You can also listen and subscribe to the podcast on : Apple | Spotify | Google Podcasts | Anchor
I'm very excited to share with podcast with you because Dr. Behel is a fantastically passionate Musician's Health Researcher. She is such a bright and effect force in making positive changes for musicians - at the institutional, education, and individual level. Her mission on elevating performance medicine for musicians is going to be leading wave of change in this industry!
About Dr. Kensley
Dr. Kensley Behel went from injured musician to musicians' health researcher to help musicians like you have a healthier career. She uses her Ph.D. in Performing Arts Health combined with years of experience coaching others to provide solutions to musicians' injuries like Stress Velopharyngeal Insufficiency, Music Performance Anxiety, and Burnout! She is passionate about sharing her story so that others know they are not alone.
00:00 - Intro
01:42 - Dr. Behel’s Journey
08:42 - Difficulty of playing the Clarinet with Stress Velopharyngeal Insufficiency
10:13 - How Musicians and Health Care Professionals can improve communication 14:01 - Growth Discomfort vs Injury and how to tell it apart
15:31 - On Musculoskeletal Injuries 16:46 - On Implementing Musician Health in Education
18:04 - How the current state of Musician’s Health Education and Support is unsatisfactory
21:00 - Dr. Behel’s Ideal Implementation of Musician Health Prevention and Education 25:39 - Why musicians struggle to receive health care in America
27:16 - Similar mindsets between athletes and musicians (hours of practice and perf. anxiety)
31:46 - How musicians can transform anxious energy to benefit them
34:12 - On Recreating performance/audition experiences to practice performing
36:35 - On “Musician ear plugs don’t work”
42:11 - Solutions for good hearing health cannot end at the individual 44:48 - On Social media to promote Musician’s Health and all her services!
Tue, Nov 22, 2022 3:53PM • 50:04
musicians, clarinet, people, injury, university, students, understand, surgery, muscle, doctor, struggle, performance anxiety, problem, play, hours, air, pay, health, bit, medical
Michelle: Welcome to the sixth episode of the open score conversations Podcast. I'm so excited to be sharing this conversation with Dr. Kinsley Behel with you. Dr. Beal is a super woman, her journey from being an injured clarinetist to becoming a thriving musicians health researcher who's also a consultant, educator, podcaster and journalist. Wow. She has a fiery passion with helping musicians, educators and institutions better understand and establish healthier environments and support systems for musicians. In this episode, Dr. Beal provides many insights and tools for helping musicians and doctors communicate better. She also addresses how post secondary education can better support their musicians, and also some parallels in mindset between gymnasts and musicians. There's so much in this podcast that you are going to love all the tips and resources that she has to provide for all of us musicians. Thank you so much, Dr. Kensley, Behel for joining me on this chat. I'm really, really excited. Because the route that you have taken with your career in your life was one possible route that I also wanted to go for. So it's just so nice to see that the performance arts and medicine community starting to come in on Instagram and on socials. And it's like the community I would have wanted to dream about when I was back in university, and also injured and I like having no resources. So thank you so much for the work that you're doing.
Dr. Behel: Yeah, thank you so much for having me. I'm so excited to share my story, and hopefully some resources for other musicians who may be struggling with injuries or teachers who may have students who are struggling and don't really know where to turn.
Michelle: Yeah, I want to wonder if it's okay with you, we start off a little bit more on the vulnerable side. Because one of the biggest things I think our classical music community and musician community needs is just being open with our story about being injured. Because it was at least back in my day was a little bit on the bit of the taboo side. But there's so much research out there like the one in 1980 with one of the biggest ones for the orchestral musicians, 82% of them were injured 76 I think it was like, it's kind of debilitating for their work. So we're not alone. But then not a lot of people are talking about this. So I share my story about how I was injured back in university a lot when I'm like also on podcast, would it be okay, if you can share your story, going through all the surgeries that you've had in your path and how you came into performance medicine?
