Ep. 96 Transcription

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, a holistic look at the power of music in our everyday lives. My guest today is joining me from Seattle. Betsy Hartman is a board certified music therapist with additional certifications in neurologic music therapy and guided imagery and music. She is the director and founder of PNW Music Therapy. Betsy is dedicated to bringing the healing benefits of music to others and partnered in twenty fifteen with Swedish Medical Group and its Multiple Sclerosis Center to develop and lead its flagship music therapy program. But she’s also partnered with Bristol-Myers Squibb American Music Therapy Association to help create MS in harmony. Welcome to enhance life with music, Betsy.

Betsy Hartman: [00:00:52] Hello. Thank you for having me.

Mindy Peterson: [00:00:54] Betsy, can you start by explaining what multiple sclerosis M.S. is and what its typical effects are?

Betsy Hartman: [00:01:03] Yeah, so multiple sclerosis is a neuro degenerative disease of the central nervous system, and it’s been described as being unpredictable because it really is every person that’s affected and living with M.S. doesn’t necessarily know how it’s going to affect their mind, brain or body, because what’s happening is the flow of information is disrupted. And so some people might be affected with experiencing fatigue, deficits in motor control, cognition or speech and language. And they may even experience some secondary effects like depression or anxiety. But it’s different for every person.

Mindy Peterson: [00:01:48] How would you most people first have an inkling that this may be their diagnosis, right?

Betsy Hartman: [00:01:55] Well, you know, some people that I’ve spoken with have said and also keep in mind that this is a disease that can happen to a young person in their 30s. And so seemingly everything is fine and normal. And then all of a sudden someone might be experiencing extreme fatigue and they just kind of think, you know, what is going on. And then sure enough, after some test, they discover that they have Ms.

Mindy Peterson: [00:02:23] Ok, so it really could show up and just fatigue and not necessarily tripping or having gait issues or things like that.

Betsy Hartman: [00:02:32] Yeah, well, that does happen as well. They might, like you mentioned, have difficulty with gait or just realizing that they don’t have as much of control over their cognition, letting go, forgetting things, difficulty recalling facts. And I’ve heard a lot of people describe it as, you know, everyone forgets things once in a while. But I knew this was different. I just couldn’t something was missing. And then again, sure enough, Ms.

Mindy Peterson: [00:03:01] Ok, well, what our music’s superpower’s when it comes to addressing the effects of M.S..

Betsy Hartman: [00:03:09] Oh, man. There’s so many. Yeah. So something that is just incredible about music is that not only when working with people have that not only does music have the ability to address those physical component, so working on things like motor skills, speech and language skills or cognitive skills, but also has the ability to address the psychosocial things that are happening, things like anxiety and depression. So it really is a tool that a non pharmacological tool that is able to address pretty much all the symptoms of M.S..

Mindy Peterson: [00:03:51] Ok, talk to us a little bit about neuroplasticity and music superpower in that way and how it is so specific to mass.

Betsy Hartman: [00:04:01] Yeah, so the brain neuroplasticity has the ability to rewire itself and we know that music is really amazing at helping that happen. So someone, for example, living with MS might begin to experience difficulty moving their fingers or their wrist. And let’s say this is a person who, you know, played the guitar before or had to type on the keyboard like so many of us do, and then their disease progresses. They’re having difficulty making all of those fine and gross motor movements. And you can actually bring in music to help rewire the brain and to help that person relearn how to how to use and do those skills again. So it might actually be through through just kind of the continual repetitive motion of coming back to the instrument. But more often than not, it’s actually using the fundamental components of music, things like rhythm, tempo, melody and pitch to help that person relearn a skill.

Mindy Peterson: [00:05:14] Ok, well, in one big component of mass is that myelin sheath damage that happens with those connections between the the brain and the body, is that right? Mm hmm. And it would make sense to me that music would be really helpful in stimulating growth in those connections between the mind and body, because that’s that’s what music does great.

