Professor Nigel Osborne: You get a group of kids together who have been through traumatic experiences and you give them something that gives them a bit of release and joy. And my god, you get a wave of energy back. And I'm quite a scientific person. I would like, I don't know how to measure that energy, but it's a colossal human energy comes flying back back at you and it says, you know, carry on, do this, please.
Dr Rupy: Welcome to the Doctor's Kitchen podcast, the show about food, lifestyle, medicine and how to improve your health today. My name is Dr Rupy. I'm a medical doctor. I also study nutrition and I'm a firm believer in the power of food and lifestyle as medicine. Join me on this podcast where we explore multiple determinants of what allows you to live your best life. And remember, you can sign up to the doctorskitchen.com for the newsletter where we give weekly recipes plus tips and hacks on how to improve your lifestyle today. Music as medicine. This is the topic of today's discussion with Professor Nigel Osborne. He is quite an incredible person. I'm so excited to introduce you to him. If you haven't come across him yet, he's Professor of Medicine, Emeritus Professor of Medicine in Human Sciences at the University of Edinburgh, I should say. He's a composer, a teacher, and a humanitarian aid worker. He's been decreed by the Guardian as one of the UK's best kept musical secrets, and I completely understand that. His works have been performed around the world by major orchestras and opera houses such as the Vienna Symphony, the Los Angeles Philharmonic, and the Berlin Symphony, Glyndebourne, the Royal Opera House. Honestly, he's had so many awards, so many prizes, there's just too many to name. And this podcast is all about medical music therapy. If you haven't come across it before, you're in good company because neither have I really. I've always thought about musical therapy as something that's quite nice to do. It might help calm nerves, but it doesn't really have that much medical validation or clinical or academic validation, I should say. I've proven myself wrong in just researching for this podcast episode because there is clear neurological, biological and psychosomatic reasons as to why music therapy can have distinct and impressive impacts on people's wellbeing and physiology. And this isn't just about anxiety and mental health, although it has impressive outcomes with that medical discipline. It's a lot about autism, dyslexia, stroke, traumatic brain injury, even neurodegenerative disease, dementias which afflict many of us over the age of 70 years old. So I think this as a specialty in itself is super exciting. And someone who's been spearheading this in the dark, if I'm honest, because I haven't heard much about this discipline in the past, is Professor Nigel, and his work is just absolutely amazing. I really think you're going to enjoy this episode. It's definitely changed the way I want to look at the brain and the subject matters that I want to explore. And on this podcast is exactly my opportunity to not only teach myself about the wider determinants of health, but also take you on this journey with me. So I'm not going to say too much about what we discuss, but you're going to learn about musical therapy, trauma, PTSD, and his incredible system, X-System, which is a manner in which we can sculpt our inner senses, our lives, our autonomic nervous system, our hormones, and and use music as a therapeutic tool. Check out the website show notes, look and watch some of the YouTube lectures that he's done. I've linked them all in the show notes. I think you're going to find this super, super enjoyable. I can't remember how I came across you. I think it was a mixture of me finding out about your work a couple of years ago, forgetting about it, and then somebody else nudging me a couple of weeks ago saying, have you heard of musical therapy? And I remember thinking, yes, no, I have heard of it because I've watched a few TED talks from some of your peers, no doubt people that you know. And I remember thinking, yeah, this is this is absolutely incredible. And I do need to discuss this topic. And and I did a bit more research about you and your wonderful work and I just thought I have to try and speak to you, if not on the podcast, then, you know, just to reach out and and commend your incredible work. So, thank you so much for making the time to to chat to us today.
Professor Nigel Osborne: Pleasure, pleasure.
Dr Rupy: Great. So I thought maybe we could start off by introducing our listeners and our community to to you and and how you got involved with some of the work that you're doing with musical therapy, in particular for children and where that that that whole journey started.