Dr. Behel: Yeah, absolutely. And I love the idea of being vulnerable. And I think that that's a key part of like my business and my research, because in my presentations that I give I you know, I give the big statistics that 98% struggle with performance anxiety and the 82% have musculoskeletal problems. And musicians are four times more at risk of developing hearing problems. And then I follow it up by saying it's really easy to hear these statistics, even the 98% struggle with performance anxiety, and still feel alone and still feel like well, no one experiences it like me, or no one understands what I'm going through. And so I actually do an anonymous exercise with people so that they're able to see like in their own community who is struggling, so that they don't have to really reveal themselves if they don't want to, but they still understand that people in their community also are struggling so so where it sort of started for me was I go back to my solo debut when I was 18 with the Jacksonville symphony orchestra, and I just I so vividly remember standing on the stage thinking like, this is what I'm going to do with the rest of my life. Like I'm going to be a professional clarinetist. And I'm going to my my goal was to get Principal Clarinet and the Atlanta Symphony Orchestra, like I wanted to be Bora like that was my that was my goal. And I went to Florida State University. And college was obviously more demanding than my high school, you know, goals and curriculum. And so I was practicing more. And I started developing this nasal air leak and it's called stress Vila pharyngeal insufficiency and which is just kind of an obnoxiously long group of words. That means that my soft palate didn't function properly. And my teachers were immensely supportive. But they also said, you know, we don't really know exactly what this is, and but you have to get it fixed because this is going to derail your career. And there's a lot of literature in the field that says people who struggle with sppi, stressful pharyngeal insufficiency are embarrassed or that they won't win auditions because the nasal air leak is so distracting. So I think my clarinet professors were quite wise and saying, Hey, you have to get this fix because your career may not be able to move along as quickly as you would want it to. The problem is, it took me two years to get a diagnosis and I Alito, a lot of it to my mom who spent hours and hours on Google Googling, like, nasal air leak and air leaking out of your nose while playing the clarinet until she sort of hit the right, you know, algorithm. And we were able to find a doctor to do some scans. And so I had to have scopes and scans, which were not the most fun thing I've ever been through in my life. And they found that I actually had an anatomical problem. So something that I had had from birth, that can develop as cleft palate, so where you're missing part of your lip, but for me, it was inside of my mouth. And it didn't affect my daily life. But it didn't affect me when I was playing clarinet, because when you're playing a wind instrument, the internal pressure can be up to 30 times greater than that of normal speech. So when I was working on really hard articulated passages, like Mendelssohn, which was the death of me, you know, like the air would come rushing out of my nose. And so I ended up going through surgery, and at the time, there were less than 20 case studies of people having to have surgery for this. And the doctor was like, Well, I don't really know if this is going to work. I, you know, do the surgery for children. I don't know if you're going to be able to return to play. And so I was really stuck at this crossroads between, okay, do I get the surgery, and maybe be able to return to playing or do I not get the surgery, and my teachers are telling me, Hey, I'm probably not going to be able to move, like, into a prominent role that I would want
Michelle: seems like a lose lose situation
Dr. Behel: It was terrifying.I mean, at 20. Like, I was terrified, but I also felt like it was the right thing to do. And as we like, go through my story very much was the right thing to sort of change the trajectory of my life. So I went through the surgery, and then I came out of surgery with a British accent. And this is the thing that was the key factor in changing my life. Because it wasn't a neurological problem, it was that there was so much scar tissue on the inside of my mouth that I couldn't produce what's called a post Vocalic R, which is an R following a vowel. So if you have the word jarred j, A R, A is the vowel so that our so I sounded British, which was kind of cool for a little time. Until people like keep asking you where you are from, and you're like, I cannot explain the story one more time. So I had to go through speech therapy to recollect it. So I sound like an American again. And that process is what opened me up to the world of performing arts, health, and performing arts, medicine, medicine, and really was the it was the key point that changed from being like, I'm not sure I want to do clarinet full time anymore, too. I think I want to help other musicians have easier access to good resources and how to prevent injuries in the first place.
Michelle: Wow, that is a crazy story.
Dr. Behel: And just Yeah, crazy, because for me, when I had my injury, it was mainly like tendinitis, maybe some Thoracic Outlet Syndrome, because you know, how everything's all connected, but to have to go through the surgeries and really, like, decide on what you want to do with your life, but also not sure what the risk was our must have been really stressful too. So props to your mom for helping you out because my mom did the same thing. You know, while I was trying to practice she'd be googling.
Michelle:Yeah, moms are heroes. They definitely are. I'm not a clarinetist myself. And maybe some of the listeners are also not clarinetist. So I was wondering if you can go into a little bit more deeply about how what a struggle it would be to play clarinet, but lose half your air. And, and some of the difficulties that come along with that. Sure.
Dr. Behel: So I mean, air is the, the key foundation to everything about being being a wind player. And if you're using your air properly, you can have beautiful tone and articulate more efficiently and, you know, a myriad of other things. So when you're losing part of your air, well, you can't articulate for me particularly it was articulation. I just couldn't articulate as quickly as I needed to, to win jobs. And then the other thing is actually having error and that pressure come out your nose, for me was particularly painful. So and then you deal with the other aspect of it being distracting. So several of the woodwind musicians that I've worked with who have sppi talked about in their recital, they actually got distracted because the air took them out of their zone. So I think there are sort of several different aspects of having this air leak that cause problems for windmusicians.
