listen to the show know that obviously this is a health show, but also know that I'm a musician. So when we put those two things together, it's like, I can talk about it. I absolutely, I can talk about it all day. So, um, so this is going to be a fantastic conversation. So, um, I was, and I know we were talking a little bit before the show, I was introduced to you by your TED Talk, which is fantastic. And those folks who haven't seen it definitely go on YouTube, check out Kathleen's TED Talk, because it's really, really informative and very inspiring. It really shows the power of music. I want to talk a little bit about your background, first of all, for the folks that are not familiar with you. Talk about your journey in music and how it led you to what you are doing today. 40 years ago, the notion of music therapy was really quite unfamiliar. It was something that ended up being like an epiphany. When I first heard the two words together, I had been a music education major. At the same time, I was working with children and young adults on the autism spectrum who were just coming out of institutions where they were physically and chemically restrained. And this was the advent of Skinner. And all of the behaviorism and in my work with them, their musicianship was unreal. It was so magnificent and it captured me. And as a musician and as a aspiring music educator, I didn't know what to do with their musicality. I didn't know how to harness it for their wellbeing or for the goals that I was responsible for. And then one summer in between my sophomore and junior year of college, I heard the words music therapy and I just knew that's who I was, but I didn't have any idea what it was. And so I switched colleges and I have been on this path ever since. Wow. Incredible. So talk to us about music therapy specifically. What is it that you actually do because I know you've, you work in oncology sometimes and hospice care and these types of things. So what are the actual mechanisms of it? There are a number of interventions that we have at our disposal. It could include songwriting. It could be passive listening. It could be active engagement where we offer instruments that need no specific skill that are handheld percussive instruments, for example, that people can join in with their own musicality. We also do lyric analysis is another way of working with people and improvisation. So we have these fundamental tools that we can use with people from womb to tomb. Actually, they're very adaptable. We have the opportunity to serve four domains, speech and language, cognition, movement, and emotions. So for example, walking into somebody's life in an oncology unit is a pretty uncomfortable few moments. I will say, you know, when you walk in and say, do you want to have music? And people are like, what, do you want me to sing? And so but once you, once you do get your foot in the door, then they, then they start to see, Oh my gosh, I forgot about music. I forgot about my love of music. Oh, I feel so supported. I feel so relaxed. So in oncology, for example, for people to reach the relaxation response, that biological state of rest and restoration is really a great way to navigate all of the steroids and all of the chemotherapy that will go into their bodies. And I can say this, not just as a practitioner, but as a patient myself, when you're not in the stress response that your body accepts Western medicine or any kind of intervention much more readily. And so for people to see that music can be used as a tool for resilience, it can be a way to occupy eight hours of chemotherapy. When I was practicing before I was diagnosed, people were watching Jerry Springer in the oncology unit. I couldn't understand the overflow of toxicity, the choice of toxicity. When, and that taught me when it became my time, I wanted to fill myself, my spirit, my body with love, joy, and laughter, right. And aesthetic beauty. And I think it had a lot to do with the way my body received the medication and the way that I was able to navigate. Those were precious hours. Those were really precious memories in my life, even though yes, it made me sick and it made me bald and it did all the things it did. What I, what I saw was I made wonderful use of that time. I didn't grade papers. I wasn't on trolling on the internet, just mindlessly. I was very much purposeful and in the beauty and power of music. And I think it made all the difference. Absolutely. You know, it's this, is this whole thing about healing because even in the nutrition space, I've worked with people in the past who, who, who had cancer and who were just diagnosed. And, you know, obviously there's, you know, you talk about, yes, what you can do on the nutrition side, what you can do to help support the body when it's going through this and, and, you know, support what they're going through as far as therapies and things like that. It's, it's, it's, it's amazing. The mindset has so much to do with it and you know, you, I didn't realize when I was doing that, that I was also had to be a therapist too, in a, in a, in a way, you know, I had to help them with their outlook and their mindset because you know, when you, you don't have the right mindset that affects the entire body, right? It's, it's a mind body connection. And you know, now seeing music as part of this also, and it makes so much sense in terms of not only helping with recovery, helping when you're going through this. I mean, it, it is, it really, really is this