Betsy Hartman: [00:05:40] You know, it’s so I tell my patients all the time that when you are listening to music, it is like a party is happening in your brain. So many parts of your brain are on fire in a good way when you’re listening to music. And then if you were to take it a step further and actually play an instrument, you are engaging that motor cortex, which we know is very important to engage in M.S. And so then you’re really activating all parts of your brain and people will say to me, whoa, whoa, whoa, whoa, whoa, I’m not a musician. There’s no way that I can do this. And the thing is, most people that I work with have no experience, competence, background in in music in any way. And so, you know, that’s what makes music therapy still powerful, is that we can come to the non musician and use music tools and interventions to accomplish nonmusical goals.

Mindy Peterson: [00:06:41] Well, when I think about M.S., I don’t know if this is accurate or not, but I imagine one way it could feel is, you know, in your mind what you want your body to do, whether it’s your fingers or your your feet or legs, whatever, you just can’t get them to do it. And they’re not cooperating and doing what you want them to do when you want them to do it. Does that sound accurate? Mm hmm. OK. And when I think about that, I can completely relate to that feeling as a musician, because there are so many times as a musician where you know what you want your hands to do on your instrument. For me, it’s piano. For you, it’s harp. You’re her best friend, right? Among other things, it’s my guess. Right? Right. But, you know, there’s so many times where I know what I want my hands to do on the piano, and I can’t get them to do it without practicing and and continuing to just try and try. And then eventually it happens. In one classic example that I see all the time with my students is when they get to that point in their studies where they need to play one hand short and detached staccato and the other hand legato, smooth and connected. And so they’re doing those two different movements with their two hands. And you could just see the frustration on their face because they know exactly what they need to do and they can’t get their hands to do it. And I’m like, I know it’s frustrating. Just keep trying. And eventually it’s like a light switch flips in those connections and those neural pathways that are established and they’re able to do it. And then it’s really fun to experience that personally and then to watch that happen with them. But it’s like you can almost feel those neural pathways being established in the brain. And so I can totally see how music could be incredibly effective with.

Betsy Hartman: [00:08:35] Well, yeah. And then take that scenario and imagine it with the person who has developed the skill they’ve been walking their entire life and then all of a sudden that skills taken away from you. So frustrating. So at the Multiple Sclerosis Center that I work at in Seattle, I often collaborate with a physical therapist. And it’s so incredible to see because the people come to me and say, hey, I have a patient who has is having difficulty with their gait. They they’re hoping to be able to increase their speed and endurance and they have some irregularities. And it’s just overall frustrating and difficult for them to walk. I think that music would be really beneficial for them. And I say, OK, great, we use a technique called rhythmic auditory stimulation, which is essentially, like I mentioned before, using those fundamental components of music, primarily the rhythm. Think about that metronome and piano lessons that so many of us are like, oh, turn off the metronome. Really? Yeah, that is the most essential thing, because that’s what’s helping the brain rewire. And when we have that auditory input, we have a direct motor output. And so our body is responding to that. Bum, bum, bum, bum. So anyways, thinking about that person who has been walking their whole life, all of a sudden that skill. It’s taken away from them, we get them in a room, we determine what their cadence is, how many beats per minute they’re walking, and it can range anywhere from thirty five beats per minute to one hundred and fifteen beats per minute. And then we we plug in that metronome and almost instantaneously you’ll see that the person straightens up their gait pattern becomes more regular and they’ll even say, oh my gosh, I’m not dragging my foot anymore. I can’t help but move to the tempo. It’s so cool.

Mindy Peterson: [00:10:34] That is cool. And that reminds me of someone I interviewed on Parkinson’s and they all come to talking about a similar effect that music has with that. Yeah. Is that related to entrainment also that synchronization that our bodies and minds tend to have with.

Betsy Hartman: [00:10:50] Yes, we’re going to be yeah. 100 percent. I always add a little scenario I like to share because it resonates with people is think about when you are whatever you’re doing, if you’re at a restaurant or driving in your car or someone in your household has music on and you’re not really paying attention to it. And then all of a sudden you notice you’re tapping your foot or swaying to the beat and then you think, oh, I didn’t even know there’s music on. That’s entrainment like our subconscious heard the music and we just move to Usher.

