About a year ago I got the idea I was going to buy a djembe. I can’t even remember for sure why but I think I was reading Eliade’s book on Shamanism, which round about came after reading neuroscientist Sam Harris’ book Waking Up. I banged on the drum a few times, thought it was moderately cool, but not enough to continue regularly. Then circumstances conspired to send me to Burning Man in August/September of 2016. At Burning Man I made a lot of new friends who were into dance, bass beats, and eventually drum circles. I joined in and found it an overall enjoyable experience; more so than drumming by myself.
Later, looking up papers on something I came across the following paper on drumming and mental health (depression, anxiety, overall mental state, and more just as interesting inflammatory biomarkers). Doing additional pubmed searching on group drumming, drum circles, etc. led to a number of papers I want to read, which I think will make for a good review blog adding papers as I go. I’m not sure how this relates to physical therapy yet but my experience in treating low back pain leads me to believe that a lot of health issues do not improve from fixing one thing, but rather a number of factors. Such that you don’t take steps to curb enough unhealthy factors then you aren’t going to cure the problem. So maybe drumming, dancing and singing or lack thereof, relates to both physical and mental health along with diet, exercise, sleep patterns, and circadian rhythms that overall make people healthier and happier. Since integrative medicine is (according to critics) just a mixture of real medicine and placebo, I’m hoping to science it up a bit as “real medicine” often seems to miss a lot, and “alternative medicine” does have a lot of flaws.
Anyway, here’s data from the first two studies I read, updates will be added below.
Synchronized drumming enhances activity in the caudate and facilitates prosocial commitment–if the rhythm comes easily. Kokal I, Engel A, Kirschner S, Keysers C. PLoS One. 2011;6(11):e27272. [FREE FULL TEXT]
Quotes from study:
“One hypothesis claims that music and dance are culturally evolved tools for fostering group cohesion and commitment, thereby increasing prosocial in-group behavior and cooperation…”
“…participants who drummed with a ‘synchronous’ drum partner in the last part of the experiment showed more prosocial commitment towards this drum partner than those who drummed with an ‘asynchronous’ drum partner. These effects were stronger in participants that acquired the rhythm more easily.”
“These results are consistent with behavioral studies that demonstrate a link between synchronized musical activity and prosocial behavior…”
“…our results suggest that this may be true only for activities a particular individual masters easily…”
“…the ease of rhythm imitation was significantly positively correlated with brain activity in the right caudate, which in turn predicted the number of pencils the participants picked up.”
“By showing an overlap in activated areas during synchronized drumming and monetary reward, our findings suggest that interpersonal synchrony is related to the brain’s reward system.”
This was the first paper I read and they had 18 healthy volunteers without any music training finger drum on bongos while they observed brain activity with functional magnetic resonance imaging (fMRI). While doing so, subjects were rated on how easily they picked up the rhythm, and later with someone playing either in sync with them or out of sync. They found that if the rhythm was easier to pick up, activity in the brain linked with cooperation (the caudate) was increased and that if their co-drummer played in sync with them it improved cooperation. This was tested behaviorally by having the experimenter “accidentally” drop 8 pencils and seeing how many the subject helped pick them up. The increase in cooperation with drumming in sync drumming resulted in subjects to pick up ~5.5 pencils, while out of sync drumming resulted in them picking up just pick up ~1.5 pencils on average. Having been in a few drum circles as of late, the above definitely sounds plausible.
PLoS One. 2016 Mar 14;11(3):e0151136.Effects of Group Drumming Interventions on Anxiety, Depression, Social Resilience and Inflammatory Immune Response among Mental Health Service Users. Fancourt D, Perkins R, Ascenso S, Carvalho LA, Steptoe A, Williamon A. [FREE FULL TEXT]
Quotes from study:
“Growing numbers of mental health organizations are developing community music-making interventions for service users; however, to date there has been little research into their efficacy or mechanisms of effect. This study was an exploratory examination of whether 10
weeks of group drumming could improve depression, anxiety and social resilience among service users compared with a non-music control group…”
“Furthermore, it is now recognised that many mental health conditions are characterised by underlying inflammatory immune responses.”
“A much less researched area is whether general music making within community settings, not led by therapists…”
“One of the community music interventions growing in popularity for mental health is group drumming, perhaps due to the inclusiveness of drumming circles, lack of fine motor skill requirements and strong steadying rhythms.”
“Furthermore, research over the past two decades has demonstrated that many mental health conditions are characterized by an underlying imbalance between pro- and anti-inflammatory cytokines (proteins within the immune system), weighted towards a pro-inflammatory response.”
“Unlike music therapy, the professional drummer was not told details of participants’ backgrounds or psychological profiles and did not have specific psychological or therapeutic aims.”
“…to reduce the bias of having control subjects who were merely more socially isolated than the experimental group, all control subjects were already regular participants in community group social activities (e.g. quiz nights, women’s institute meetings and book clubs) and continued with these activities for the duration of the study.”
“The overall decrease in anxiety from baseline in the drumming group averaged 9% by week 6 and 20% by week 10.”
“The overall decrease in depression from baseline in the drumming group averaged 24% by week 6 and 38% by week 10.”
“The overall improvement in social resilience in the drumming group averaged 16% by week 6 and 23% by week 10.”
“…wellbeing scores… …improvement in the drumming group averaged 8% by week 6 and 16% by week 10.”
“When levels of TNFα and IL4 were assessed, there was a shift away from a pro-inflammatory profile towards an anti-inflammatory response. The changes noted in these cytokines are relatively small so future research remains to be carried out as to their biological significance.”
This paper is interesting for a number of reasons. Unlike the above paper, the subjects were not otherwise healthy but were a diverse group undergoing concurrent mental health services with an average mild depression, moderate anxiety, and below average social resilience. All of which were improved with the drumming sessions and all of which further improved after 6 weeks and further so after 10 weeks. They used a djembe drum (the one I have) and performed in a drum circle where the leader did not know about nor care to address any particular psychological pathologies.
It would be interesting to know if there is a dose response relationship where increased weeks, sessions per week, or minutes per session led to further improvement, and then what is the optimal dose. Looking at the 10 week over 6 week improvements, it does not appear they were hitting a ceiling of benefits and improvements were largely maintained 3 months post. Personally I’d like to see the control group having some kind of intervention rather than continuing social activities as usual, even if they went out of their way to find a social control group.
The above paper is also interesting to me in that it looked at inflammatory markers in relation to mental health and how they improved somewhat with the drumming. I read a number of papers looking at BDNF and mental health and blogged about it. I think this is worth further reading to find out whether and how much other favorite interventions of mine like exercise, caloric restriction and intermittent fasting might overlap with regards to systemic inflammatory mediators, and I’ll bet money they do. However, unlike exercise, diets, and fasting, drumming is actually fun.
Chad Reilly, Physical Therapist