healing thing. And I think people folks, again, the folks that I've worked with who have gone through this, they automatically kind of they're, you know, they go into this apathy, obviously there's this denial, there's this apathy, there's this whole thing. And then, you know, then actually some, you, I mean, I, and I'm sure you, you know, and then you kind of come to come to terms with it and say, okay, what can I do now? What do I need to do to get past this? And it's you know, you know, not only the, the, the talk therapy of it, the whole piece, but I didn't think about it as a, as a musician back then when I was talking to these folks of adding the musical piece to it. And, and now that I hear this and, and, you know, what I saw from you, and I looked at a lot of the testimonials and things on that from your channels and stuff like that, it absolutely makes so much sense how music can really help you in this, in this process. It's incredible. It's a distraction from the treatment and a focus on beauty. Exactly. Exactly. Absolutely. Absolutely. So, you know, one of the stories that I told on on the program that I did on music is my journey when I was a kid and how music helped me. So and I'm an open book on my show. I'm pretty open about my, my, when I was younger, you know, I've, I'm a child of divorce and my parents had a particularly nasty divorce when I was maybe about eight years old or something like that. And so what I, what I did is my, my bedroom was literally right next to my parents and it was literally just a wall dividing us. And prior to the divorce, I would hear them argue. It was almost every other night. So as a child, like six or seven years old, obviously that creates a lot of anxiety. So what I would do during that time, I had a little radio next to me and I would put on the radio and it did two things for me. It drowned out my parents arguing, obviously, but it also took me away. It really, it just, it brought me into another world of, of music. And it, it calmed me. It calmed my anxiety. It calmed me. And it actually helped me go to sleep. And I started using that nightly to help me go to sleep. And to the point where even after my parents divorced and I, you know, my mom and I were living alone, I couldn't go to bed without music. It was, it just became a part of me. Have you in your practice heard things like that, especially with children, developing children, children, young, dealing with let's say post-traumatic disorder or things like that, where music has helped them? Very commonly. And you found that circumstantially you happen to have a radio versus as a music therapist, we're making sure that with intention with, with clinical practice, that these are, are with a child, that they say, for example, a working with a, a set of parents who are awaiting a baby or the baby arrives too early. Okay. What will let's create your own lullaby. What do you want to say to your child? What do you, and then incorporate that into song. And that comes both the mother and the child. And that bonding continues in a more normal way. So it is always helping people find where does music meet you in this moment? Right, exactly. And then what comes next? What's the next piece. And then the piece after that, so that you can move in the direction that is all about wellbeing and survival or thriving, even if you're dying. Right. I have seen, I have seen music fill the void, that empty void, as you wait for people to take their last breath, to fill it with beauty, to soften people's faces, to lower people's shoulders and to fill that empty void and to see it regulate the breathing of the person who's actively dying. So it is incredibly salient to our brains, whether we are premature or fetal or at the end of our lives. And I think it's a tremendous gift that is not considered strongly enough in education or in medicine. Agreed. Agreed. You know, it's interesting when I was, um, when my wife was pregnant, of course, as a musician, you're like, okay, I'm hoping this, you know, help hoping my child is, you know, comes out with the love of music. And of course I was one of those that took the headphones and put it on her belly and played music and stuff like that. And now I, I did read some, uh, books back then. Uh, the Mozart effect was one of them that I read and some others, but I'm, I'm just, I always wondered if that did make a difference because now not my, my, just so you know, that now my, my daughter's 16, she does love music. And I think a lot of it is because she saw her dad playing and her dad loving it. And she got into it. And she actually, I, I even, um, she did, uh, um, she did a, a project for school and, uh, she had a draw. Um, I, I forget what the project was called, but her drawing was of a snowman. It was very interesting. The drawing was of a snowman with headphones on and it was all this stuff around the snowman, crazy things happening, but the snowman was just there with a smile and headphones. So I went up to her and I said, I said, what does this mean? What does this signify? And she's, she says, um, she's dad. Um, this is me when I'm listening to music and drowning out the world because music is just taking me away to another place. And I was blown away. Yes. I, I was shocked at how, how she was so, you know, how she, how she thought of it. Cause I didn't, I never realized. And again, I knew she loved music, but I never realized that she thought of it in that way. Yes. You know, and, and you, you know, you surprised