Disclaimer: This is transcribed using AI. Expect (funny) errors.
Mindy Peterson: [00:00:00] I’m Mindy Peterson and this is Enhance Life with Music, where we explore the ways music makes our lives better and spotlight the resources you can use to enhance your life with music. Today I get to talk about some of my favorite music overlaps, music and health, and it involves a new book. Any book is a favorite of mine, but here we get to talk about a new book, which is exciting. My guest today is the author of a new book. It was released in June called, “The Connection Cure: The Prescriptive Power of Movement, Nature, Art, Service and Belonging. Julia Hotz is a solutions focused journalist whose stories have appeared in media including The New York Times, The Boston Globe, Time, and Scientific American. She currently works at the Solutions Journalism Network, where she helps other journalists rigorously report on what’s working to solve today’s biggest problems. Julia is a world traveler, graduate of the University of Cambridge in England, and a former Fulbright Scholar in Greece. Welcome to Enhance Life with music, Jules.
Julia Hotz: [00:01:09] Thank you so much, Mindy. So great to be here.
Mindy Peterson: [00:01:13] It’s great to have you. Your book is fantastic. It tells the story of social prescribing, including the science supporting it, real life examples, and how its practice is spreading throughout the globe. Listeners, if you are regular listeners to this show, you will be familiar with the term social prescribing or social prescription. In episode 172, Tasha Golden was a guest and described in detail what social prescribing is and the new resource that she helped write on the topic for US communities. We’ve also had the CEO of Art pharmacy as a guest on the topic, and Renée Fleming actually touched on it in her book and when she was a guest on the podcast. I’ll include links in the show notes to all of those interviews, in case you listeners missed them and want some of that background. In fact, you could always just even hit pause on this and go back and get that background, since we won’t kind of be redundant with information that was covered there. But just as a refresher. Jules, could you explain social prescribing in a nutshell?
Julia Hotz: [00:02:20] Yes, sure. And love all those people. Chris and Tasha have done amazing work in the social prescribing movement in the US. But yes, I’ll use the international definition, which is that it is a social prescription, is a non-medical resource or activity that aims to improve our health and strengthen our connections. And that means it could be anything that affects our health, meaning access to food, access to housing. It could also be, as I’m sure Chris and Tasha talked about an art class, a concert, a cycling group, a nature club. And what I love about it is it’s really anything that gets at what matters to you. Social prescribing is about shifting from what’s the matter with you to what matters to you.
Mindy Peterson: [00:03:15] Going along with that, you use the phrase quite a bit in your book Social Determinants of Health. Explain to us what is meant by that term.
Julia Hotz: [00:03:25] I’m glad you brought that up, because sometimes people hear a social prescription and they think the social comes from, you know, socialization, be social friendships. And that is certainly one element of what it refers to. But you’re right that it refers to this general concept of social determinants of health, meaning that our environments, the social factors in our environments where we live, how we work, who we surround ourselves with, all of this affects our health. Actually, 80% of our health is socially determined by these factors. And so we’re social prescribing actually gets its name from is this idea that just as social determinants like our job, our community, our neighborhood can affect our health for the worse, social prescriptions can improve them and affect them for the better. So it’s a really wonky phrase, but it’s kind of just like this basic idea that our environment really affects our health.
Mindy Peterson: [00:04:29] Yeah, well, when you gave that percentage 80% of our environment, it reminded me of that saying, be careful who your friends are, because you’re going to become like the five people that you spend the most time with. And it’s kind of like our environments, whether it’s our people or other aspects of our environment, really do shape us in a way pretty significant way. It’s interesting in your book when you’re talking about these social determinants of health, you talk about how this is not necessarily a new concept. Back in the 50s, psychoanalyst Franz Alexander popularized a field called psychosomatic medicine, a practice exploring how psychological factors and emotional tension can influence disease. And the 70s psychiatrist George Engel pioneered the biopsychosocial. Did I say that right? Biosocial biopsychosocial model of health a means for clinicians to look at social, psychological and behavior aspects of their patients illnesses. And then you talk about in the 90s other influences. Integrative medicine with Andrew Weil. Is that his name? Mhm. Um, that approach really considers the whole person’s body, mind and spirit what their needs are. So that was really interesting.