Michelle: Yeah, makes a lot of sense. And the fact that it's painful is also something that needs to be addressed. And I'm wondering, because also with my journey, is there a vocabulary that can be built between musicians and medical healthcare professionals that can kind of bridge the gap and making communication easier for both of us to work together? Because back when I had my injury to that, that was a little bit of a gap. And it made it difficult for both of us to really come to an empathetic conclusion as to how to move forward.
Dr. Behel: Absolutely. So one of the things that the physicians that I work with more closely now talk about is there's sort of a problem on both sides. So one, a lot of medical provider providers who don't understand what the musician practice schedule and performance schedule is like, and that a lot of people are freelancers. And they cannot just take a break. And the doctor saying, Well, you just have to rest and they're like, but I need to eat as well. What are they? What else do you have for me? So the medical side needs to be a little bit more informed about what our job entails and be creative and finding solutions to help us continue to play and heal at the same time, if at all possible. And then on the musician side, I think things that will help expedite that process is understanding that a musician's injury is often multifactorial. And there's a model for this, that's called the bio psychosocial model. And it's one that I teach a lot. Which says that there are biological factors like age and gender, that play into our injuries. So we know that, for example, women tend to struggle more with injuries. And I'll talk a little bit more about that in a second. And then there's the psychological factor, which is like trauma and beliefs and anxiety. And then there's the social factors, how does our culture impacting our ability to get help, and you talked at the top of the podcast about stigmas. And so that's, you know, a social and cultural aspect that could affect us getting help. One for clarinet as specifically is the use of neck straps. So the second most prominent place for clarinet is to get injuries as in their right hand and wrist area. Well, that's because the clarinet sits here. So it makes a lot of sense, it's a constant point of contact. We also know that neck straps alleviate the amount of force on the right hand and wrist. But a lot of clarinetist or band directors will tell students Oh, well, that's not cool, or clarinet, I just don't need it. That's when b, which is totally incorrect, I do not hold to this belief at all, you should you'll listen to that people. So that's an example of a social factor. So I think when musicians are able to understand all of the aspects that come into play with their injury, and they can explain that concisely to the medical professional, it will help expedite the process because in the US, you make it maybe 15 minutes with a medical provider. They don't have the time to go through, like all the different aspects. So if you're able to say, Hey, I'm a clarinetist, and I also work in an office job, which means I'm utilizing the same muscles on the on the computer that I am while playing the clarinet. I think that this is a contributing factor. What can I do? Okay, well, that just gave them a lot more information a lot more quickly, you know?
Michelle:Yeah, I think it's really important for musicians be able to tell the judges physicians, like what their lifestyle is, like, how important it is. And also how did like describe their pain? Sometimes when I'm talking to other musicians, and they're telling me like, oh, you know, this part hurts, my arm hurts. And so often ask them like, well, what does it feel like? Why otherwise, if you just say, Oh, it hurts like we there's nothing much we can do. So what are some vocab that musicians can have to describe pain? So they can also recognize it for themselves and also be able to tell if it's like, is it just growth discomfort, or is it actually an injury?
Dr. Behel: Yeah, I love the wording that you just used it's, it's one that I I utilize all the time. So is it growth, discomfort, or is it pain so growth, discomfort might be something like tiredness, fatigue, soreness, I talk a lot about professional athletes, or maybe a musician, if you've gone to the gym and you've worked on a muscle group that you're not used to you may be sore, or maybe your muscle gets tired. Well, that means you should stop for the day. That doesn't necessarily mean that you need to go see medical go seek medical help, right? Versus if you're having, stabbing, shooting, numbness, tingling, these are signs that there is something actively wrong, you need to stop and you need to go seek medical care. And it may be something that's really easily fixable, like maybe you have a muscle that's compressing a nerve, and you just need some massage therapy to help or some, maybe some dry needling to retrain that muscle. So it's not going to compress that nerve. And if you catch it early enough, then you're not going to have to have a really severe intervention. And so I agree that understanding those vocabulary words, and what that actually indicates is going on in your body will also go a long way for prevention, and Musician's Health.
Michelle: Yes, definitely. And I love how we're starting to kind of creep in a little bit to kind of education, because I know that you do a lot of consulting, a lot of coaching in implementing, I guess programs into universities on how to educate not only musicians, but educators and and everybody involved on injury prevention. So can you talk a little bit about that, and also maybe into musculoskeletal injuries as to what that is, and then maybe use that as a jumping off platform?