at how children grow growing up, you know, whether their parents are musicians or musicians or not, or whether they love music or not, how music, especially because now there's music everywhere, you know, on social media and everything. It does inspire children growing up. Yes. When I, when my daughter was four, we had a car accident, just a sliding winter accident, but it was very unnerving. I had a child in the car and she said, mama, just listen to the music. Just look at that. Look at that. Wonderful. It's incredible. Wow. Yeah. So, um, I wanted to get into, um, so you have, one of the things that I, I, I have found that was very, it's very interesting to me is music, how it affects people who are going through cognitive decline, dementia, Alzheimer's. Now I've seen it and I'm, I'll be I'm not a neuroscientist or anything like that. So I don't know all the mechanisms to this, but, um, I've, I've always been interested in that whole piece of how a person who's going through that cannot recognize a loved one, but we'll know every lyrics of the song or we'll know, or even the musicians know how to play the song. You know, examples like Glen Campbell who went through that, uh, couldn't recognize his own kids, but yet he would be on stage playing the song perfectly. Yeah, no, absolutely. Tony Bennett is going through that now. Do you know, can you explain a little bit about the brain and the mechanism and how that works? Well, that's a very big topic. Let's take a look at, um, your average person, for example, a non-musician, and then we'll talk about how perhaps being a musician can be neuroprotective to cognitive decline. So for people, especially those that in Vivek Murthy's brilliant book, um, called together, showed us the cost of social isolation in terms of cognition. So just living alone increases our risk for dementia by 40%. And it's a lack of stimulation. It's a lack of cognitive engagement. So you think about, say, elders doing find a word versus actually doing a crossword puzzle. The cognitive demands are vastly different. Um, and one of the best things that you can do is listen to music, but not just music, you know, but really going through the CDs or LPs or whatever you have or technology. If you feel comfortable in exploring music, like if you can take a favorite song and put it into Pandora, now you're going to let the algorithm give you that the breadth of that. So it's, it's having an adventurous spirit a little bit or having an adventurous spirit that's encouraged, but listening to music alone can be cognitively stimulating. And in some very interesting studies from Finland showing that after a stroke, people did better when they were and had better recoveries when they were listening to music daily. And I think, and there's nothing in science to say this is true, but across science and across my experience, I think that what music does in its orderedness is help order brain function. So rhythm being very, very fundamental patterns that are that that are redundant and that vary, but they're recognizable. This is so different. Um, and then of course there's the emotional salience of it, which can give you jolts of joy that can motivate you, um, and have you engaged. So I think listening to music for non-musicians is really important in cognitive decline, um, and should be considered as a daily dosing like mid, especially at times when they might be inclined to nap because cognitive decline is, you also see people napping cause they're bored. They're not engaged. So when they're napping several times a day, those are the times a day that music should be put on and it should avoid the naps. Now, naps are very, very healthy, but not frequent napping and particularly due to boredom. Then we can look at Glenn and Tony and I met with Glenn's family when they came to town to debut the movie, um, Bobby me with, um, NIH researchers in Boston. And it's amazing to me what the researchers miss. They'll keep saying, well, he's still playing because he's talented. And I'm saying, Oh Lord, no, he's still playing because he has thick neural networks that were developed over years in decades of playing. And when Alzheimer's came a calling, it's like chipping away at marble and Glenn was symptomatic for a decade before he was diagnosed. Um, so I remember talking with his daughter. He started being symptomatic when she was 16, 17, she was 27 when he was diagnosed, um, and continued to persist at mid stage Alzheimer's for over a year. So what I think we can say is that being a musician and actually being a college professor is neuroprotective. We have thick neural circuits that are practiced over every semester. We get to practice what we know again and to extend it. And so you're looking at neuroprotectiveness. You can look at the opposite of neuro unprotectiveness in the high incidence of Alzheimer's in, um, people with down syndrome. So that genetic deletion syndrome has a high incidence of like 70, 74% of them will get Alzheimer's and they start in their thirties and forties and it moves through them in a matter of weeks and months. But it takes months in years for neurotypical people in what appears to take be even a slower burn for musicians. This was my hypothesis with Glenn. And then when Tony came out, it was like, okay, now we're onto something. Right. Right. I think we're onto something. And when I looked at other research about occupational incidences of Alzheimer's, those like professors have low incidence again because I think