Mindy Peterson: [00:05:54] And back to that social determinants of health. I thought it was really interesting in your book too, when you’re talking about how we still don’t really know where the term necessarily came from. Yeah. But what is known is that most people hated the term. Yeah. Part of it was that social, the word social because it kind of went against the conventional medical mindset. And then the social word hated it. They hated the word prescribing because it implied medicalizing something that’s fundamental about just being a human. So, so, so many interesting things in the book. But your book title really captures the five categories, how you kind of categorize the different areas of prescription. There’s movement, nature, art, service, and belonging. This podcast obviously is focused on music, so we’re really going to focus on that art chapter, along with some of the other information in your book that applies to this topic in general. But tell us a little bit more about art. Explain why art, especially music, is so valuable as a social prescription, and some examples of how and why it’s prescribed.
Julia Hotz: [00:07:12] Sure. And if I could, I’ll just go back real quick and I’ll I’ll say that you’re right. Social determinants of health, social prescribing, like these are concepts that have kind of been around the last, you know, a hundred years more or less. But it actually even goes back further than that. Like these are indigenous concepts. These are eastern medicine concepts. Sure. There have been so many different sort of conceptualizations of the way that, yes, like our body is very much affected by our environments and it even goes back to evolutionary times. And that’s why I chose the five ingredients I did movement, nature, art, service and belonging. But to your question about art, you’re right. This is, as you know, you of all people know and all your listeners know like this is not just a nice to have. This is really essential to living a good life. And we actually have some proof that artistic expression has been around for, you know, the beginning of time. There’s cave paintings, there’s storytelling, there’s jewelry. And unlike movement and nature, which are sort of like, understood that, okay, this we needed to do these things to survive with art. It’s less clear, right? Like we didn’t need to make art if a bear was chasing us, we didn’t need to make art to weather us from a store, although maybe that one.
Julia Hotz: [00:08:45] But, uh, but it did help us, I think, learn to make meaning from our lives, to make meaning of the stories that we need to keep going. And so in my book, I talk about art being especially powerful for people who are experiencing anxiety or trauma. And why is that? What does art do? Well, anxiety and trauma is often, you know, a result of us sort of being consumed by a story. Right? Like a story that consciously or unconsciously, you know, something terrible is going to happen. And sometimes it’s oftentimes it’s reasonable, right? Like if you had a traumatic event happen to you, it’s very reasonable to think that something traumatic will happen again, anxiety as well, even though the things we get anxious about might not seem reasonable or rational, our impulse to experience anxiety is ultimately about protecting In ourselves. Right. And so these, these states very much like keep us in our head and they keep us in our head and not present and consumed with worry and fear and anxiety. But what does art do? What does music do? I think art and music help to take us out of our head. Number one, sometimes it’s about being lost in the sheer beauty of the art, and sometimes it’s about exposing us to another kind of story.
Julia Hotz: [00:10:22] Sometimes art can also help us access the part of our pain that we’re storing that that isn’t so expressible in words. That’s why art therapy, when it came about in the 1950s and 60s, it was used on people who had experienced trauma and whose pain was so deeply stored within them that talk therapy alone wasn’t eliciting it. They used art as this additional medium. And so in my book, I talk about how art was prescribed in two instances. In the first one, it was prescribed to a woman named kun, who was herself this wonderful, creative, aspiring artist. She always wanted to be a novelist. She’s really interested in fantasy and hero stories, and yet in her own life, she sort of was her own hero. She had a pretty traumatic childhood. She was the daughter of refugees who escaped from Vietnam, endured a lot of abuse, and in adulthood she found herself really feeling the effects of that. She was depressed. She was anxious. She was, you know, sort of consumed by this story that bad things were always going to happen to her and that she was never going to be good enough, because that was a story that was told to her a lot in childhood. And so, long story short, kun ends up being prescribed an art workshop. She’s based in Australia, where the government actually, like invested in this art workshop.