Professor Nigel Osborne: Yeah, well, it started very early in my life because I was always interested in music therapy. And I'd also been very attracted towards medicine. It was a kind of vocation that I could have. I'm sure I'd have been a lousy doctor, but I'd love to try. Um, and uh, anyway, I was always fascinated by that. And it was actually when I was studying and working in Poland, Eastern Europe, at a time, you know, when the old communist system was in place, different life. And I've been involved in performances where we'd gone around hospitals and other places playing. And I'd noticed the huge effect that the music was having on people. Simply cheering them up at one level, but also getting them moving, people who were not supposed to be able to move around, started moving around, and things like that. And so I got very interested. So when I got back, I started working in bits of music therapy. And at that time, there was no clinical qualification. That came later. And so I'm still in the position of being an unqualified music therapist. I'm at peace with the profession because I admit this openly, and I'm actually what they call the grandfather generation. In other words, the generation that had to start up, you know, and so actually I taught in music therapy departments and taught music therapists, but I'm not actually qualified. It's a very important thing to say, as you'll appreciate, keep good faith everywhere. So I started doing that. And the other thing that was really interesting was in doing little bits of music and nursing and things like that, I was able in the back door that existed in the medical profession at that time. And I'm going to be very careful about this on this podcast. But I did manage to get myself into various lectures. Oh, brilliant. And and I got and particularly and and began a lifelong fascination with neurology. And I was very lucky after that, having been able to by the back door get and I hope I've never abused my back door status. I did that. I was able to have some wonderful mentors. So one of my mentors was the head of neurology services in Northern Ireland, Michael Swallow. And he was one of my mentors. We worked together on music and Parkinson's and things like that. So it was wonderful to have and I'm lucky still to have people like that in my life. Currently working with a wonderful man called Michael Trimble, who was head of Queen Square, Britain's chief neurologist, and we're working on music and epilepsy together. So anyway, that was the part of the journey. And then, so I'd kept that going as an interest from the earliest stage, though I'd had to earn my living at times doing other things. It was not, there was not always the capacity to stay alive doing that, but I always kept it going. And I suppose the other important step was when I started working with children with trauma was I was actually for human rights reasons, I was in Bosnia at the beginning of the war visiting. And saw the situation with children, which was dreadful. Unbelievable that we allowed that to happen, a medieval siege of a modern city for quite some time. And and then I thought, well, is there something we could do, you know, with I think this is this is something we could help with with music. I had no, I had no evidence that we could. It was a hunch, but knowing the things that we've done in music therapy before, sorts of transformations we were able to offer, particularly to children. I thought, let's have a go. And so we did. And so with colleagues in the besieged city, we started work. And we discovered some extraordinary things. I mean, one is that you get a group of kids together who have been through traumatic experiences, and you give them something that gives them a bit of release and joy. And my god, you get a wave of energy back. And I'm quite a scientific person. I would like, I don't know how to measure that energy, but it's a colossal human energy comes flying back back at you and it says, you know, carry on, do this, please. And so we got those kinds of responses. And then more official responses came because I didn't use the word therapy. And we just were making a distraction for the children in terrible circumstances. And then the Ministry of Health sort of came to see our work, said, can we have a look? And and they liked it. They asked me to scale it up, and they used the word therapeutic. They said, this is, you know, we think this is a good therapeutic program. So please, you know, keep it going if you can. And then that led to many things. We went to other cities in Bosnia, to Mostar, where we built the Pavarotti centre with Pavarotti, attended by the rock stars, you know, Bono and you name it. Zucchero and whatever. But, yes, so we were able to to to to build a kind of fairly permanent things. And so it's gone on like that. And that's that's the history really of me early interest and then a new wave of interest when I discovered that we could really help kids with trauma.
Dr Rupy: That's incredible. I mean, the first question that comes to mind, and I don't know whether you're able to speak about this on the podcast, so so don't worry if you can't, but how were you able to go into Bosnia at that time? How are you actually able to to get access to the city and work with the children?
Professor Nigel Osborne: Yes, it was through a couple of things. I mean, I can admit to it now. On some occasions, I had got commissioned as a journalist. Okay. And I went in as a journalist. And I guess the journalistic profession will never forgive me, but I don't think I was putting them into danger. I did write the articles, but actually I was doing something else as well. And then later when I felt that that wasn't right for me to pose, and I didn't have any commissions to write articles, so it would would have been simply a lie. Then I, there was a way by that time into Sarajevo by a tunnel. There was an old drainage ditch under the airport. And there was a way of getting over Mount Igman at night. You walked down at night because there were snipers down at the the people besieging Sarajevo had full sight of the mountain track. So you went down at night, and then found a way of getting to the entrance to the tunnel at the edge of the airport. Then you went through the tunnel into the city, which my back still hurts from those days. It was far too low for me, about four feet high or something. And and you had to put a rucksack you put on the front of you. And so you can imagine what that did to your back, hunched over for a mile or whatever it was under ground. I mean, you know, something I couldn't even contemplate trying now, but I I managed just about, but still have a sore back from it. And and so that was that was how I got into the city. Yes. So so that that was open for the tunnel for much of the time. A very dramatic experience because it was used by the Bosnian army to defend the city as well. They'd send, you know, groups of troops out to to give trouble to the besiegers. And it was the main supply route as well. So what you had to do frankly was flatten yourself against the wall at certain points when troops came running through or indeed when some, you know, important consignment of stuff was being delivered. So that was that was the drama of that. And then then in the city, I stayed in various places and I knew you learned to survive. I learned a lot of things about how to wash with a teacup of water. I mean, a very very good kind of, you know, covid time exercise, you know, can you actually make yourself completely clean with a cup of water? Well, the answer is you can. You know, if you're careful and meticulous, you can. And people were clean. It was amazing. You know, the hygiene levels were superb in that city without water. It's an interesting human paradox, you know, when we have easy access to water, people get quite lazy and sloppy, like, you know, lockdown Britain, I know, it's as sloppy as I've seen it get. Whereas there the people were, you know, having real problems were beautifully clean. It's amazing.
