How to Re-pattern Neurological Function with Drumming

In this video, Jeff talks about neuroplasticity and how to use complex drumming to create new patterns.

How to Use REI Drumming for Long Term Change

In this video Jeff shows how he uses progressive stimulation to achieve long-term improvements in sleep.

This professional journal article, written by REI creator Jeff Strong, explores why REI may improve a listener's ability to fall and stay asleep.

Introduction

Rhythmic Entrainment Intervention is a musical program based on ancient therapeutic rhythm techniques used to synchronize brainwave patterns through entrainment and stimulate brain activity through novelty and complexity (Strong, 1998). The REI Custom Program consists of two twenty-minute recordings played as background music that contain complex, unusual percussion rhythms chosen to address the specific issues a person faces. Each client receives a custom-made REI Custom Program designed specifically for his/her needs based on a comprehensive intake questionnaire and interview process.

Data from numerous previous case studies, several pilot studies, and two controlled studies have suggested that listening to specific musical rhythms played at 8 beats per second may facilitate improvements in sleep for people that experience difficulties falling or staying asleep (Strong, 1996, 1998, 2008, 2011).

In these studies it has been observed that listening to the REI music often sped the onset of sleep and aided in facilitating a more restful sleep period. One case in particular is of a 52-year-old female, referred to as M.M.

Good, restorative sleep is an essential component in life and contributes to overall health and general alertness and energy levels. Sufficient sleep is also associated with reduced stress levels, improved memory, and increased mood. In contrast chronic sleep deprivation can increase feelings of anxiety, reduce energy levels, and increase susceptibility to depression. These were all issues for M.M. before starting the REI Custom Program.

As a professional with two separate masters degrees working professionally as a psychotherapist, she was well aware of the negative impacts of her sleeplessness and sought many therapies to help her sleep. Up until she began the REI Custom Program nothing worked for her. Because of her education and employment background, she was particularly capable and articulate in being able to describe her condition and symptoms in way that many other clients cannot

M.M. described herself as “a mildly depressed, moderately anxious person who has problems sleeping”. Her symptoms before starting the REI Custom Program CDs included; difficulty falling and staying asleep, trouble concentrating, speech dysfluency, and generalized anxiety. One of her main concerns was that, because of her inability to sleep and her tendency to fidget at night, she and her husband slept in separate rooms. This had a significant negative impact on their relationship.

She also reported that, because of her low energy levels, depressed mood and anxiety, she wasn’t interested in social interactions. Her lack of social interest further stressed her marriage as well as contributed to her feeling of isolation from her friends and family.

Despite her efforts at practicing good sleep hygiene, which included taking a bath before bed, going to bed at the same time each night in a dark, quiet room, and avoiding alcohol and large meals before bedtime, she still had difficulty getting to and staying asleep. She also reported that she felt she didn’t sleep deeply enough to have dreams and when she used melatonin she reported that she often experienced nightmares when she did finally fall asleep.

Upon starting the REI Custom Program, M.M. described that the CD “was a pleasant experience to listen to” and that for the first few days she experienced a “rush of energy” that was unusual for her and bordered on uncomfortable. This energy rush passed after three days and was replaced by an energy level that was still higher than before starting the REI Custom Program but wasn’t uncomfortable for her. She described that she had more energy “just to be” and found herself able to socialize more.

She reported that she began sleeping after three days of listening to the mid-morning CD#1 of the Program. She described that she would fall asleep within 1/2 hour of going to bed and would sleep deeply for 7.5 to 8 hours. She also related that for the first time in her memory she was having pleasant dreams every night.

She found that the listening volume needed to be very low for her, as evidenced by one day playing the CD while in the shower and turning it up loud enough to hear over the water. She was irritable the rest of that day. This is not uncommon for sensitive people, so it was suggested that it would be best to alter the week three protocol to ensure that the transition from CD#1 to CD#2 would not over-stimulate her and cause her mood or sleep to be disrupted. It was recommended that she alternate days (CD#1 day one of week three, CD#2 day two, CD#1 day three, and so on) instead of playing both CDs alternately each day as it typical for the REI Custom Program.