Julia Hotz: [00:11:54] We could talk a little bit about how this happens in a minute. And she had gone from, you know, not really wanting to do it, not really having an interest, thinking, oh, I can’t, I can dream of being an artist, but I can’t actually do art to becoming so prolific, painting all these beautiful paintings, drawing all these beautiful drawings, starting her first novel. And it really came from this exposure almost to this new method of expressing herself and these extremely encouraging instructors who reminded her, as I’m sure you remind people you work with, that it’s not about being good, it’s not about talent. It’s really about expression and creativity and the act of producing art. You know, with all these cases, even though the book is called The Connection Cure, trauma is of course. A very complicated thing. She’s still in therapy. She in the past has really been helped by medication. But I think what that art workshop did for Kuhn is it helped her get in the practice of telling herself another story, like she can do hard things, like, yes, terrible things happened to her, but that doesn’t have to rule her future. And when things get really hard, drawing and writing and painting is a way of coping with that.
Mindy Peterson: [00:13:15] Mhm. Well, along those same lines of telling yourself a different story, I came across a new term in your book that I had never heard before. Bibliotherapy. Yes. And referring to my introduction where I said I love books and I love being able to talk about the overlap of music and books and music and health. I do love books, and I was just fascinated to read about this bibliotherapy. And the idea is that books allow us to have a form of exposure therapy, where we’re using vicarious experiences to engage our emotions and experience a rewriting or a reframing of a story, and sort of experiencing somebody else’s story changing and being told and implementing a different story. But I found that so fascinating, and it totally made sense once I heard it explained. But I’m sure you could. Could you elaborate on just a little bit on that and maybe explain it in a better way?
Julia Hotz: [00:14:21] Yeah, that was beautifully explained. And that really gets to the nuance of when we’re prescribing art. Like that first story I told with Cune, it was about creating the art. But the second story in that chapter is about somebody who consumes art, and that is where the bibliotherapy comes into play. So this is a story about somebody named Jonas who kind of, like, had this really vivid imagination, very common, actually, in people who deal with anxiety. And, you know, sort of spent his childhood fantasizing about the Roman Empire and these ancient history, you know, eras and these and also these kind of like, sci fi worlds that he’d read about as a kid or he’d played with, you know, through his online computer games. Fast forward many years. Jonas, unfortunately, was bullied as a child. He comes to develop pretty severe social anxiety, gets diagnosed with panic disorder and agoraphobia, a fear of leaving the house. And suddenly, you know, he’s this adult who is so consumed with anxiety. And I think on some level, maybe so afraid of the pain that those bullies and that sort of constant rejection had caused him, that he ends up just shutting in and becoming more anxious at the thought of it. So Jonas lives in Denmark, and he ends up getting proscribed by virtue of being, you know, so unwell that he’s actually out of work. He ends up getting prescribed what are called culture vitamins. And what do culture vitamins do? They are sort of a form of exposure therapy to people dealing with anxiety, two different cultural forms of expression. So whether that’s a concert or whether that’s a day at the museum or whether that’s what they called a shared reading session at the library, where kind of like book club, you know, people are coming together to read books and get lost in a book.
Julia Hotz: [00:16:26] And sort of, as you mentioned, of Bibliotherapy like maybe be comforted by some of the experiences in the book that the main character is having. That’s certainly proved to be the case for some of the culture vitamin ER participants. I spoke with and for Jonas, I think, who ends up saying that the shared reading was his favorite culture vitamin. That along with the Harry Potter concert nights, um, what it allowed him to do was to escape from his thoughts and sort of be able to see them from the outside looking in, you know, sometimes bibliotherapy, especially in children, it’s like very on the nose, like if someone’s afraid of monsters at night, the book that you might read to your child at bedtime might be about defeating the monsters and it being okay and how you might cope with that. But for Jonas, who’s an adult and the other culture vitamin are participants, the themes are a little bit more adult and complex. It’s, I guess, less like preachy and moralistic, but more about just exposing people. And this is certainly why I think I turned to art and music as a way of reminding ourselves that other people have suffered and they’ve made it through, and I’m going to make it through okay. And that, you know, we are more powerful than than our thoughts.