Dr Rupy: Yeah, it's the, it's the incredible ability of humans to adapt to any given situation and thrive as well, which is amazing to see.
Professor Nigel Osborne: It is, and compensations, you know, we've we've we're missing something, so, you know, we create something to take its place. It's it's it's good for us maybe in some, I mean, sieges are not good for us, but but sometimes we probably do live in too much comfort. Even in lockdown for many people, maybe uncomfortable, but the levels of basic survival don't seem to be too difficult. Whereas I think that occasionally in our lives, if we have to face real difficulties, it's good for us to and to value the good moments, you know, to value when we've been lucky. Okay, that's good. I've got a meal today, wonderful.
Dr Rupy: Yeah, it's this new found appreciation for the simple things that we would have otherwise overlooked, right? Yeah.
Professor Nigel Osborne: Yeah, and it's difficult to get it right, isn't it? Because on the one hand, you know, we don't want to put people through difficulties in order to appreciate how lucky they are. On the other hand, it really is important to appreciate how lucky you are for human beings, really, really important.
Dr Rupy: Absolutely. Yeah. So I'm loving this story. So, you know, it came out of your humanitarian instinct to want to try and help people under the siege. And I suppose you you came at it from a like an unscientific perspective. It was like just something you thought would would help the children, a distraction like you described.
Professor Nigel Osborne: Yes, absolutely. It was a hunch. I mean, there were some bits of, you know, music therapy experience that were relevant and scientifically proven, but no, and that's why we were so surprised by the results. That the physical changes in presentation, the way that the way the children behaved and adults, we were quite shocked by what those change and and, you know, that was what drove me on the lines of dusting off my neurology textbooks and and looking at, you know, what is the reason for this? And I was very lucky because that was the exact at the moment when there was a big growth of knowledge about this. There was music medicine and the science about music had begun to grow. I'm talking about the 90s. I think it was a number of things. It was advances, more common access to things like fMRI, you know, to the brain scanning. And I think advances in science itself in realizing that things like, you know, heart rate variability are important as well as heart rate, respiratory sinus arrhythmia are important, realizing that endocrine changes can be very powerful and and, you know, important for human beings. I mean, people had that knowledge had been accumulating, so it had kind of come to a head at that point where we were ready for a musical medical science. So the answers I was looking for were there in the articles, you know, they were coming out by the day. Oh, okay. That's why. And it was very convenient because I didn't want to and can't experiment with traumatized children. I mean, there were some studies, of course, I mean, the Harvard social medicine school did a very good study, which we've used a lot. There was in Sarajevo, a longitudinal study, which was very helpful. But that was that was simple psychometrics. But what we needed was physiological measures and things for the things we were doing. And we didn't want to invade the children in any way. We occasionally were able to piggyback on GP and other research, little bits and pieces, but not nothing consistent. But what we were able to do was we were able to take data from, you know, people who didn't have trauma and what was it doing to their heart rate and breathing and so on. And discovering things we could kind of almost triangulate, you know, that way. So so it is a problem, you know, it remains a problem researching this because there's another obstacle. If you want to do an RCT trial, say in a camp, refugee camp, that's really difficult with moving populations. And also for me, when I work there, I want to help the kids as much as I can. Establishing a control group that you don't work with and measure has ethical issues, I think. And so we get round that sometimes with doing comparisons. So we'll do a compare say visual art and music and we we get get round it sometimes by doing offering everybody something and then they become one another's controls. But but there are lots of ethical problems. And I do think that they point to a way that maybe we need to see some changes in science. I mean, it's happened in medicine already, a far greater willingness to look at a broader picture than and although the RCT is still correctly the gold standard, correctly, nothing wrong with that. Nevertheless, it misses some things and it and there are places it can't be implemented. So let's do something else intelligent. And I think we're getting there. And I think particularly the medical profession has led in in in moving that. It has managed to escape the claws of the drugs companies and you know, with for whom that is the the only perspective. And to do other things. So I'm very optimistic that we'll get a broader science capable of capturing these important human things.