of the thick neural networks and it just takes longer for the Alzheimer's pathology to chip away at it. Interesting. Interesting. Yeah. See, that's, that's an interesting take on that. Here's another point that there are lots of studies that show I'm training adults to play piano and I was going to ask you about that. Increased brain matter. So we can see density given to that training. Right. But like any of us who've tried to, especially piano to learn as an adult, it's just a gosh darn difficult thing to do. Yes. Very true. Very true. Because the developmental window that makes that easier has closed to make it easier to do two different things with two hands to have that type of coordination going on. That window has closed. So what I think would be much more sustainable is actually to teach children K to 12 fundamental piano skills that they can use for their life rather than trying to train elders or for elders to train in music, not to choose such a difficult instrument, but then to go to ukulele. Ukulele is very easy to play. And as you know, you learn three chords, 500 songs, four chords, 1500 songs. And you see that now in senior centers, lots and lots of opportunities to learn and play the instrument. And it also puts them not only in a cognitively engaging task, but a socially rewarding experience in a community. Absolutely. Well, and that's, it makes sense also because you, and you're right, because when you're, whether it's you're in a band or whether you're in an orchestra or whatever it is, you learning to work with the rest of the group, you're learning to or you're leading, you're learning to lead, you're learning to become a leader of that orchestra or that band or whatever it is. And that's actually igniting another part of, of you as far as, Oh, okay. Now, you know that, you know, whether it's the confidence part or whatever it is. Yeah. Now I can actually lead a band, you know, and, and that type of thing, because it makes so much sense. One thing I wanted to ask you was, so if you're teaching, let's say we're teaching K through 12 piano or, you know, that type of thing, have they done, have they looked, have they done really long-term studies on if they've taken it up at that point and then looked at them when they got older to see if there's a difference or is there less cognitive decline because they learned it at that time? Those type of longitudinal studies really can't be done. They're just too expensive. The attrition is too much. But there have been studies that look retrospectively. And part of that is trying to estimate how many hours you practice like George, how many hours, if you played music, it would be very, very difficult because it waxes and wanes through life, as we know. And how much people practice and how truthful they're being about what they practice is a difficult. So there are a lot of studies that look at musicians versus non-musicians. And now because of a certain type of neuroimaging equipment, we can see the difference between singers and instrumentalists. One of the series of studies that I love shows that people who age with hearing loss also have an increased risk of dementia by 40% just because of hearing loss. Again, a lack of stimulation to the brain. But for those who, if you and I had equal hearing loss profiles, but one was a musician and one wasn't, the musician is going to hear a signal in noise better than a non-musician. In other words, being able to make better use of the hearing that they have because of their music training, even if they haven't played since high school. Wow. Because they learned to play music at a, at a very formative age in brain development, they have these long lasting benefits. And this is the brilliant work of Nina Krauss at Northwestern University. I find that stunning. That is unbelievable. Wow. I didn't know that. That's, that's incredible. And now Frank Russo has been looking at training people who are non-musicians in music so that they gain that benefit in seeing that they do are able to gain that benefit. So their training in singing and ear training type exercise, like you would have at a college of music and finding that's improving their ability, because as soon as they start to have a hearing disorder, it makes going out into social, uh, social gatherings, very difficult. They can't hear their ear, their, uh, hearing aids only make that worse. So they tend to socially isolate. And remember, I also said that social isolation increases the risk for dementia hearing loss increases the risk for dementia. So music training actually is benefiting people in the long run. And I just love, love, love that work. Incredible. Incredible. These are, these are the insights that I just like, I find fascinating as well. Um, I heard you talk about, which I found fascinating also, um, children with dyslexia. Yes. Can you talk a little bit about that? This is also Nina's work. Okay. Um, and, and others, um, you have to be able to process sound normally. And for children who at three years of age, we'll say there were patterns of music. If a three-year-old says those are the same, instead of saying they're different and their score is low, the risk of them being dyslexic can increases the lower their score, the higher the risk for dyslexia showing that we have to be musical before we are linguistic and before we illiterate. So there's a biomarker. Now we can look at a, um, a screening, a simple screening of three-year-olds and start to look at what their capacity