Mindy Peterson: [00:17:47] Sure. Well, that explanation sort of answers another one of my questions too, which was what difference is there between creating art and music and consuming it? And I think the answer is the both and are are valuable and helpful. And so if listeners are hearing this thinking, oh, I’m not someone who’s going to create art, I’m not someone who’s going to create music. You might surprise yourself, you know, give it a try. But even if that’s true, consuming art and music can be so therapeutic and helpful as well. And I want to point out, too, that even though we’re talking a lot about the art chapter of your book, because of the focus of this podcast being on music, I couldn’t help but see so many correlations between all of those other chapters and music. So take for instance nature. You’re talking about, um, forest bathing and things like that, and how that decreases the production of stress hormones like adrenaline and cortisol and increases the production of mood boosting serotonin and things like that. But there’s so much of what you wrote about nature that I’m thinking you could easily substitute music for these things. In fact, you even point out in your book the the similarities between music and nature, and that music is often or art is often called the imitation of nature. So, you know, nature and then belonging. That’s another section of your book. And I mean, there’s so many scientific studies that show the social connection and bonding that is a byproduct of of music engagement. Even just listening to a song, say, for example, a sad song can be so therapeutic and feel so good, ironically, because it helps us know we’re not alone. Somebody else has experienced the same thing, so you feel the sense of connection to other people in so many ways through through music for sure. Also, if you’re playing in an ensemble, playing in a band, participating in a choir, things like that. So yeah, you’re right.
Julia Hotz: [00:20:02] Yeah. You know, music is one of those I and I’d love to talk a little bit about that. There’s so much about music I wish I could have included in the book. And in some ways it was tough because as you said, it’s a little bit of art, it’s a little bit of nature. If you’re dancing, there’s also movement involved, right?
Mindy Peterson: [00:20:18] Right.
Julia Hotz: [00:20:19] Certainly, you know, I used to be in an a cappella group. I sang in choirs my whole life and oh my gosh, the belonging, the sense of belonging that you have with your fellow singers is unlike any other. And, you know, I would say that a common denominator and this does get discussed, actually in the nature chapter, whether we’re singing music, whether we’re performing music, whether or whether we’re just like hearing a song that really takes our breath away is this experience of awe. And I think you’ve had people on here talk about awe before, but just to refresh, you know, or is this experience of being it’s almost like an out of body experience that transforms your understanding of the world. Mhm. We know awe when we feel it. You know, it’s the full body goosebumps we get when we hear a harmony. It’s contributing to that harmony. It’s writing music and feeling like wow this is truly beautiful. And what awe is the opposite of is rumination. Mhm. Or takes us out of our head. It makes us marvel at the wonder of the world and everything in it. Rumination keeps us in our head, dwelling on the negative. Sure, rumination is very strongly correlated with depression and anxiety and stress and even chronic pain.
Julia Hotz: [00:21:54] And so I would say that the awe that can come from all kinds of different, you know, social prescriptions, but in particular music is so powerful. You know, I think it’s the unspoken thing that that keeps us going. And, you know, one just quick tidbit I’ll mention that I didn’t get to include in the book is about the power of music for dementia. Once upon a time, this is just a quick story about this. I was interviewing somebody about social prescribing who particularly works with people with dementia, and they told a story of this woman. We’ll call her Mrs. Smith, who was in a hospital and was in a wheelchair. And, you know, her whole time at the hospital, she was pushed around the wheelchair. People didn’t really know much about her, just she was kind of quiet, kept to herself. Well, one day they wheeled her wheelchair over to a musical performance in this hospital ward. And what do you know, Mrs. Smith? Whom everybody assumed would just be immobile and, you know, need sort of constant assistance, actually gets up out of her wheelchair and starts clapping and dancing.
Mindy Peterson: [00:23:06] Wow.
Julia Hotz: [00:23:07] And it was just such an aha moment for these caretakers who said, oh my gosh, like, why did we never think to explore this? Like, what else could get Mrs. Smith out of her chair? And I actually think you see that a lot with people with dementia like even. Absolutely. Other sort of faculties are gone. Other basic cognitive abilities. There’s something about the way our brains store music that there’s loads of, like dementia choirs that exist, dementia music programs. And so it’s extremely powerful. I wish I had more space to talk about that in the book.