Dr Rupy: I I think that's it really speaks to the kind of work that I'm biased towards, which is nutritional medicine and lifestyle medicine because the same paradigm of being or the inability to measure those outcomes is is the same essentially. Randomized control trials, we can't really use them in a nutritional medicine context because there are just so many variables and it's very hard to control and and maintain observations over that long period of time and and actually make sure that we're removing any things that can confound the results. So I and I so that I totally think that yes, RCTs are fantastic and they should be the gold standard, but we do need to think a bit laterally when we're thinking about scientifically measuring other aspects that aren't as binary as a singular intervention.
Professor Nigel Osborne: Absolutely. I mean, we have the same in music is the food of love, right? I mean, it's awesome form of nutrition. And and we have exactly the same problem. And also other things is in biological data are messy and fuzzy always. And and we apply a 19th century mathematics, you know, P values, you know, standard deviations and what have you are not very good at capturing this kind of fuzzy stuff where the significant thing can be something little thing that's happened up there. You know, that actually can be giving you the clue to what's really going on. And and and so there is that too, that we probably need to upgrade the mathematics a little bit. I don't mean in any way, I mean, I'm actually arguing for more rigor. I'm I'm I'm arguing for using some of our our newer approaches to to looking at data a little bit differently for significance, for example.
Dr Rupy: Absolutely. Exactly. Yeah. And so how how did your love of of musical therapy sort of progress from Bosnia to the other countries and and experiencing how musical therapy can be useful for for children from from different scenarios as well? And maybe even, you know, close to home.
Professor Nigel Osborne: Yes, well, what happened was it kind of flowed. When I'd done the work in was doing the work in Bosnia, and by the way, I never stopped. I still run summer camps for children, you know, and indeed some of the adults who were children at that time. We're still together. It's very important. We have no exit strategy. That's really important. If you want to go into a job like that, don't you don't go if you have an exit strategy. You've got to be prepared to stay your life, right? So anyway, so we have done. But what happened is through word got around with word aid agencies. And so I was invited to work in Kosovo with the refugee problem there. Developed and later places like Chechnya and later was invited to East Africa and and even ended up in India through all through through invitations. I I it and I thought that was important and always in relationship to local NGOs and organizations, which I think is very important too. I mean, I'm not in any way criticizing international NGOs, may they thrive and prosper. But there's something about local NGOs that is appropriate for the work I do, you know, close to people, community. And so it developed through that through a series of serendipities, very nice invitations. My whole, my most important work in India began. I was invited to a retreat in Jodhpur. The Maharaja has something called the Indian Head Injury Foundation. And I've been one of their advisors because actually music therapy is very useful for getting language back after head injury, but that's another topic. Anyway, I was there and ended up chatting to a guy at breakfast. And and I'd got a day, it was a free day. I planned a trip into the desert and all kinds of wonderful things. I started breakfast with this guy and at dinner, we were still sitting there at 8 o'clock in the evening. It's Michael VJ Podar, who was head of the Aurobindo, the administrator of the Aurobindo Foundation. And so I ended up in an ashram. I'm not a devotee, but I'm a great respecter of the spiritual values. And what I like hugely and enormously is their attitude to work. The people that work for the ashram are working with such beautiful altruism. And they're qualified people. These are, you know, these are not, you know, do gooding romantics. They are qualified nurses and what have you who are who are doing this work out of a kind of tremendous commitment to making the world a better place and taking responsibility for society. And that feels really good to work with. And it's one of those things also, it's a very funny thing about India, you know, it has this, it has a capacity, you know, to lose it in various ways, you know. And my god, it has a capacity to get things right, you know. When things go right in India, my god, like you won't find better, you know. And so I've had had that, you know, that pleasure and privilege to to to be working, you know, and in the same thing in China, working with, you know, the top people and with the best. And so that's how it it it has progressed in different cultures. I feel very, very, very lucky. I don't know where this good fortune came from. I, you know, it it I'm very, very, very lucky man.