Dr. Behel: Absolutely. So musculoskeletal injuries would be anything in the like muscle, bone, tendon, any part of that aspect of our bodies, the physical body, that is not functioning the way it should. And that can be for many, many different reasons. I actually went to a seminar at the performing arts Medical Association conference earlier this year, and the doctor was talking about how the majority of musicians come into her with hand pain, and they say I have carpal tunnel. And most of the time, they don't actually have carpal tunnel, it's something else that's going on. And so the performing arts Medical Association and the National Association of Schools of Music, which is the accrediting body for Schools of Music in the United States, that's Oh, sorry, that was, that's a mouthful. They sort of came together and created these standards for that musicians needed to understand more about their health to be informed about musculoskeletal hearing, vocal health and injury prevention. And I wish that they actually listed mental health and that list, it says like, it's not limited to these. So I would say mental health is like loosely included, if you understand that, but I wish that they actually spelled that out. But they are very unspecific, and how this information has to be disseminated or shared with the students, faculty and staff in the program. And so what has happened is you have some universities on the far end of the spectrum who have medical professionals on site, and they have classes and trainings and yoga and all of this wonderful information. Although it's still not getting to all of the students, faculty, and staff, it's kind of those who are just interested in it. And then you have this way of our end of the spectrum unfair, which is like they post a PDF on their website, and call it a day. And I think it's really interesting. And I'd love to have a conversation with people at the accrediting body someday about, well, if music if you think music theory is really critical to the development of a musician, and you require them to take four semesters of music theory, and it still doesn't stick with a lot of people. And I can tell you, it doesn't stick. Because when people go for their masters, they have to take an entrance exam on music theory, and a lot of people fail it, I am included in that list. So if you have to go through, you know, all of those trainings, and people still need more time to understand the basics, then why is it acceptable for people to post a PDF about musicians health? What like why do we not have mandated training? And why do we not have people with PhDs in every school teaching, all the faculty, all the students, all the staffs, that just the basics, the vocabulary, how to know what's wrong, How to Find help at your university. And so this is sort of where I come in, because as you mentioned, I do a lot of consulting with universities and I have consulted with the National Institutes of Health through the national networks of library medicine, I have a training coming up with them on hearing health. And I sort of feel like this has been left to the individual teachers right to take this on and say, Oh, my student has an injury, I need to figure out what's going on. Teachers don't have time, they do not have any more time to do this. They are not getting paid more to do this. And so I have a couple of different options depending on the school's budget where they can pay me to come in and consult or they can pay me to come in and do one lecture. or I have an option where the students get a really, really severely discounted rate to get access to this information as the cost of an etude book. And then you can the teachers can implement this musicians health information into their existing studio or into their classrooms. So they don't actually have to do any more work, they actually get more time back, because they don't have to plan for classes. This is sort of where we are in the musicians held academic community is there are a few of us who are consulting and are helping but I, I dream of an envision a world where the the institutions themselves are actually taking this material and going even further and producing research.
Michelle: Yeah, I think it's so important that there are these courses or just everyone being educated to a higher degree on this injury prevention. And I like to kind of go in a little bit more deeply on your dream of like having this implemented in the academic setting. In your ideal world, if it was fully flourished, what would that look like for you?
Dr. Behel: So I want to jump back a little bit into my gymnastics career to tell you how and why I envision this in music. So when I was at the University of Michigan, I was washing dishes, and I actually sliced my finger open and wasn't able to play for the first semester. And so I was like looking for other jobs. And there was this Olympian I really wanted to meet. And I thought, well, the best way to beat him is to volunteer for their team. And so I went to volunteer for their team. And they were like, well, we don't have any volunteer positions open, but we have a paid position. So I, you know, through this long series of events, like ended up working with the men's gymnastics team, and then volunteering with USA Gymnastics, and then going and covering World and Olympic level gymnastics all over the world. But when I was working with the team, I was like these, they have access to dry needling. And they have doctors on speed dial, and they have nutritionist and they have psychologist. And they have injury prevention and massaged, weekly massages. Men's gymnastics loses money for the University of Michigan and basically every university men's gymnastics loses University. Meanwhile, our music department was over here, putting on sold out full fledged, you know, opera productions and musical theater productions and Symphony concerts. And we had like a yoga class that we could pay to take now to University of Michigan's credit, I will say they have done significantly more since I since I left and they do have a physical therapist for musicians now. So like they they're doing wonderfully but but they're still behind, like the access is given to musicians is still significantly behind the medical access and resources given to athletes who are losing money for the university. And so this really got my brain thinking about, Okay, well, how do we implement this. And so I'm going to give a simplified version, and there's a lot more hoops to jump through. And I understand that. But the sort of the basic idea that I have is, if you take a university like Florida State University that has 1000 music students, and you do a fee that has, it's a $50 fee for every student, or $100, or even $200 student fees, like have you looked at how much money university students spend on fees on things that they never use, okay? And explain to them, okay, here's how insurance works. Here's how much the deductible is, your deductible is probably somewhere between like two and $5,000. But, and you'll probably spend like $200 on a physical therapy appointment or a doctor appointment each time you go. So if you have this one time fee, and we're able to have an in house physical therapist and an in house physician for you, it will actually save you money. And so if you can explain it in those terms, and you can have someone on site, then I think we'll start to see a lot more progress. Another way I think this could happen is having athletic training requirements be that you have to spend a semester with marching band. So right athletic training students, they have to spend semesters with different teams to get their hours under their belt. Well, marching band is a sport. I don't care what anyone says it's absolutely a sport and they have injuries too. And so I would love to see as part of like the credentialing program for athletics. trainers, that marching band could be included in their in their hours. And so the new they're getting hands on experience with performing artists and the performing artists are getting. Like, I don't know, how would you say it like getting better access to medical care in a way that's maybe D stigmatized?