Mindy Peterson: [00:23:44] Sure, yeah, that musical memory is the last to fade away, which it’s invaluable and priceless and bringing back some quality of life, even just momentarily, for people with dementia and then just for their loved ones to have them back for a moment. Obviously, it’s not a cure. It doesn’t last forever. But for those moments or those hours, yeah, it’s like they they have themselves back. The loved ones have them back again too. Yeah. When you were talking about wonder and awe too versus rumination, one word that came to my mind is perspective. And that sense of wonder, that sense of awe can really refocus our perspective, whereas rumination can really distort our sense of perspective. So, so, so much value in that. Absolutely. One thing that I really loved about your book is all the specific organizations that you spotlight and you name them by name, and I just I love that because it shows that they’re out there. We’re not all just fending for ourselves. And it also it gives inspiration to those who may want to use their organization to help in a similar way, or start an organization or start a local chapter of one of these organizations. You mentioned already in our conversation that culture vitamin or I’m not sure if I’m pronouncing that Danish word right, but culture vitamins I love, I love that term.
Mindy Peterson: [00:25:12] But singhealth makeshift nature come alive outside. I mean, there’s so many that you mentioned. It was really inspiring and kind of comforting to know that, oh, there’s other like minded people out there who are doing this. We can do it too. Let’s figure out how we can collaborate. But you also mention a lot of social prescription organizations like Social Prescribing Network, Global Social Prescribing Alliance, their Social Prescribing USA, and counterparts in Canada and the UK. So I’ll list some links in your show notes to these. But for sure, I mean, to me that’s enough of a reason to buy the book, right? There is just to be encouraged and inspired by the existence of these organizations and just the inspiration to sort of tag team with them, collaborate with them, or start a local chapter or start your own, you know, if you’re especially inspired by a company or an organization in Finland or in Australia, and there’s just not a way to participate, say, in the US in that specific organization, start one here, you know?
Julia Hotz: [00:26:20] Yeah, that’s so true. And I would say for anyone who is based in the US that wants to get involved, you know, there’s a tremendous group called Social Prescribing USA that is building this national momentum for social prescribing to exist here. The way that it exists in other countries. And, you know, as Chris, your former guests, Chris Appleton and Tasha Golden might have talked about like this movement is is here in the US. You know, there was a really powerful pilot in Massachusetts that then expanded to an arts on prescription pilot in new Jersey, which was supported by an insurer. And these insurers are literally covering prescriptions for art excursions, for music excursions, the same way that they would cover prescriptions for medication. And so I did a.
Mindy Peterson: [00:27:13] Lot of cases. It’s more cost effective, cost efficient than the whole cycle of diagnose, treat, repeat. You have these people coming back. And it was just fascinating where you talk about how I think it was like the 12 most prescribed medications in 2018 were. Like all related to lifestyle diseases, many of which can be treated with some of this social prescribing. But continue.
Julia Hotz: [00:27:41] Yeah, that’s exactly it. You know, it actually for the same reason that some insurers have started to, like, cover gym memberships or exercise classes, like investments in our long term health. I think that same logic is increasingly being applied for art and music. Like, okay, if we invest in a gym class, why don’t we invest in music classes? And what’s so great about those organizations? You know, Mass Cultural Council has led this pilot. New Jersey PAC has led the one in new Jersey is that they’re really open with sharing their process and their notes. And the idea is to get this to spread locally, like, yeah, I want to, you know, be mindful and, and say that we do have a pretty tough health care system in the US, where huge and there’s all these inequities, and historically there’s been a lot of influence from pharmaceutical industries. But I think that and first of all, I want to say this is not a replacement for pharmaceutical medication. It’s just another option on the menu. I think that where we’re getting to this place, where it should be as easy to prescribe a music class or a concert as it is to prescribe a pill, because we know intuitively and from the science that these kinds of medicines are sometimes just as, if not more effective.
Mindy Peterson: [00:29:09] Yeah. Well, love your book. The first part of your book talks about the real science supporting the social prescribing movement. The second part talks about how social prescribing is happening in 30 plus countries using social prescribing to treat a wide range of of illnesses in patients, but also in health care systems like high wait times and staff shortages, time pressures, high costs, you know, all of that. So that’s really interesting. It talks about some of the challenges that we are facing that you alluded to here in the US, but other countries are not immune from their own challenges as well. And then part three, while we wait for the rest of healthcare to get on board with social prescribing, prescribe it for yourself. And you document how you do this. When you found yourself with certain symptoms feeling stuck or distracted or anxious or lonely, kind of prescribed your own connection cure for yourself. So lots of just, I mean, just packed with information for anyone who’s at all interested in this movement. Apart from getting your book, which I highly recommend to anyone interested, what other recommendations do you have for listeners, musicians, organizations who would like to get involved in this movement, and also listeners who say, I’d like to see this social prescribing offered by my practitioners. How can listeners sort of be the change that they want to see and give the movement momentum?