will be for learning to read, because we know that say 40% of people incarcerated are dyslexic and 90% are illiterate. That by not being able to read because of conventional school systems, they don't have access to the kingdom of knowledge and inspiration. Right, exactly. And so we are not yet to the place to say what, what would remediate that finding? Because this is all relatively new, but assuredly it will be to put them into an early childhood music class. Absolutely. Wow. Incredible. Incredible. Yeah. It's unbelievable. Here's another one. I think you'll really like, um, the work of Kathleen Verma in Germany has been collecting children's vocalizations, their cooings at two to four months of age. And they are, um, actually music students will take dictation because children vocalize in, in noticeable, uh, musical intervals. And furthermore, what she's shown is that if the children do not have varied, a nice variety of vocalizations that they're capable of doing, it demonstrates what they're perceiving is not typical. And so by looking at the vocalizations of, of children at two to four months of age, you can predict those that will have a language delay at age two, because they're not in this way. They're not, they're demonstrating to us what they're perceiving, what they're hearing. And they're demonstrating to us that it's constrained. That's incredible. That's incredible. That's unbelievable. I, and I love the fact that they're actually even doing this. They were seeing this and doing this work, you know, because it's, it's, it's, it's wow. I have a happy research dance that I do. And I did that for days after reading both of these, uh, series of studies. Yes. Wow. You know, it's interesting. I, um, for me, my, my mother used to tell me, cause my father's side of the family was very musical. They all played some instruments at some point, you know, whether it's piano or congas or whatever. And I had an uncle who was very, very good gifted piano player, but he's got a very good ear for music. So my mother used to tell me that when I was a child, there, there was, we had a washing machine in the kitchen and it would go through the cycle. So it would make a rhythm and I would walk over to, and I would actually just stand there and just Bob to the, to the cycle of the washing machine. Yeah. And she, and I used to do this constantly. And she said that, um, she always said, he's going to do something in music. I just have this feeling that he's got to do something. And the funny thing is that she ended up putting me in piano lessons. I played piano probably for about a year where I was starting to play with two hands. I was getting good. But you know, as a kid, you, you kind of get bored with it sometimes and it's like, okay, whatever I stopped. Then I ended up picking up the drums later on. But what I found for me was that music was easy. It was very easy for me to pick up, to learn, to, and I found that, and I did was a lot of jokes in the bands. And when we played that for me, when I, I was able to have this pitch, like I, I knew the notes, I knew the pitch, I knew the songs. And as long as I could hear the song once and I would know it. And you know, and I'm like, I can't remember to take out the garbage, but I can remember the song perfectly, you know? And I always said to myself that had to be through my father's side that, because my uncle is that way. And I'm that way, you know, but a lot of, some of the musicians I played with would marvel at that because they didn't have that even, you know, even if they're actually bass players or guitar players, but the drummer, for whatever reason, knew the pitch and knew the, knew the notes, knew the songs. It's just one of those interesting things, how you, you know, how you, you have this gift and it's, it seems to be heightened that I, for me, I felt that it was very heightened, even as a kid. Now all I had to do was kind of develop it as I got older. Yeah. I think talent is actually a myth. I really do. I think like any other trait, human trait, it's normally distributed. There are those with above average aptitude, capacity, average, below average. And you sound like you are very much above average, but that has to also be matched to opportunity. You had your uncle as a model. Perhaps you were going to live music. You had access to instruments, lessons. That's, that's nurtures a contribution. But then there's that other piece that's grit. You didn't have the grit for piano. You, and we also kind of make it a chore. I think music educators should really teach how to practice. I think the Suzuki method is just right because if your child is going to do this challenging task, you should too. So I studied violin when my daughter chose it and it was hard, but I did it so that we played together. We did duets. I played her something. She played me something. And, and that's really important to, it's an opportunity to teach grit. It's an opportunity to tell people, to incentivize it, to use your own music for relaxation, like play me something you love. You know, it's hard to do the woodshedding. It's hard to go over and over that same passage. Right. So making sure that you play music you love. And in fact, there was a elegant study from a German conservatory of music looking at three tiers of violinists, the very best, the next best, and then the third group. And what they found was the top two groups played informally, which meant they jammed or they played the things that they loved. They