Mindy Peterson: [00:11:23] Well, I think it’s pretty safe to say music is a bridge between the mind and the body. Yes. And so it totally makes sense that with mass, it could be incredibly helpful. And would you say that it it’s accurate to say that the use of music therapy with those dealing with M.S. can not only help them cope with the effects of M.S., but help restore function?

Betsy Hartman: [00:11:49] Yes, definitely. And those are the primary goals that I work on every week when I I lead a weekly group and with people living with M.S. and in this group, not only the group is virtual now at this time. And so it’s a little bit different, but in this group we are working on giving people tangible tools to help improve those functional goals like those those motor goals, speech and language goals. So we might do things like vocal exercises, working on our breath. We might even do some different exercises that help engage our cognition and improve some of our memory skills. But then throughout that entire time, we’re also working on things that help improve our coping, like recognizing that living with MS is incredibly hard. It can be incredibly isolating. And so giving people the opportunity through music, through songwriting, through listening to lyrics to help them express themselves and creatively process where their life is at right now.

Mindy Peterson: [00:12:56] Yeah, and one thing that you said at the beginning of that was talking about the the therapeutic goals, kind of depending on what those goals are, that will guide what you do in the group session. And I think it’s important to point out that music therapy is an established health care discipline and you work collaboratively with people’s medical team. And and they that’s kind of where your involvement starts. Is that right, where you start by collaborating with the medical team and saying, OK, what’s the therapeutic goal here and then moving forward from that?

Betsy Hartman: [00:13:28] Yes, definitely. You know, I mentioned that I work closely with the physical therapist. And so when I’m working with Peaty or primarily working on all of those gross motor skills and all of those physical goals, when I’m working with patients, I generally I always assess them and ask, hey, what are you dealing with? What are you working on? What are your goals? What do you want to see be improved? And then talk about these are the ways that music therapy can help support you. And it’s a beautiful collaboration because most patients, if they’re able to are working with an occupational therapist and a physical therapist, their nurse, their doctor, maybe a counselor, a psychiatrist, a music therapist, we want more music therapy in there. And we all work together to treat the whole patient well.

Mindy Peterson: [00:14:15] And one thing that you touched on earlier and that I love about music therapy is it is non pharmacological. It’s non-invasive. There are no side effects. Right. And it’s enjoyable. You know, I mean, if you think about physical therapy, a lot of us, myself included. OK, one more thing. But music is fun and it’s social. And, you know, the best exercise is one that you’re going to enjoy because you’re actually going to do it.

Betsy Hartman: [00:14:41] Oh, my goodness. I know you. Part of the work, not only do I work on great training with the physical therapists, but we also just work on some of those simple exercises like bicep girls and building up strength in your lower extremities, like marching in place. And almost every time the physical therapist will say, oh, my gosh, I. I never thought I could get that patient to do that many reps for two minutes a time, but when it’s paired with that strong tempo, the bum bum bum and maybe an enjoyable or familiar melody, that the patient is just like, oh, I worked out for five minutes. I had no idea

Mindy Peterson: [00:15:20] What you’re describing the music therapy session, too. It really sounds like a holistic blend of occupational therapy, physical therapy, mental talk therapy and psychotherapy. I mean, it’s really all of those things blended together in an enjoyable experience. This is pretty awesome. Well, my guess is that music therapy could really be helpful, not only for the people who have been received the diagnosis, but also for their loved ones. How common is it for you to have family members or friends involved in some of these sessions or just involved in the activities that the patient is doing on their own during the week?

Betsy Hartman: [00:16:02] Right. You’re you’re so right. It really can be meaningful for family members or caregivers. One reason why it’s meaningful is because it gives the caregiver something really tangible and hands on to do with their loved one. Together, they’re able to listen to music, to talk about the music. If a caregiver is with taking care of someone who has lost a lot of their their cognition or physical abilities, and it can be really hard to connect with that person because in some ways that relationship just feels that person feels gone in some ways. And it can be really sad. But we know that music has the ability to stir up memories and our brain has the ability to recall lyrics. Like, it’s just incredible. Like, no, no other tool can transport us back to a time. And and because there’s all of these mnemonic devices in music, our brain is really good at remembering lyrics. And so one simple activity that I do with caregivers is simply to say, hey, what are the songs that you used to listen to when you first met? What was the song that you played at your wedding? And they’ll play these songs together. And sure enough, they’ll they’ll connect the bar and we’ll have a moment. And when I see that it is so meaningful for me because it’s just it’s priceless for that family and for that couple.

