Drumming Proven to Help the Immune System and Reduce Stress

A summary of Barry Bittman’s research by Robert Louis Friedman

Originally published in Percussive Notes 70, August 2004

The area of wellness and drumming has taken huge leaps during the past three years due to the work of Barry Bittman, MD, a scientist, researcher, author, inventor, and pioneer who has scientifically proven that drumming improves the body’s immune system and reduces stress. His research on the health benefits of drumming has been so far reaching that it has been cited on CNN and in U.S. News and World Report. Through his research and findings, Bittman has literally changed the landscape of drumming and health.

Based on his conviction that Recreational Music Making is an effective therapeutic strategy in conventional medical settings, Bittman led a team of researchers who investigated the biological effects of the HealthRhythms group drumming protocol he co-developed. This study (“Alternative Therapies,” Jan. 2001) links group drumming with increased activity of Natural Killer cells—specialized white blood cells that seek out and destroy cancer cells and virally-infected cells.

His recent research (“Advances in Mind-Body Medicine,” November 2003) demonstrated substantial reductions in burnout and mood disturbances in long-term care workers, as well as significant cost savings, using a Recreational Music Making protocol. Using rigorous research standards, Bittman has proven unequivocally that drumming makes us healthier.

Drumming and the Immune System

Bittman’s research began with the hypothesis that through group drumming,an individual’s stress-related hormones would diminish. His team worked with 111 subjects whose average age was 29. He recruited these individuals from his Mind-Body Wellness Center in Meadville, Pennsylvania.

Initially, 61 participants were assigned randomly to six groups, with nine to eleven members in each group. Each person agreed to have his or her blood sampled before and after drumming. In order to eliminate any other factors, participants who had medical illness or were receiving medical treatment were excluded. In addition, anyone who had past heart problems, lung problems, hearing loss, pregnancy, or who missed their last menstrual cycle were excluded. Volunteers who were smokers, used illicit drugs, or had more than two alcoholic drinks daily were also excluded.

Each group arrived at the Mind/Body Center in the afternoon, and their blood was drawn 45 minutes prior to drumming. Each person was then asked to fill out two surveys, one focusing on anxiety and the other on depression.

The six groups included: The Resting Control group, who simply read books and magazines and did nothing else; the Listening Control group, in which participants listened to drumming but didn’t do any drumming themselves; the Basic Drumming group, who drummed half the time and were instructed half the time; the Impact Drumming group, who drummed 80 percent of the time and were instructed 20 percent of the time; the Shamanic Drumming group, who drummed according the Shamanic tradition; and the Composite Drumming group, in which participants were involved with various rhythmic activities and drumming with a music therapist leading the group.

The only participants who exhibited an increase in T-Cell or immune-system response and a decrease in stress levels was those in the Composite Drumming group. Composite Drumming thus became the research model.
The protocol for Composite Drumming was as follows. Initially, the participants were given “egg shakers” and asked to pass them from person to person. This ice-breaking activity was done in a lighthearted manner. The eggs were passed faster and faster, until all of the eggs were dropped. Typically, this kind of activity induces laughter and creates camaraderie and teamwork.

The second activity in the Composite Drumming protocol involved the use of hand drums. Each participant was asked to tap out the syllables of his or her name on the drum, after which the entire group played the syllables of that person’s name. The music therapist would then alter the volume and tempo of the drumming for 20 minutes.
The final activity involved guided imagery. Two descriptive stories about 15 minutes in length were told while the participants played their drums. This session lasted an hour.

The individuals then had their blood drawn again to determine any changes in their physiology. They also filled out anxiety and depression surveys a second time to determine any change.

The results showed that after Composite Drumming, the participants’ NK, Killer Cell and Lymphokine cell activity increased, all relating to an increase in the body’s immune system. This research has profound implications and demonstrates clearly that drumming activities can have very positive effects for the body. Thus, not only does drumming feel good, but it has health benefits as well.

Burnout Research

Bittman’s second study involved the use of drumming with long-term healthcare workers. He chose to work with this group because turnover in this industry ranges from 40 to 100 percent. He felt that if healthcare workers continue to leave their jobs, this could diminish the quality in healthcare on a long-term basis. Some of the factors noted for the high turnover include low pay, taking other positions, the difficulties of caring for individuals, heavy patient caseloads, and workplace injuries.