did that more than the third group. Right. So it's important to keep the love there. It's important to have a teacher who cares for the child, who cares for the music, who's not just phoning it in. And I deeply, deeply resent movies like Coda and Whiplash that show music education as a brutalist and brutal profession. I don't think it's that at all. I was very much cared for by my music teacher. And I had everything to do with fueling my grit and maximizing my aptitude and giving me every opportunity to be a musician 50 years later. Absolutely. You know what? It's funny. I, you know, you talked, we talked a little bit, you mentioned jamming, for example. And I was, I, I was the type of person that when, when I started playing, I just jammed. And again, it was very natural for me, but I didn't learn how to actually read music until later. So, and, you know, I remember my uncle telling me, he was like, sometimes he goes, there are people that are perfect readers, but they don't know how to jam. Absolutely. And I was like, you know, and I was young when I, you know, I was, I was a teenager when he told me this and I was like, really? He was like, believe me, because he played with a lot of different people. And he said, there are people who, you know, can play, you know, they need a chart in front of them in order to play. And it's very, you know, kind of stiff type thing versus a person who's just can jam, because there's a feeling when you jam, whatever instrument it is, that that is like no other, especially when you click with all the other members of the group and there's just push and pull and you, and then there's, because again, music is communication. You're communicating with each other and you know where that person's going and you know when to lay back and you know when to come on. I mean, it's a beautiful communication. It's almost, I find it's a spiritual communication. There's this, you're all together and you're, you, you kind of get to this higher level of being, because to me, when I'm playing, and I'm sure you, you felt this when you're playing, it's almost an out of body experience. You find that you're, especially when you could even be practicing, but when you, it's almost like you close your eyes and you're almost like watching yourself and you're like, and then it's funny because you get to a level sometimes that you've never gone to before. And you're like, Holy cow, where was high? But it's absolutely marvelous. And the work of Charles Lim who's a neuroscientist and surgeon has shown that and wonderful piano player has shown that when people are in that state, it's like chicks. Mahali's flow, that self-expression areas in the brain related to self-expression are enhanced in areas of the brain related to self-criticism. That negative voice are attenuated. Isn't that lovely? And that was done with people laying on their backs, making music in a scanner. Really? Yes. Interesting. Charles Lim has a wonderful Ted talk on this topic. Oh, I definitely will check that out. And you've talked about also how music lights up the whole brain, right? Music is very engaging for the entire brain. Absolutely. Activates subcortical cortical areas, both the left and right hemisphere. It's very, very complicated. And what I think music does so beautifully is it braids together different functions. So if you think about, if you decode music notation, you're taking a visual representation of sound for time and pitch and it's creating motor patterns. So then that, that visual is connected and braided with the motor system, which is then braided into the auditory system. You're predicting what that pitch is going to sound like. And you're assessing what that pitch did sound like. Was that a little flat? Was it a little sharp? Then your executive functions kick in like, Oh my God, here comes that Heidi. Is my read going to hold this? I better pull up on this. And then sometimes you reflect, which is never good because sometimes you're like, was that supposed to be an F sharp? And then you start making mistakes in the now because you're looking back. So it really does involve so many areas. And it's not that there are separate islands, but that they're braided together with, with really thick circuits to allow this work to flow as easily as it does. Absolutely. Do you find in your work? Um, and I guess it depends on, um, the person, but do you find that, is there any specific type of music that is more or that works better than others? Or is it just personal, a personal thing, depending on what the person, what stimulates the person? Absolutely. There's no perfect song, which is why a music therapist, um, you have music degrees as well as psychology degrees and 1200 hours of clinical training. It takes a long time to nurture an aspiring music therapist into a professional music therapist. Um, I, I remember going into an oncology room one time and there were three people, one man loved Elvis Presley, another guy like Bach. And it's like, okay, where are we going with this? Um, and, and there needs to be tremendous versatility, um, in a music therapist in order to be able to use people's preferences for their wellbeing in that moment. Or sometimes it would be bringing in something that's novel, that's unfamiliar to them for a specific, uh, clinical purpose as well. So it, it is, it requires deep training and there's no one genre of music or one artist or one song that meets the needs for everybody. Um, and so we have to be very flexible and