At the end of three weeks, M.M. described that listening to CD#2 gave her more energy during the day and didn’t disrupt her new deep sleep patterns. The biggest impact for her aside from consistently having restful sleep, was that she was less anxious and her mood was elevated. She was enjoying more social contact and wasn’t tired during the day.

As the REI Custom Program progressed over the ten-week duration of the Program, she continued using CD#2 in mid-morning and continued to have about 8 hours of sleep each night. She described that the CDs “were an important part of my day: A part that I look forward to”.

Aside from improvements in her sleep M.M. felt fewer feelings of depression and anxiety. Her concentration also improved, most likely as a result of no longer being sleep-deprived. And probably most importantly, she and her husband we able to sleep in the same bed. This improved their sense of intimacy. She was also more socially connected to her family and friends, which further increased her sense of well-being.

Nancy was a 5 year old girl diagnosed with sensory processing difficulties. One of her biggest challenges was her sleep. Before starting the REI Custom Program Nancy's father often needed to sleep on a mattress on the floor in her room. She had difficulty falling asleep and also woke up at night, often between 3 and 4am, and stayed awake for several hours. As well, she rarely slept past 6am if she fell back asleep at all.

The first week on the REI Custom Program Nancy had some difficulties, which where determined to be the result of playing the recording too loud. We determined this because Nancy's sleep was immediately disrupted, a change typical of over-stimulation from an REI recording.

The following parent report demonstrates how over-stimulation, due to too high of a volume, manifests on a listener's sleep and progresses over time:

The first night:

She listened to the audio track at 7:30pm while building a marble run tower with her brother. She fell asleep at 9pm in her brother's lower bunk. Initially, I did not sleep on the floor like I did prior to her listening to the audio track because she was sleeping in her brother's room. She woke up during the night at 3am. I went into the room to comfort her and to help her fall back to sleep. She fell asleep immediately.

The second night:

She listened to the audio track at 8pm while laying down in her brother's room. She stopped the audio track 2x for 20-30 seconds, but I resumed playing the track from where it stopped. After she finished listening to the audio track, she listened to relaxing music on Pandora on her iPod. She began having vocal outbursts at 10pm, so I gave her melatonin and put her in her room to go to sleep. She fell asleep at 11pm and woke up at 2:30am. I went into her room to comfort her and she fell back to sleep at 5am and woke up at 7:30am.

The third night:

I played the audio track at 8pm and read her books until the track finished. I slept on the floor in her room the third night and she slept from 9pm to 6:30am, which is normal for her.

The fourth night:

She listened to the audio track in the car on our way home from the aquarium at 9pm and fell asleep at 10pm. However, she woke up 3x wanting to sleep on the floor with me instead of her bed. After the 3x, I let her sleep on the floor with me and she woke up at 6am today.

Today, she is really wound up. There have been several vocal outburst and periods of out of control behavior. Over the course of the last few days, the vocal outbursts have continued at home, although she has been more affectionate than usual with my wife. Nancy has been able to engage for longer, continuous periods of time with my wife, 1-2 hours of diong various preferred and non-preferred activities. She is also using names more frequently to gain your attention.

On the flip side, the level of stimulation present in Nancy's first REI track played at the volume ti was played at, presented enough stimulation to begin having an impact on language an socialization. These issues are ones that we usually begin addressing later in the program, when the listener can better handle the higher level of stimulation that his track at this volume presented. Again, from her parent feedback report after one week of listening:

On the positive side, Nancy is doing more self-talk, especially conversational self-talk. She is also being more social with people outside of our family and exhibiting less anxiety outside of the home.