In his study, Bittman defines and comments on burnout as follows:

“Burnout” is a syndrome comprised of emotional exhaustion, depersonalization, and reduced personal accomplishment that occur among individuals who work with people in some capacity. Data demonstrate growing numbers of long-term care workers in multiple capacities becoming emotionally exhausted with the subsequent development of undesirable consequences including increased turnover, absenteeism, low morale, and diminished on-the-job performance. The increased risk of elder abuse associated with chronic burnout must not be underestimated.”¹

The approach Bittman used involved combining a number of known modalities for managing stress, such as providing workers with a sense of control, nurturing support, guided imagery, verbal and non-verbal creative expression, and teambuilding. The specific format involved meeting with workers for six sessions.

One element Bittman used in his protocol with workers, which he did not use in his Composite Drumming protocol, was the use of an electronic Clavinova keyboard in one of the exercises, based on its use in prior successful studies. The focus, however, was never on creating good-sounding music, but on self-expression and “nonmusical outcomes.”
In a one-year period, 125 individuals (24 men and 101 women), who ranged in age from 19 to 78, were selected. The individuals were employed at the Wesbury United Methodist Retirement Community, a non-profit continuing care retirement community. The individuals included RNs, housekeeping staff, accounting staff, and clerical staff.

Bittman created two groups. Administrators were all placed in one group so as not to influence results based on fear of judgments from supervisors.

The drumming/music activity was presented to the workers as an enrichment program. Only a small amount of information was given to them in order to minimize their expectations. During the non-intervention period, the individuals continued to do their work. Those who were asked to do the drumming activity worked with a trained facilitator following the HealthRhythms Group Empowerment Drumming Protocol, which was introduced by the Remo company. The drums that were used included Soundshapes, percussion instruments such as maracas, bells, and hand drums, and the Clavinova.

The sessions began with a welcoming of the individuals, followed by an introduction and overview of what was to occur. The first exercise involved body movement, breathing, movement, and awareness exercises. The next exercise involved the egg-shaker passing, which was used in the prior study.

Participants were asked to select a drum, and the facilitator demonstrated basic drumming skills. The individuals were asked to tap out their names on the drums. Participants were then asked to play improvisational rhythms to the music of the Clavinova.

Halfway into the program, the protocol changed significantly from the original Composite Drumming program used in the immune study. During each of the six sessions, participants were asked to use the drums to non-verbally express their response to two of the following questions, which were developed to inspire contemplation and deep thinking, as well as respect for those in the group.

  1. What are you bringing to work today from your personal life and how does it sound?
  2. What is one of the unique gifts (not necessarily in your job description) that you bring to the experience?
  3. What do you find particularly challenging or stressful about your job or co-workers?
  4. What do you find particularly rewarding about your job or co-workers?
  5. Can you recall something a co-worker did that was admirable? What was the result and how did it make you feel?
  6. What does your own personal pressure sound like, and where does it originate? Can you change its (your) tune?
  7. Which resident are you most like, and which resident do you find most inspirational?
  8. How did you feel the last time a resident close to you became seriously ill or passed on?\
  9. Can you share how you felt the last time you were at the end of your rope?
  10. What does it feel like when the atmosphere is perfect for you to do your best?
  11. What would you be if you weren’t here and why?
  12. If you could change anything at work, what would it be?²

The session ended by drumming with the Clavinova or talking about any physical or emotional changes the individuals experienced.

Results showed that burnout was significantly reduced, participants’ mood was elevated and, based on the fact that turnover was reduced, it was determined that at a typical 100-bed facility, there would be a cost savings of $89,100. This was the first study to not only determine the effectiveness of group drumming, but also to determine that there would be a clear and positive economic impact.

Bittman’s research has unequivocally shown, therefore, that drumming boosts the body’s immune system, lowers stress, reduces burnout, and boosts our mood. His work will hopefully increase the use of drumming in healthcare facilities as well as in areas where immune system increases can be beneficial—which is everywhere!

1. Advances in Mind-Body Medicine, Fall/Winter 2003, Vol. 19, No. 3.4.
2. Ibid.

Robert Lawrence Friedman, MA, is author of The Healing Power of the Drum, a psychotherapist, President of Stress Solutions, Inc. (www.drumming-event.com), and a member of the PAS Health and Wellness Committee. He is also on the advisory counsel of the Drum Circle Facilitators Guild.