in the moment, um, with, with deep training in order to be able to meet our, these people's needs. Have you ever, and I, and I've seen it in, I guess I've seen it in movies. I've heard of, you know, things like this, but is it true that people who are in comas can be stimulated by music? Oh, that's such an important question. I wanted to do my master's work in coma and my professors wisely said, no, no, no. Because it's such a vulnerable population. I would offer to you and to your listeners, um, a beautiful film that was done at Spalding hospital by my colleague, Brian Harris. And what he did was a traditional sensory stimulation program has you clapping, yelling, somebody's name, trying to get them to orient you. So a therapist is doing it on one side of the bed. And then Brian is on the other side and replicates that same protocol. And they see no reaction from this young man who had an anoxic event following a drug overdose. Brian starts to create a simple pattern, a simple pattern in music. It could have been something as simple as Lou, Lou, Lou, Lou, Lou, Lou, Lou, Lou, Lou, Lou. And then he would have done what's called an expectancy violation. He interrupted the pattern in an awkward place. Lou, Lou, Lou, Lou. And it's very compelling to want to finish that. And what they, what they witnessed was a full body turn toward Brian and the vocalization in the timing of the missing element. No way. Yes. Way. Wow. So I've always found the traditional and conventional sensory stimulation program to be noxious. Honestly, people are pinched for a response. People are startled for a response. And I think that we can do better than that. So our brain is a pattern perceiving organ. And when we give them a pattern and we interrupt it, then we can see what's possible. So not all people in comas can do this, but as we assess them along their path, we can identify using music the potential for further treatment. That young man had been diagnosed as vegetative at that time, meaning just brainstem level functioning. But when they saw that type of reaction, now he merited more rehabilitative services as he should. Wow. That's that is unbelievable. So until there's a music therapist assessment that's done properly and over time, because it's a very, very vulnerable population. Sure. I mean, their brain is shut itself down or they are medically put into comas to save their brains. And so having music is if you're going to diagnose somebody as vegetative, it requires in merits and music therapy assessment before that is done. And services are rendered to be just, you know, custodial in a nursing home. Absolutely. Absolutely. Wow. So Kathleen, this has been absolutely enlightening for me. I mean, I know I just kind of scratched the surface when I, uh, when I did the show music is medicine, but, uh, some of the, you know, the things that you talked about today have just been absolutely incredible. Isn't it startling? It is exciting. It is. It's very exciting to me, you know, and it's just, you know, and it's not just because I'm a musician. I mean, I'm just a lover of music in general, even if I'm just passively listening and music touches everyone. I mean, everybody has heard music, you know, whether they just, again, passively or actively listening. But, you know, I think people need to understand how powerful music really is and, and really what it can do. And, and, um, you know, folks like yourself and programs like this, hopefully can at least, you know, get the word out and say, listen, there's, there's just something that you would, no matter what you're going through, it doesn't have to be, it doesn't have to be something you were diagnosed with. It could just be, you know, you, you could just be going through a bad time, you know, in your life, but use music to lift you up to help you through that time. Because I mean, again, I'm, I'm, I'm a person, you see it daily. And I, I'm a person who went through it as a child, that music can be a healing thing. So I, I definitely encourage everyone to, to really explore that, explore music and even playing an instrument, you know, learning an instrument again, the motor skills involved in things like that as well is very, very beneficial. And I, and I definitely want everybody to not only check out your Ted talk, which is on YouTube, but also to go to your website, Kathleen Howland.com to check out all the services that you offer. And you've, you write a great blog. You have some great blogs on there, by the way. So I definitely, I definitely encourage everyone to you know, check those out, read those. And just, you know, think about music for, for healing because it is absolutely healing. And Kathleen, I really want to thank you so much. It's been an honor for you, you know, to, to have you on the show and thank you so much for, for being on and really enlightening me and my audience. Thank you. It's a privilege to have been asked and to be able to share what I know and what I love and what I love to know. Absolutely. Absolutely. Thank you so much. I will be right back. All right guys. So that was Kathleen Howland. I hope you really got a lot out of that because just incredible information that she offers. And again, just check out her site, check out her Ted talk and again, explore music and the power of music. So I want to thank you guys for joining me. Make sure you guys take care of yourselves and make sure you guys take care of each other. And don't forget, as always control your health. Have a great day.