Dr Rupy: Yeah, that's brilliant. I mean, just some of the from the description of some of the work that I've I've read and and stuff, it just sounds absolutely fascinating. And what's particularly interesting to me is that when I first come across music, when people first come across music, they initially think it's a humanity subject rather than something that actually has medical rigor and actually can manifest as one of the, not curative, not not something that can, you know, reverse anything, but one of the many tools in our suite of lifestyle interventions that can lead to to better clinical outcomes. And that and that for me is fascinating to to dive into how on earth this is possible and if there are innate mechanisms that we are tapping into with the shared enjoyment of music that, you know, perhaps can be used in a therapeutic manner going forward.
Professor Nigel Osborne: Yeah, I think absolutely. I mean one of the interesting things that's happened is an interesting sort of thing of history. Our ancestors believed fervently in music medicine. You know, so-called primitive societies and actually also the first civilized societies believed in. I mean, you know, the great, you know, Arab scientists believed in music therapy, you know, Al-Farabi, you know, Ibn Sina, you know, the founders of medicine believed in music therapy. Ibn Sina knew that music could change the heart rate. I mean, basic things that are quite important. And, you know, because actually changing heart is easy if you get something moving, but what's someone sitting down? How do you change their heart rate? Well, with music. What if they're lying in a bed with music? So he discovered that. And so there was this long development and in Europe too, right the way up to the 16th, 17th century, there was a music medicine development. And there was a wonderful doctor called Robert Fludd, who was also a composer, you know, who invented by the way the thermometer and various other things. He was quite a brilliant guy. But he, you know, was thrown out of the Royal Society because he had among other things proposed music medicine. Because the kind of Cartesian revolution had begun and so the proofs weren't there. The observations were there but not the, you know, but not in the form to be able to establish the sort of proof that the early Cartesians wanted. Also, he happened to be a Rosicrucian as well, which didn't help. So he but he and Mersenne called him a, you know, heretic and even, you know, he he was he really got the whole European scientific establishment kicked him out. But actually that was a moment when, you know, music medicine was kicked out of science. And it came back slowly in the 20th century, partly through people realizing in in the Second World War that music therapy was helping veterans quite a lot. But then that science suddenly got there. We got through, you know, brain imaging, through decent endocrinological research methods, you know, spectral analysis, all sorts of things that made us better at seeing what's going on inside the body, all showed up, my god, that music is changing that. This looks totally different after the music. And so we we started getting the evidence that Robert Fludd, apart from his Rosicrucianism, was right, that Ibn Sina was right, you know, that actually there are some fundamental things about me. I think human beings created music to heal themselves, not heal themselves, to help themselves. Music doesn't heal. It can help with symptoms. It can make life a bit easier in various ways. It doesn't heal. You don't reverse things. We can be quite spectacular sometimes. I mean, for example, with Parkinson's, we're just talking with Michael Swallow, that is pure Lazarus pick up your bed stuff. You know, you can have people in phases of Parkinson's shuffling into a room, and with music, we can get them running and dancing. I mean, you have to see it to believe it. So there are some things that look like healing, but they're not. They are helping people with symptoms.
Dr Rupy: Just just for the just for the listeners who haven't ever seen what you just described, that phenomena of Parkinson's patients whose motor circuitry is degraded because of the progress of the disease and suddenly being given a piece of music with a physiotherapist and a musical therapist, and then all of a sudden their auditory and motor cortex almost collaborate in a way that overrides the degradation of their their um their motor cortex, motor cortices so they can actually walk seemingly in a in a non-Parkinsonian fashion, which is really pronounced and it's something that, you know, like you like you said, it's kind of, you know, pick pick yourself up and and you know, wow, this is this is a heal, this is a been cured, you know, it's quite amazing.
Professor Nigel Osborne: And very proud, one of the Michael, the great Michael Swallow, so chief neurologist from Northern Ireland, was very keen on on the idea of of music as as medicine. I remember in the early days of working with Michael, and he said, we don't have the proof yet, but also this is to do in part with dopamine transmission as well. And and so but we didn't have the proof because actually getting that proof is hard even with modern science because it involves time coordination of different measures. But anyway, a wonderful guy in Montreal called Robert Zatorre did it. And he put together positron emission tomography with fMRI, with EEG and you name it in order to get a time coordination at a specific place in the brain and prove that music was actually generating dopamine release. And and I was so pleased because Michael was no longer with us, but I thought, Michael, you were right. You know, how wonderful that I've lived to see the day, you know, that your great doctor's intuitions, because actually intuitions, I think are important for doctors too. His great doctor's intuitions, he had was spot on, you know, absolutely correct. So yes, stimulating motor cortex, but also probably helping to release whatever dopamine, obviously there is a depletion of the dopamine circuits, but but probably being able to encourage what's there to actually happen is is is part of it. And I was so thrilled to be part of the conference where Michael's intuitions of 50 years ago, you know, were proven to be correct, absolutely scientifically correct.