Last night we took Nancy to an invite-only event at the local aquarium for kids with autism and their families. Nancy had one brief verbal outburst in line while we were waiting 15+ minutes to enter the aquarium, but no additional outbursts for the next 2 hours. There were a LOT of people and there was a lot of waiting in confined areas. She was patient and engaged the entire time with no further outbursts, only communicating with words what she was seeing and what she wanted to see next. We were nervous when we saw the crowd of people bc she was very excited to go to the aquarium and we were worried she was going to have a meltdown since it was in the evening and she was tired, but she did a great job!

Based on the feedback for the first week, Nancy's parents and I decided that she should listen to the same track at a lower level. This represented a trade-off between Nancy's unimproved sleep and her improved language and social participation. They were asked to let the REI Program Client staff know if her sleep worsened or if her anxiety remained high or if her behavior didn't improve.

After another week on her first recording, her parents reported that her meaningful, pragmatic language was continuing to improve, as did some of her impulsive behavior. As they described:

We continue to hear an improvement in Nancy's language. She is using meaningful language more regularly in sentence format. We are also hearing more verbs, adjectives, and adverbs, as well as more pragmatic language. We are playing the music softer and her sensory has improved. She still has bouts of excitement when she tears through the house, but it is in shorter increments (10-15 min) vs 30 min+.

Regarding Nancy's sleep, she was still struggling. She also was more tired during the day. Her parents noted:

There is little to no improvement in Nancy's sleep. She continues to wake between 3-4am each night and has been up regularly at 5:30am for the last 4 days. My husband is still sleeping on a mattress on the floor in Nancy's room, but she is now coming into bed with me. Sometimes she is able to fall back to sleep within 10-15 minutes on her own. However, a couple nights she has been up 1+ hours. Last night she was up from 3:50-5am. We listened to the sleep track and I gave her melatonin. She slept until 7am. One great thing is we are continuing the same bedtime routine, playing the track while she hears a story, and she is falling asleep faster than in the past. Yesterday she took a nap in the afternoon -- very unusual for her. I tried to wake her bc a nap normally means a late bedtime, but she literally would get up, walk around, and as soon as I turned my back she would be asleep on the floor! THis happened 2-3x. Very strange...the good thing is, she was asleep by 9pm last night. Nap days she is usually up to 11-11:30 pm.

At this point, even though her language was improving and she was listening at an appropriate level for her, it appeared that this recording was still too stimulating for Nancy. This was evidenced by a decrease in eye contact and no change in focus, anxiety, and impulsive behavior. Again, according to her parents:

Nancy's eye contact is getting worse. She needs to be constantly prompted to look at our eyes when she speaks. There is no improvement with her turning when her name is called and she continues to exhibit poor focus. Also, she continues to have occasional verbal outbursts and it has now begun at school. She also has times when she bursts into laughter for no apparent reason and cannot control herself. She falls on the floor laughing hysterically at very inappropriate times. Nancy has also been very short-tempered and is getting upset easily. Her anxiety level is still high, especially if anyone she doesn't know looks at her. She is still very disorganized, too.

We reduced the level of stimulation for her next several REI recordings hoping that her anxiety, impulsivity, and behavioral outbursts would diminish and her sleep would improve. After six weeks on the REI Custom Program (4 tracks) Nancy's parents reported that:

I just spoke with Nancy's teacher. She called to tell me that Nancy has seemed different at school the last week and a half - that Nancy has been more huggy and nurturing, but also sad. She said Nancy hasn't been her usual happy-go-lucky self and has instead been more sensitive and has been asking for hugs. The teacher has noticed that there are times when she expects Nancy to get upset and yell, but Nancy catches herself and does not. Perhaps Nancy is experiencing and discovering new feelings from the latest track. This is a good thing!