Mindy Peterson: [00:17:33] Yeah, well, and that leads right into another question that I wanted to go to, and that is Swedish does a really great job, it seems from their website of recognizing that treatment of MS is not just the body, it’s also the mind and the soul. And you’ve kind of talked a little bit, touched on a little bit how the music therapy that you do does address the body, but then also these other parts. So we talked about the body a little bit in terms of music therapy is application to motor function and movement and using rhythm entrainment, those auditory inputs that have motor outputs that are related speech, things like that. Talk to us a little bit about the mind and the soul and how music therapy can bring healing to the mind and the soul for those who are experiencing.

Betsy Hartman: [00:18:27] Right. So you have two elements of the mind. Do you have the cognitive piece, which we’ve talked a little bit about how music can help improve memory recall? And that can be really important because that’s what helps us live our daily life, like your memory in our grocery list and the people’s names in our family. But it also can help with the part of the mind that might be dealing with anxious thoughts. And similarly, it can help with part of the soul that might be dealing with feelings of isolation and depression and just kind of stuck in this loop of like this. This disease isn’t curable. You know, there’s things that I can do. And so that’s where music can come into play to help people creatively process and work through some of those feelings or emotions. And it’s why I also love the you know, I work with people individually and I mentioned the groups. And it’s why I love the groups, because it builds up community and we know it’s why we form groups everywhere we go. It’s because when you feel that support other people going through similar things, that’s what helps you can help you make it through. And the music really becomes a great connecting factor for those people.

Mindy Peterson: [00:19:41] Yeah, well, there’s so much research on the the bonding chemicals and hormones that are produced when we make music together with people or just experience music together. If you think about a concert and everybody gets away and together we’re connected. Yeah, I. One thing you brought up that’s important is M.S. is a chronic condition, it’s not something that’s going to be cured. Hopefully it will be at some point. But most people are living with this as a chronic condition that they’re they’re not expecting to be completely eliminated. And so the music therapy really is vital for treating the whole person, body, mind and soul and not only restoring function, but also quality of life. And that’s what’s so important to all of us. I mean, we all have those thorns in the flesh, the words healing with that kind of drag us down a little bit and quality of life is what we’re all really after.

Betsy Hartman: [00:20:40] Mm hmm. Definitely.

Mindy Peterson: [00:20:41] How common is it for hospitals and clinics to approach treatment here in the US the way Swedish does in terms of really focusing on not just the body, but also the mind in the spirit?

Betsy Hartman: [00:20:54] You know, I think it’s becoming more and more common. I’m really impressed with what Swedish Ms. Center does. And as far as bringing in so many different support systems, not only do they have OTTI and music therapy, but they’re connected with speech and language pathologist. They’re also working with yoga instructors and pilates instructors and art teachers. And so they’re really bringing in this full group of professionals to help people living with MS navigate their disease in a way that keeps their life good and joyful and meaningful. I can’t speak fully to what other organizations or clinics are doing across the country, but I know through through conversations that we are just realizing more and more, hey, it’s not just about taking medicine and then you’re done. There’s so much more involved in it. And that’s what makes me happy to be a part of this, of doing research, of working in clinics like this to help people continue to understand why it’s so vital to have professionals like music therapists as part of the interdisciplinary collaborative team.

Mindy Peterson: [00:22:04] Your your work was featured in a short film by Novartis called The Power of Music as Therapy, in which I loved the video. I’ll put a link to it in the show notes in the video you said music therapy isn’t alternative therapy, it is therapy. There’s enough research and data to prove that. Do you have a favorite piece of data or research or two or three find especially exciting or compelling that you want to share with us?