Michelle: Yeah, I totally agree with you on how much support people in sports have in terms of the medical, like, you know, the backing, to just make sure that they're healthy, and musicians or athletes to have that little small muscles. And we're kind of uneducated about this, we don't get a chance to speak about it, and then we don't get the support. So you wonder why all of us are basically injured in some way, shape, or form.
Dr. Behel: Yeah, and with the US medical system, unless you have a family who's really well off, or unless you are extraordinarily poor, and are able to be on state funding, where the state book covers, and the state funding really only covers very, very basic things. So that even a lot of times doesn't even cover all the care that you need. But most musicians are in neither camp, like they kind of make just enough money to not be in state funding, and they're definitely not rich. So they're working with the insurance company, and they don't have the ability to pay. And you know, our Un t the university I got my PhD from they used to have free access to the medical doctors on our campus for musicians. And then I think it went up to like $25 for each session, and they were like, Oh, well, it's not that much money. And my colleague was like, well, but if they're in a minimum wage job, that's three and a half hours of work, that they have to work to get one session, well, not much can be fixed in one session. So like, think about the, you have to think about it in those terms of maybe $25 Doesn't sound like a lot to some people. But if you're a student working a minimum wage job, that's a lot of time. And so you're weighing like the risk benefit, reward thing.
Michelle: And it might even be that after you work three hours at that job, and you're gonna get that session, it gets undone as you try to work three hours. session again.
Dr. Behel: Absolutely, absolutely.
Michelle: Yeah, there you go. One thing that I'm also really interested in is like the parallels between an athlete's mind and a musician's mind in terms of like how we look at practice, how we look at injury, how we're tuning into our body. So as someone who has close contact with gymnastics, and was also a musician, and is also working musicians. So what are some parallels that you have seen between athletes and musicians?
Dr. Behel: I think one of the most common ones is that there's a belief and working longer, not smarter. I just I remember being in school, and people would be like, Well, I'm practicing four hours a day, and the next person will be like, Well, I'm practicing six hours a day. And there's, so I work almost exclusively with gymnasts. And we have a lot of the same problems where young athletes are working 40 hours a week. And then an athlete named Shawn Johnson, she's an Olympic gold medalist from 2008 came along and she was working out like 20 hours a week, and she was winning the World Championships now, like leading up right into the Olympics, she did increase her hours. And we see similar things with Simone Biles. The last I had heard is she was not in the gym 40 hours a week, and was having a social life and enjoying other parts of life. And so there are these athletes who are creeping in who are saying, you know, you don't have to do it this way. And you can work more effectively. And in college gymnastics, it's college athletes are capped at the amount of hours that they're allowed to work out, I think it's around 20 hours. And they're still performing at really high levels. And so I wonder if we sort of brought this idea to music, that was like, teaching people that you don't have to brag about how little sleep you got. And you don't have to brag about how many hours that you're working like, just work efficiently for you. And that will look a little bit different person to person. But maybe, yeah, working more efficiently. So I think that's one of the most common mindsets. Other ones would be a performance anxiety, for sure. And this brings me to one of my favorite topics, which is the difference between anxiety and arousal. So there are some theories that describe performance anxiety as being either facilitative or rehabilitative so either helpful or not helpful. But there isn't more On the emerging idea that because in the diagnostic, the DSM five, anxiety is only a negative thing, like anxiety is a rehabilitative disorder. So you can't have a debilitating disorder be facilitative. Like, that doesn't make sense. And so there's this idea of using different terminology and which that energy before performance. So if it's debilitated, it's anxiety, if it's helpful, or facilitative, it's arousal. And so one of the examples I like to use is in gymnastics, because you know, that's, that's my art world. So like, if you're on the balance beam, right? If you're on a 10 centimeter balanced beam, and you have these nerves, or this energy, it's probably not very helpful, and it would be debilitating. If you move over to vault, though having more energy can be turned into more power, which can equal more height and more distance, and then therefore a better score. And the same thing is true for musicians have it has anyone listening or have you specifically had a really technical piece and you had this energy beforehand, and maybe leading up in the practice session that you've actually never been able to play it up to tempo, but you get to that performance, and you have that extra rush rush of energy, and it helps you actually play it better?