Overall, Nancy was still showing improvements in language, however her sleep had not improved and she was still exhibiting impulsive behaviors and poor focus. As they described:

There are moments when Nancy's eye contact is great, but not consistent. We have also noticed a slight improvement in language in terms of sentence length and continued pretend play. She is also using more pragmatic language, especially with the immediate family. However, the sleeping is the same. She is still struggling with focus, following direction, sensory and organization. I have noticed more vocal outbursts over the last 3-4 days. She also has had bouts of sudden energy where she will run through the house laughing and screaming, turning on the dishwasher, ringing the doorbell to make the dog bark, running outside alone, climbing across the room by way of the furniture, dumping toys...Nancy received a disciplinary referral at school on Tuesday for bumping into a friend and knocking him down. She has not received a referral since Fall 2011. I was told Nancy was upset as she was getting off the bus because she didn't want to go to school and was screaming for me (this has NEVER happened - not wanting to go to school or screaming for me). They tried to redirect the behavior, Nancy became more agitated and bumped the kid in front of her...

The next track, #5, was even less stimulating as we tried to put the focus on calming her nervous system. Her response was initially somewhat negative but after a few days she began to calm down and many of her issues improved. According to her parent's feedback report:

She exhibited increased negative behavior over the first several days of the track (sensory, aggression, anxiety, etc), but her behavior, mood, focus, and language suddenly and dramatically improved over the past 7 days.

She is still having moments of uncontrollable and inappropriate laughter at home and at school as I've described before, but it is for shorter periods of time. It's easier to redirect and calm her behavior within 5-10 minutes versus 20-30 minutes. Her eye contact and language have dramatically improved and she is spontaneously asking questions with appropriate eye contact. We still see anxiety and moments of "weepiness". Yesterday she suddenly burst into tears. I asked her what was wrong and she said, "I remember something." I asked her what but she wouldn't tell me. She cried for 2-3 minutes, then wiped her tears and said, "I better. I happy now." She has also expressed to me this week that, "I scared of people sometimes." I am then able to talk her through it and comfort her. When she feels better she'll look at me, smile, and say, "I happy now." It's an unbelieveable break through! She had the best day of her life on Tuesday - great day from start to finish.

Sleeping has also improved. She has slept all night for the past 3 nights but if she wakes up alone in the morning she is afraid and screams.

The next several again focused on calming Nancy's nervous system in the hopes of continuing the positive path we were on and to further stabilize her sleep. After 4 weeks of new tracks (3 tracks) Nancy showed considerable improvements in language, social interaction, and problem-solving (parents gave an example of figuring out how to navigate the monkey bars from end to end).

Her sleep was improving but her father still needed to stay in her room in case she woke up. She also had high anxiety and was frequently:

"yelling and screaming vs using words to solve problems. Eye contact, focus, and language have decreased. She's been moody and quick to anger".

Nancy's parents reported that she recently had gluten and was on Spring break, which may have affected her behavior. Because of this we continued on the same path of highly calming tracks to further improve her sleep while still offering enough stimulation to address the language, socialization, and sensory issues.

Overall, Nancy was making great strides with more social engagement, focus and attention, and language skills. As described by her parents:

Nancy has been talking more and focus has improved. She is actually able to sit and watch a full 90-min movie. She is also able to sit and play with her littlest pet shop toys quietly for 15-20 minutes doing pretend play. She is also beginning to ask family members to play with her! She still has bouts of impulsivity related to sensory, but she is much calmer than in previous weeks. Nancy has recently been able to sit and play quietly with toys for 1-2 hours during her brother's baseball games. It's great!!

Part of the process of addressing sensory issues, especially with sensory seeking people is to help them become aware of their bodies. In Nancy's case this wasn't a positive experience. Because she wasn't potty trained, she became:

increasingly acxious about the potty during the last track and has begun screaming about the potty and several days in a row last week she had multiple accidents each day. This has not happened in months.