Betsy Hartman: [00:22:32] Yeah, you know, so I promised my practices from the practice of neurologic music therapy and I mentioned rhythmic auditory stimulation. And in this data, not only is it beneficial for people with multiple sclerosis, but traumatic brain injury, stroke, Parkinson’s. And we know they’ve pulled the data. They’ve done the research to determine what is it about music that gets our bodies moving. And what they found is it’s coming back to those fundamental components of music, the rhythm, the tempo, the beat, sometimes the melody in the pitch. But that is what our body is having a physiological response to and to see how we can take just like dancing in a group of people to helping it benefit someone with a neuro disease and finding the research and the data to prove that there’s rhyme behind that reason. And we know why this is happening. We are just rhythmic people is pretty exciting for me. They even did a study, gosh, in 2009 ten, I think, wanting to give people an at home walking program using rhythmic auditory stimulation. And they did this with people who are living with multiple sclerosis. And essentially, you know, it’s pretty simple. For two weeks, they sent ten participants home, people living with M.S. and they said you’re going to use rhythmic auditory stimulation for two weeks and everyone could have predicted this. Who knows anything about music, but those are the people’s who their gait pattern improved more so than the people who didn’t have anything to listen to. And it was just a simple play this song and walk for twenty minutes.

Mindy Peterson: [00:24:18] Simple and inexpensive, right? We’re not talking about overwhelming the health care system with expensive policies and procedures and in gear. Yes, it’s

Betsy Hartman: [00:24:29] Such a good point.

Mindy Peterson: [00:24:30] Yeah, well, you partnered with Bristol-Myers Squibb and American Music Therapy Association to help create MS in Germany. Can you tell listeners just real quick about that resource available?

Betsy Hartman: [00:24:43] Ms in Harmony is so great. It really is a first of its kind initiative, giving people living with MS and their caregivers an opportunity to tap into music therapy interventions at home. So I knew that when I got involved with MS in. Harmony, I was pretty excited about it as a music therapist and really happy to contribute my expertise into their program, but now that it’s released, I’m even more thrilled because they’ve done such a good job. It really is a resource that not only if you’re living with me. Yes, of course, check it out. But it really is for everyone. If you want to learn how music can help improve your sleep, if you want to learn how music can help improve your memory, whatever it is for you. Check it out, OK?

Mindy Peterson: [00:25:30] Wow. Well, I’ll have the link on the show. That sounds amazing. I’m going to take a closer look at it again now that you said that. Yeah. And any other recommended resources that you want to mention to listeners who want to dig into this topic more?

Betsy Hartman: [00:25:44] Yeah. If you are ever wanting to know more about music therapy, I recommend checking out the American Music Therapy Association. They have so much information and resources that you can find through looking for the website, and it can also help connect you to a music therapist in your area.

Mindy Peterson: [00:26:02] Awesome. Well, thank you so much, Betsy. I ask all my guests to close out our conversation with a musical ending coda by sharing a song or story about a moment that music enhanced your life. I’m sure you have a bazillion of them, but do you have a song or story that you can share with us in closing today?

Betsy Hartman: [00:26:22] Yeah, definitely. I, I have so many beautiful and amazing encounters with the with the patients and families that I work with on a daily basis. But this year, in light of the year that we’ve all experienced, I really wanted to focus on how could I use music for me personally and for my family. And so my family has gotten into the habit. I have a three year old and a one year old and my husband and I, you know, night just being home, we kind of started thinking, like, what are we going to do? And so we started just creating fun playlists to listen to with our kids. And that’s just been really sweet. Or my daughter now always asked, like, turn the song, turn the playlist on and she loves the song. I like to move it, move it from Madagascar and I won’t sing it because it’s probably already stuck in your head if you like. But that’s been really sweet. But the thing that’s been the most meaningful for me is has been playing my heart for myself. I love giving harp music and my music to other people, but giving myself permission to just sit and play without any expectations or end result has been very life enhancing for me.

Mindy Peterson: [00:27:38] Love that. Do you want to play anything on the harp for us?

Betsy Hartman: [00:27:41] I would be happy to. Yeah, let’s do. Of course, I have my harp with me here. I’ll play you a little snippet and then you can feel free to add it in whenever this is something that I might play. And today I will just share something that I’ve been doing is just coming to my harp and whatever comes out of my fingers, I just go with it.

Mindy Peterson: [00:28:02] Sounds great.