Michelle: Yes, more times that I'd like to admit.
Dr. Behel: Hahaha! So that would be like facilitative arousal. And I think that athletes are given that vocabulary more often than musicians are given that vocabulary of, hey, actually, this energy doesn't have to be bad, because we're conditioned to be like, at the age of four, they're like, are you nervous? Are you nervous? Are you nervous? And so that like that, like gets in your brain?
Michelle: It does. Is there a way for musicians to be able to maybe tell when their body’s a little bit like the butterflies, and then be able to get in a mindset where it's like, okay, this might be anxiety is starting to like, funnel me down? Is there a way that we can go, oh, how can I use this to my advantage and have it become an arousal and help them perform better?
Dr. Behel: Yeah, so one of the tools that I think is most effective is visualization. So examples, and I'm so glad you asked this question, because so often we think of performance anxiety as like maybe the shaking or the butterfly in the stomach. But it can be so many other factors, it can be negative thoughts ahead of time, like I'm going to fail, it can be having an upset stomach, like maybe you're running to the toilet, you know, right beforehand, that actually is a symptom of maybe performance, anxiety, having sweaty palms are sweating, or increased heart rate, any of these things can be symptoms of performance anxiety, so it doesn't have to look the same for everyone. But I think that it's really critical to understand that you your, your brain is really powerful. And it's also simultaneously very susceptible. So you can tell your brain and and work through trainings to, to reframe those negative thoughts is, I am excited to perform, I am going to do positive things. And there are different tools you can use, like tapping you can there's like pressure points in the body. And you can say, you know, I am going to perform well, I'm going to end under the eyes and on the shoulders and the collarbones. And you can repeat that. If you've had really debilitating negative experiences, you can use a tool called EMDR. I think it's high movement, rapid desensitization is I think what it stands for, and that is a really powerful tool to help people retrain. So maybe if you were really young, and you went to the bathroom on stage, or you know, if you had a huge memory slip, and that has just stayed with you, and you need to overcome it to move forward. EMDR can be a really good tool to help you do that.
Oh, thank you for sharing all this, because I'm sure that there are some musicians out there who can recognize like, Oh, I'm anxious, or I'm not, but like, I don't know what to do afterwards. You know, like, I feel this way now what and then just go on stage like hoping for the best. So thank you for sharing that.
Michelle: Yeah, there's, um, there's one more tool that I think is really cool. And I'm gonna throw this idea out for because I'm sure there's like an engineer out there listening who can do something like this. But the Royal College of Music in London has this really cool system that they pre recorded? Why of people acting in different manners as an audience so they can clap and they can cheer and they can boo and they can have cell phones go off and cough and sneeze and all these different things. And then there's a three person panel and they can not along like things are going well, or they can say oh, you You know, don't call us we'll call you and write. And so they have this whole backstage area set up, and they have someone like running this, this program, which I think has to be like the most fun job in the world, like, I would love to be the person who runs that one day. And so people can practice integrating these techniques in a backstage area. And having a performance setting without it being maybe a performance setting that is more critical, like an audition that they really want to win. So they have they have a practice opportunity. But I think that this simulation can be reproduced and should be implemented in every, like College of Music and every studio, that there is. So if someone has that sort of training to do a simulation, I think that I think that that would be a really powerful tool for musicians,
Dr. Behel: I think so too much value, because part of performing you know, you have to practice being in that kind of performance state. And right now I feel anyways, our only disposal towards that is actually doing that performance, that audition. And you can say like, oh, you know, you can perform for friends, or you can record yourself, it like kind of gets you close to it. But it's not enough to really be able to handle it the real deal. So having some a simulation like that, I believe it's going to be so helpful.