Her next few tracks focused on increasing her sensory processing with a particular focus on potty training. This appeared to work, as described by her parents:

Nancy has turned a corner with potty training! We are thrilled!!!! She is doing a great job urinating on the potty, although she has gone in her pullup once or twice in the morning (she sleeps in a pullup each night) - we don't even need to ask or remind. Nancy also defacated on the potty for the first time this weekend all by herself. She has no interest in wiping at any time.

The other area of focus for her last tracks was making sure that she was sleeping well and that her dad could sleep in his own room with his wife. According to Nancy's mother:

Sleep has improved and my husband is no longer sleeping on a mattress on the floor of her room. The last two nights she has been able to sleep by herself and she does need the light to be on the whole night. However, there have also been two nights over the last week when she has woken up multiple times during the night and needs someone with her to get back to sleep.

Nancy continues to make progress and continues to receive new REI tracks when she has plateaued on the past one (usually every four weeks as part of an extended REI Custom Program).

Background

Rhythmic Entrainment Intervention was derived from two traditional therapeutic rhythm techniques that have been employed around the world. One rhythmic technique, termed Shamanic drumming, has been used to alter consciousness for tens of thousands of years. Shamanic drumming is the world’s most prevalent rhythmic technique and can be found in nearly every part of the planet. According to anthropologist Michael Harner, this technique is "...strikingly similar the world over, even for peoples whose cultures are quite different in other respects, and who have been separated by oceans and continents for tens of thousands of years." (1990). In some places today, such as Nepal, you are still more likely to be treated by a traditional Shamanic practitioner than a Western-trained medical professional (Cook, 2004).

The shamanic drumming technique uses a simple, repetitive pulse at approximately 4-5 beats per second. This drumming rhythm is used to help the healer enter a specific altered state of consciousness, referred to as the “shamanic state of consciousness (SSC)” by Harner (1990). The SSC is considered a meditative state where the healer “journeys” to an unseen word to diagnose the patient’s condition or to facilitate healing through specific rituals.

This simple drumming technique is part of the shamanic practice in nearly all the cultures that employ shamanic healing throughout the world. Cultures that don’t use the drum use hallucinogens such a peyote or ayahuasca. According to many anthropologists, including Harner, the altered state of consciousness produced by the drum is similar and every bit as all-encompassing as the effects of the hallucinogenic substances. One advantage to drumming is that a skilled shamanic healer can more easily and predictably control the level of the altered state of consciousness and end it at will.

The second traditional therapeutic rhythm approach that forms the basis of Rhythmic Entrainment Intervention is referred to as rhythm-healing. Rhythm-healing distinguishes itself from shamanic drumming in that the rhythm used is dependent on the patient and his symptoms (Diallo and Hall, 1989). This technique is most prevalent in Africa, but can also be found in places where shamanic drumming was also used including indigenous people in North America (Cook, 2004).

This technique historically uses a similar tempo rhythm (typically between 5 and 6 beats per second), which also is used to alter consciousness through entrainment. This is viewed as spirit possession - the listener enters an altered state of consciousness and is “possessed” by the spirit of an ancestral healer (Wilcken, 1992, Davis, 1998). Another aspect to rhythm-healing is that rhythms used are often unique to each person and are complex and variable in contrast to the steady, repetitive shamanic rhythm (Diallo and Hall, 1989).

Foundations

Rhythmic Entrainment Intervention relies on two aspects of the nervous system to influence consciousness: 1) auditory rhythm can drive the frequencies of the brain. This is called auditory driving. 2) Novel auditory stimulus can increase neurological activity and to allow the brain to entrain to the alpha state of consciousness.

Auditory Driving: Research on auditory driving can be divided into three basic categories: drumming, tone bursts, and beat frequencies.

• Drumming: Early research into the ability of repetitive drumming to direct consciousness showed an entrainment mechanism (Neher, 1962, Jilek, 1975) but left many questions as to why this was happening. A study conducted in 1993 answered many of the questions still remaining about the ability of repetitive drumming to drive brain wave states (Maxfield, 1994). In this study, Maxfield showed a direct correlation between the tempo of the rhythm played and the brain wave activity in the listener’s brain. Maxfield also showed that the rhythm need not be repetitive in order to facilitate this entrainment response. This aspect of drumming for directing consciousness is important because auditory driving mechanisms have been less effective at an alpha tempo than theta due to habituation.