Dr Rupy: That's fantastic. Yeah, no, it's wonderful to see. And it's it's wonderful to see some outcomes with um with post-traumatic stress disorder as well. Something that I think should become more topical in a post-pandemic era, particularly for medical staff. I I recently had a conversation with one of the chief psychologists at um combat uh combat stress. Um and as you're probably aware, it's a charity that deals with PTSD for particularly for veterans. And um you know, one of the things that we were discussing is this uh uh impact of moral injuries. Moral injuries being where you've had to take decisions that challenge your inherent moral code. And I I wonder the application of what you've seen for music therapy in children and and adults as well for PTSD and how that could potentially be translated for for medics going forward.
Professor Nigel Osborne: Yes, I I mean, I think we have a mass of interesting medical evidence. And it starts very simple. You know, one of the things that tends to get overlooked in trauma is its physiological symptoms. Like people with trauma will have on the average a heart rate of five or six beats per minute average higher than normal, their normal, their normal, pre-trauma normal. And and they'll have also endocrine dysregulation. I mean, for example, cortisol in trauma will go sky high to begin with, obviously. But then paradoxically, it goes too low. There's a paradoxical effect, you're probably aware of it. And something to do with glucocorticoids and, you know, the hippocampus and and and, you know, the command system of of of the cortisol HPA axis. But something's going on there that reduces cortisol levels dangerously. Um and then there's the whole autonomic dysregulation that we've mentioned. There's movement dysregulation, the way that, you know, the children in particular who are traumatized either become very hyperactive or very sluggish. Oliver Sacks used to portray it like that. Had the pleasure of working a little bit for his institute in the Bronx. And uh uh he so that those repertoire and breathing, very underreported, the breathing difficulties. And what's really important is music has a magic bullet for each of those. Music can regulate heart rate, it can regulate endocrine processes. It's highly interactive with cortisol, the HPA axis. It's highly interactive with the motor cortex and movement. So it's got things we can, we can't cure these things, but we can make life more comfortable for people when we can exercise them a little bit like that. And indeed we can, we do seem to be able to free up some systems, but that needs more research to to to to verify that. So there's lots. And then the psychological level, as you say, the idea of having, you know, trans moral transgression of and all all sorts of things to do with trust, negativity. I think art and music is a wonderful machine for dealing with this. I mean, when we make music, we communicate with people in a particular way, intersubjective way, in which we begin to share not only our thoughts, but our feelings and the chemistry of our body as well. There are neural substrates to that kind of musical communication. We start, you know, firing the same neurons, you know, in one another. And so all sorts of things we can do for for for trauma. I mean, I think we're on, I'm I'm working with my great privilege is working with T and We Valley NHS at the moment, a wonderful clinical leading clinical psychologist, Angela Kennedy. You know, who has been developing trauma informed care in her trust. And and it's great to see these things eventually, I mean, coming to one of your earlier points, it's my opportunity to bring what I've learned home. And I'm no expert, but I do have some experience. I've been 30 years working with people with trauma. I've I've seen some things and I'm still doing it, which means I can't be that bad. And and so I've got a few things. It gives me a chance to bring home some of the bits of experience and they're simple things and they work and you know, and so I'm really looking forward to to this phase of exploring this, um, you know, to a proper arts medicine that must be accountable. It's really important that it is scientifically rigorous. As we said earlier, it would be nice to have some better mathematics than we have. It would be nice to have something more embracing of the natural chaos of biological data. It would be nice to have that. But if if we apart from that, it must be scientific, it must be rigorous, it must be totally accountable at every stage of what it is. Because once it starts getting starry eyed, we've lost it. Yes, yeah, I agree. It it's and it also has to, you know, respect and and conform to the standards of the medical profession. You know, it has to take a Hippocratic oath somewhere along the line, you know, it has to be. Um, but it's interesting when I when I talk to my music students, um, I often tell them you've got to be like doctors. Interesting. Yeah, yeah, because in your care of your students, but also in your behavior, as is in, you know, vast majority of medical professionals, extremely high standards of behavior. And in in, you know, in your reliability, your human reliability, your trustworthiness in your behavior towards others, you have to be like doctors. So, you know, I think there's an interesting thing for music there too. But it it it is certainly an important part of it.
Dr Rupy: Yeah. I I think that's it really speaks to the universality of human experience and and through music that is across culture. And I think this is this phenomena that people understand it when it's explained to them. It's, you know, we we talk about it, but otherwise we forget about just how interconnected we are across cultures and how a single piece of music can evoke similar responses from seemingly separate cultures.