Michelle: Yeah, yeah.
Dr. Behel: One thing I would also like to talk about and just kind of a little bit of a detour is when I was in university, we were talking a little bit about hearing health and how to prevent that any any hearing loss. And so we had like musician, customizable, like, you don't have to go into a doctor get all modes, modes, and you get the different like decibel degradation that you can get. But I remember seeing on a post that you had on social media, or was on your website, where I said, like, musician earplugs don't work. And I was like, Oh, this is really interesting. So can you go into that?
Michelle: Yeah, I think, you know, saying musician earplugs don't work.
Dr. Behel: It's a little click-baity, but it is actually. Okay, there's there's a lot of different facets to this. So we know that musicians are four times more likely to experience hearing loss than the normal population, and are 50% 57% more likely to have tinnitus, or the ringing ringing in the ear. And there are some very famous musicians who have talked about this like Barbra Streisand. Well, I am the rapper, and many others. And so to combat this, people were like, oh, we should just like shove things in our ears. And like, obviously, this will help. So on the most basic level earplugs do reduce most earplugs, reduce decibel levels. I'll give a caveat. And we'll talk about that in a second. However, they don't actually usually reduce the decibel levels at an at the even amount that they claim to across the board. So a lot of the earplugs claim like oh, you know, you'll get the same sound quality. But it'll just be, you know, reduced five decibels or 10, or 20, or whatever they claim. Well, okay, so musicians bought this, and they were like, I don't know about this, I don't think this is actually true. And you know, other things that they found where maybe the earplugs were uncomfortable, or it was really annoying, because you have to constantly take them in and out specifically if you're in a chamber setting, because maybe your chamber partner is telling you like, Hey, we're not blended, or can you play this with more emotion, or whatever. But you have to take the earplugs out to actually hear that. And so a lot of musicians don't actually want to use them. So then, so that's one issue. So then you have these customizable earplugs that you're talking about. And these actually can be done really well. But you have to go to someone who knows how to work with musicians. Now, for you as a pianist, this isn't actually such a big issue because you're not moving your jaw very much yours is I would say most of the time and a pretty stable position. Would you say that's correct?
Michelle: Yeah that's correct. Like I'm not a vocalist that really needs to work on their jaw movements.
Dr. Behel: Right. So customizable earplugs fit your eardrums, but the thing is your eardrum shape sort of moves with your jaw. So if you're a vocalist or if you're a woodwind player, that can actually be really painful. Now there are some audiologist who do this correctly, which is they have you move your jaw around wallets forming. So the the ear plug is able to work a little bit better for those type of musicians. So that is just one thing to keep in mind. And then we have this other type of ear plug And I will be careful about saying what it is. There is a musician's earplug that claims to reduce decibel levels 20 per 20 decibels evenly. And there was research done and a lab in Texas that says that the decibel levels actually increase no low at low frequencies when wearing this ear plug. And what happened was was this earplug used a testing protocol called the React testing protocol. And it tested seven, like frequencies. Well, music has a lot more than seven frequencies. And it also didn't test low frequencies, which Hello, like, we have a lot of musicians who play instruments and low frequencies. So you would think that this is maybe important. And so their testing protocol was inadequate for them to be able to claim that a test 20 You know, lowers at 20 decibels across all frequencies. My colleague, Megan Taylor, who is just wonderful, it came up with this idea that I think is like sort of the perfect analogy, especially for you have any listeners you have that are pianos, and she said, It's like they had a piano tuner, come in, and tune seven notes on the piano, and then just leave and be like, okay, the piano is in tune. And I thought-
Michele It’s really it's a brilliant analogy!
Dr. Behel: Yeah. So all of this to say, musician, like wearing earplugs, especially, maybe in settings where you're at a concert, like listening, like maybe a rock concert, or something of that nature is still important. But be aware and know the research that shows that it's not necessarily going to lower decibel levels equally, like some of these specialized earplugs claim, it doesn't mean that using some form of hearing protection isn't important. Does that make sense?
Michelle: Yes, it does. In the grand again, it's pretty nice in the grand scheme of things, you know, you have to do your due diligence and be like, you know, put some research into it, see how true it is. And I'm hoping we can get better and better technology in the future that will help us as musicians.