By being able to vary the rhythm, habituation becomes much less of a barrier to initiating auditory driving. A variable rhythm is a crucial component when attempting to drive the brain into an alpha level of activity, because a repetitive pulse in the alpha range causes habituation before entrainment can commence.

• Beat Frequencies/binaural beats: Beat frequencies and binaural beats are pulsations that the brain perceives when two dissimilar tones are heard bilaterally. Beat frequencies were the results of research conducted by businessman Robert Monroe in the 1960’s and 1970’s. Considerable study has been done with beat frequencies and binaural beats (Owens & Atwater 1995; Hiew 1995; Hink, et al, 1980; Foster 1990; Oster, 1973; Sadigh, 1990).
• Tone Bursts: Over the last twenty years researchers have been experimenting with computer-generated, repetitive rhythms called tone bursts (Kalluri S, Delgutte B., 2003; Joris, et al, 1994). Tone bursts use the same basic approach as ancient shamanic drum rhythm except the white noise tone used theoretically eliminated any interference caused by the frequencies produced by the drum. This interference was suggested by Jilek but was observed by Maxfield not to be an issue.

Another reason tone bursts have become many researcher’s method of choice is that beat frequencies have proven to have limitations, especially at alpha, and using a computer generated white noise rhythm employs a higher technology than using a drum. This makes it more attractive to researchers.

A recent survey of brainwave entrainment (BWE) research concluded that, “Findings to date suggest that BWE is an effective therapeutic tool”. (Huang T L, Charyton C., 2008)

Novel Auditory Stimulus: Research on novel auditory stimulus suggests that listener’s brain activity increases with the introduction of a novel stimulus are part of the CNS orientation response (Knight, 1996). Familiarity causes a decrease in neuron firing response (Rutishauser et al, 2006). It has also been shown that novel rhythmic stumulican increase brain activity even for people with severe neurological disorders (Parsons, 1996, Rossignol, S.; Melvill Jones, G. 1976, Scartelli, 1987).

Entrainment to the alpha state of conscious has been shown to be difficult with auditory driving techniques when the stimulus is repetitive. Though, Maxfield showed that a drumming rhythm needn’t be repetitive in order to entrain the brain. REI Rhythms use an underlying pulse at 8 beats-per-second but also include a complexity of accents, thus creating variable rhythms able to sustain attention long enough for entrainment to alpha to take place (Strong, 2008). Binaural beats and tone bursts can’t be varied in the same way as a well-played drum, making them very repetitive, thus causing habituation problems at faster tempos such as those in the alpha tempo (Strong, 2008).

Theories

Results that have been observed with improved sleep suggest that listening to REI rhythms synchronizes the listener’s nervous system, allowing one to shift states of arousal. REI employs non-repetitive auditory stimulus at an 8 beat-per-second tempo. This tempo correlates with an alpha state of consciousness, often referred to as a pre-sleep state. Synchronizing to the pre-sleep state allows the listener to fall asleep from this state naturally.

The variable, complex rhythms aid the synchronization to the alpha state of consciousness by keeping the brain engaged long enough for entrainment to occur. The complexities of the rhythms seem to have an effect of helping the listener develop better sleep patterns. It is currently unknown how this occurs. Future research will explore this correlation.

Conclusions

Research to date, as well as clinical observations, suggests that listening to 20 minutes of complex, non-repetitive auditory rhythms can have positive effects on the listener’s sleep. The mechanisms involved may include auditory driving, but may also be the result of neurological organization.

Future research will attempt to further document the clinical effects and well as explore the outcomes and the mechanisms involved.

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