Julia Hotz: [00:30:43] I think that’s exactly it. I love that you’ve said be the change, because I think that is true for all of us. Like, I think if we want social prescribing to go mainstream, we all have to do what you have been doing for quite a long time now is talking about the ways that these medicines can enhance our life, can improve our wellbeing, can improve our health. We have to make social prescribing a word in our vocabulary. You know, not to be cliche, but we have to talk to our doctors about social prescribing. And then from there, you know, I think that there are organizations in the US that are working to build this into our national and local healthcare care systems. I would say a great place to start is Social Prescribing USA. If they are a provider or a music organization that’s curious about how to actually make this available on prescription, I would say that through them and also on my website, Social Prescribing Co, you might be able to find some templates and case studies of how local arts organizations have teamed up with health care systems. And what’s great is, you know, probably the templates that worked for a nature prescription would work for arts Prescription as well. Sure. Yeah. Um, and again, I think it takes some boldness and bravery on the behalf of health providers as well to be able to start talking about this as medicine. And many have. I want to acknowledge that there are many, many, many art therapists and music therapists and even people who are doctors and social workers in the more traditional sense that have been integrating elements of these medicines. So I think we rely on them for what this actually looks like in the context of US healthcare. So all of the above.
Mindy Peterson: [00:32:32] Sure. And we do have listeners all over the globe. So I’ll definitely include those US links to the organization, but then also some of the sort of sister organizations too, for Canada, for the UK, I know there’s the Global Social Prescribing Alliance. Yes, that you include in your book, so I’ll definitely include some of those other links as well. Yeah. Just two quotes from your book that I want to close out with. One is a quote by Michael Dixon, who’s one of the pioneering doctors that is that you discuss and quote in the book. He says the end point with all of this is not social prescribing. The end point is developing a health creating community. So I just say amen to that. Yeah. And then and then a quote of yours that I really loved, that kind of summarizes some of this conversation and content is social prescribing isn’t, hasn’t been, and never will be a cure all. We still need other kinds of prescriptions. But here’s what I do understand. As we wait on healthcare to put social prescribing on its menu of options, each of us can work in our own lives to make its sneakier goal come true, creating our own health and our own communities, becoming our own health professionals, experts in and practitioners of the connections that uniquely bring us joy, meaning, and relationships. End quote. What a great quote to end on.
Julia Hotz: [00:34:01] Gosh, I wish you. It sounds so nice when you say it like you have a very. I’m not surprised, but you have such a gift for narration, so.
Mindy Peterson: [00:34:10] Oh well. Thank you.
Julia Hotz: [00:34:11] That’s exactly it. Like, and again, you know your listeners and you know that this is life changing, right? Right. Um, the connections that music and art and all of the other kinds of, you know, social prescriptions can bring us. They’re not just nice to haves, right? They can really change the trajectory of someone’s health. And so whether or not we’re sick, whether or not our healthcare system currently has social prescribing, I think we can all do what we can to start integrating these five medicines more into our lives.
Mindy Peterson: [00:34:50] Absolutely. Well, I know you have back to back interviews, so I’ll let you close things out for us with a coda. As you know, I ask all my guests to close out our conversation with a musical ending. A coda by sharing a song or story about a moment that music enhanced your life. Do you have a song or story that you can close us out with today?
Julia Hotz: [00:35:13] I do, and if I didn’t have a cold, I’d maybe sing it with you. But, um I mentioned earlier, I was in two a cappella groups when I was in college and gosh, they were my everything. I got so much joy and meaning and relationships from being part of that group. And at our graduation, we sang this song Rivers and Roads by the head and the heart. And for those of you who haven’t heard that song, I encourage you to check it out. But it was just I remember singing that song on stage with them. Everyone got their little solo bit, but then at the end we all came and sang the like kind of refrain together. The lyrics are rivers and roads, rivers and roads, rivers till I reach you. And it was just this beautiful moment of like. It’s so sad that this era is ending, but how grateful we are to have had that experience and to know that, you know, maybe one day we’ll see each other again and recreate some of that magic.
Transcribed by Sonix.ai