Professor Nigel Osborne: Absolutely. And and the fact that we even when cultures have developed their own codes, you know, we can learn them very quickly. You know, it's it's a it takes, you know, I mean, obviously it takes about seven years if you want to be a good musician to learn to play well in another culture, but it takes you seven years to play well in your own first culture anyway. That's what we say. But for example, when you're traveling in in in Java, in Indonesia, and with the gamelan, and and you you know, come to a group of gamelan players, you know, and they say, come over and play with us. But I don't know what to play. And they sit you by the most important instrument in the gamelan, the big gong, the gong ageng. And they say, play that. And I say, I don't know when to play. And they say, don't worry, the gamelan will tell you. And it does. You know when to play. You know, you listen, if you're, okay, yeah, now. And and so within, you know, a few seconds, someone who has no knowledge of another musical culture is playing the most important instrument in the ensemble. I'm not underestimating the knowledge that needs to be got to be a good gamelan player, seven years to make any kind of start. But um but the the the music, the human musical bit is is immediate. You're in there. Um yeah, and of course appreciation is something getting to know the music of another culture so that you recognize the nuances. I mean, for example, in Indian music, to learn the rags is very enriching. If you have the patience to learn the rags, then that gives you a richness of experience that you're not you're not going to have if you don't know them. But the rags can still talk to you. They'll still affect you, you know, but you but you can actually be in conversation with the rags, you know, you can actually be in there with them if you want. But that's that's a learning process. You've got to put some time into that.
Dr Rupy: Absolutely. And and and this has wet certainly my appetite for for engaging a lot more in music and potentially music therapy going forward. If people who are listening to this want to engage in some of this, how how how do we find, you know, where to where which pieces of music we should we should start listening to or where to start?
Professor Nigel Osborne: Yeah, I think it's it's there are, I mean, the the commercial sites give you offer you some things. And they're okay to a certain level. I mean, they've done it through, you know, often through looking at, you know, the likes and dislikes principle. And there's some basic technology that some of them use. So I'm hoping that, you know, with X-System, we can get to a point where we can make that more available. I'm not doing a commercial beyond in my life though those kinds of judgments. But I I'd like to get a more flexible tool out to people. Absolutely. That would be one of my hopes. And it's there, it's ready. It just needs, it would need the music industry to wake up a bit. They're quite asleep, oddly enough. And not realizing that they've been engulfed, you know, the world of music has changed totally, you know, streaming and everything. So they've really got to, for example, I'm talking to people now, we really do need a music license for the NHS, right? We want we need to be able to free to use whatever music we want in music medicine. We can't at the moment. We for our website, we've bought a trial license. But anyway, there are things where people really need to wake up. And in that awakening, I'd love to see a situation where people will be able to get access to these these things. As I say, the only things that are commercially available are from the commercial platforms. And they're not that bad. I mean, you know, the Spotify relax and so on is fine. I'd like to think that we're able to do a job that is more commensurate with people's hopes.
Dr Rupy: Yeah, yeah, I see that. And so your your website being the Recovery College online.
Professor Nigel Osborne: That's right. Music music wellbeing, yes. That's right. And it's some yes, it's it's the Recovery College for T and We Valley Mental Health. They've been fantastic. Absolutely. And and one of the the strange paradoxes of this difficult time, I mean, it is difficult for Britain in particular. I think we, you know, I don't want to get political, but I I think that our politicians have allowed a situation where this has got out of hand. It didn't need to be. But on the other hand, you know, the the in in this terrible cloud, there is also a small silver lining, which is that there's been an opportunity to and an awareness of the importance of things that maybe we haven't valued always. And so, for example, my colleagues in, you know, T and We, we've been talking for many years. And now, you know, we suddenly have the moment where a door swings open and and and that's good. I hope we can use it well, that opportunity. And there's one nice thing about music, you can't do people any harm, can you? So if we're totally benighted and totally wrong about what we're saying, we're not going to do anybody any harm. So it's okay.
Dr Rupy: I think that you know what, it's interesting. I think there will be certainly an appetite for music streaming websites certainly to to get involved in musical therapy and wellness. Um because if there is this mountain of data, mountain of research that could be, you know, therapeutic for a whole bunch of different conditions, whether it be stroke, autism, neurodegenerative conditions, um even PTSD or or general wellness for the for, you know, people who don't regard themselves as having an issue. Um there's certain there's certainly a market there. And I I would try I would love to try and facilitate some of those conversations as well.
Professor Nigel Osborne: Please, if you could, I would be delighted. I mean, it would be absolutely wonderful. It's the, you know, it's the moment and it's there. And we've got lots to do. I mean, we can't take our system to the next stage until we have got larger usage, you know, to be able to develop it. So it needs it needs that as a human resource, irrespective of anything else. The chance to to to to develop in that way.
Dr Rupy: And in the meantime, I would definitely direct people to the website where you actually do breath work as well as listening to the music, which I think is brilliant. It's such a great idea. I'm definitely I'm I'm a keen meditator myself and I use breath work, but I I haven't done it to music before. I'm definitely going to entertain that.
Professor Nigel Osborne: Yeah, you don't the great thing is you don't have to count. It does it for you. You know, if you've got a tempo of 60 to a second, okay, there's a second. It's difficult to find the right kind of music because the the optimum breathing, you know, for standard 10 second patterns, you know, which corresponds to, you know, sinus arrhythmias, heart rate variability, may wave, you know, all of those things are happening and can be tracked and entrained by that. But of course, 10 beats in a bar is not normal for music. So so actually you have to look around for the things that that give you that. I mean, but clearly for generations, composers have been intuiting it. And, you know, there's a piece of Bach we use that, Bach must have known because it breathes so well. It's in six beats, but it goes in 10 just in the right way for breathing. Somewhere, either consciously or probably unconsciously, the guy knew, you know, somewhere in his body that this was sounding good and feeling good. And so it really is interesting phenomenon.
Dr Rupy: That's brilliant. Yeah. And I can imagine people listening to this now, undulating to the music in their heads as they think about it. And certainly, you know, I'm going to link to all of these in the show notes. I I just wanted to to end with, we've talked a lot about um musical therapy almost in the sense of of passive reception of music. What about the active role of music? I.e., um singing, uh the the the manifestation of music.
Professor Nigel Osborne: Yes. I mean, we, I mean, most music therapy is active and interactive. Um, I mean, the most common form of music therapy is something we call in in the UK, something we call co-improvisation. We we make up music with people. We find out what they like, what they want to say, and we help them say it basically. And through that, we become, we share the things that music allows us to share, and we're able to lead sometimes to lead people into better places, sometimes accompany them into better places. So, yeah, I mean, there is a that that the active thing which is tremendously important. And singing is is really vital. I mean, um, uh, so, I mean, for example, you know, we're we're we're sitting here, we're probably using 20% of our lung capacity. If we're working hard, maybe 50 or 60. Um, but there are only one or two activities that give 100% and good singing with proper support is the one thing that enables us to actually properly to to exercise our lungs. It's as simple as that. So you couldn't get more basic than that. So yes, active music therapy is tremendously important. And the work I did with traumatized kids, you know, in war zones is very much active and interactive. They are singing, they're playing, absolutely. Um, and the the strength of, you know, trying to make, you know, platforms for listening is that you can get some of that effect by listening, not all of it, but some of it. And so that's worth having. And so that's why we we have we just listen. It's it's people something people can do at home on their own, you know, um, and without needing instruments or people to play with.
Dr Rupy: Brilliant. Brilliant. Well, Nigel, it's been a pleasure to speak to you and um and you know, just trying to invite the listener to a new form of therapy that perhaps they haven't entertained before or, you know, hadn't hadn't understood. I've certainly got a lot more to learn about this and I love the uh the entwinement with um neuroscience. Um it's something that I need to, you know, spend a bit more time on myself. Um just a final question. This is a little bit fun, but can you explain baby shark? Can you explain why why it's become this phenomena across the world in terms of the universality of how many children love this song?
Professor Nigel Osborne: Yes. Well, I think that it's um uh part of it is we're, you know, we can we learn and remember music is also about learning and memory. So actually you get the right promotion machine behind you. And and and I mean the music industry works like that. And there's nothing wrong with that whatsoever. That's great. Um I I just wish they'd do a bit more variety and baby shark's great, but I I I I would wish they'd be a bit more adventurous in what they pump to people, just to give people a little bit. I mean, for a nutritionist, it's a little bit like the music industry is peddling a large number of very sweet desserts with lots of sugar in them to people. And and I want I'd like people, you know, to have their vegetables and and you know, proper I like people to have their vitamins and proteins. And and music is like that. It it does involve a variety of things. We do need a balanced diet in music as well.
Dr Rupy: Definitely. I I hear that absolutely. Nigel, thank you so much. Honestly, it's been a pleasure to speak to you and um and you know, just trying to invite the listener to a new form of therapy that perhaps they haven't entertained before.