Dr. Behel: Yeah, and I, you know, this idea that the solution should be well, just wearing earplugs, I think is completely inadequate. And there are other factors. So there's a paper that describes, like, band directors as risk regulators. And I think it's a really interesting concept, because if the band director isn't aware, it could be really easy to get the ensemble to get louder and louder and louder and louder without actually and utilizing the, like softer dynamics. And so I think that that's a really interesting thing. So maybe also, the band director could be responsible for programming. So maybe you don't want to have like 1812 Overture and a John Mackey piece, like on the same concert, because, like, maybe we need to give our ears a break. So I think that's a really interesting concept. Another one could be that musicians themselves take some ownership. So think about an athlete. So if an athlete is going to have run a marathon, they're probably not going to do a large warm up in the days leading, like a large workout in the days leading up or even the morning of. So think about that for musicians. So if you know you have a long day of rehearsals, so maybe have the self control to not be listening to music or listening to podcast on your, in your earbuds at a height at a high volume and give your ears a rest, so that the decibel levels that you have for the day aren't expended too early. So I think that there's you know, things from all different aspects that we can work on. So we need better earplugs for manufacturers. We need band directors to be and choir directors and orchestra directors to be more aware of their their impact. And then we also need the musicians themselves to think critically to say, Okay, well what is my responsibility for my own hearing health and what can I personally do to limit myself to exposure throughout the day?
Michelle: Yes, I totally agree with you in that. At the end of the day, there isn't one solution, but everybody needs to basically level up on the whole health aspect. And the faster that can come would be amazing. Yeah, absolutely. So before we close off, I do want to have the listeners know and also before the sun starts to really get into you eyes-
Dr. Behel: I know I live in Colorado, so the sun is very vibrant here.
Michelle: So before that total It blinds you. I want to let listeners know that you also have a social media you have the musicians health lab. So can you explain what you do there and your experience on spreading more of this awareness to others through social media?
Dr. Behel: Yeah, absolutely. So I finished my PhD and performing arts health. I am also a certified hearing conservationist. And so I have just taken all of the tools that I have at my disposal to make my tagline is research made simple, because I think one of the biggest barriers for musicians is the academic jargon or maybe not having if you're not a university student, you basically don't have access to even read the research, like you have to pay between, like 30 and $100, for one article. And so I have compiled this research into an easy to understand deliverable format. So of course, I have free options on my Instagram, which is at Kinsley Beale. And I'm sure it'll be like linked in the show notes. And then I have a free downloadable PDF on music, performance, anxiety and understanding why it happens. And things that you can do to help alleviate music, performance, anxiety. So those are the three things that I offer. And then I have a training program called the Musician's Health lab. And it is a year long program where you get access to classes on musculoskeletal vocal hearing and psychological health as well as injury prevention and a whole bunch of other things, including burnout. And then you get bi weekly, out to two times a month meetings with me to ask questions, especially if you're you're having you're experiencing a problem or your student is experiencing a problem, and you need just more direct access. So I have that. And then I have consulting, the consulting part of my business, which I go to universities, and I help them understand what they can be doing better. And then finally, I have an access for, for university for university students, because I think that funds shouldn't be a barrier to getting this information. So the way that works is an educator or a studio Professor contacts me and says, Hey, I want to add this into my syllabus. And then I send them a payment link, and it's $22, a student. Wow. So it's the cost of an etude book, and you can implement this in your classroom. All of the videos are pre recorded, I have all of the deliverables done. So there's exercises, discussion, questions, everything. And then this meets the NASM standard, it covers all of those basics. And then the students gets the information like given to them and in an easy to understand way so that they know how to prevent injuries and understand some of those symptoms that happen if they are experiencing an injury.
Michelle: Wow, tons and tons of resources. Thank you so much for providing that so we know we can find you on Instagram, you also have your website. Is there other places that other people can contact you or do you have any upcoming projects that we should be on the lookout for?
Dr. Behel: Yeah, yes, I am. Also you my email is kenzley at musicians health lab.com. If you really care about gymnastics, I have a Twitter that's Kinsley and but it's like all like it will bomb your Twitter feed. Everything to do with gymnastics. So if that's your interest, you can find me there. Upcoming projects Guess I'm really excited about I have a couple more podcast interviews coming out specifically on musicians burnout, because that's what my dissertation was on. And then next week, I have a free seminar on musicians hearing health, but the National Institute of Health that will be recorded on YouTube that you can find, I have a couple other universities that have reached out to help me help me design curriculum and come speak at their university. So just it's just sort of a wonderful time of life where I'm actually getting to help musicians understand about musicians, musicians health, and which is my dream. So I'm so happy. So if anyone has any questions, you can find me like you said on my email, you can find me on my contact form. I'm happy to help in any way I can.
Michelle: And I'll definitely put those down in the description in the show notes as well. So they'll all be there for everybody who's interested in just getting educated oral, so needs help. Definitely find Dr. Kinsley, thank you so much for your time. We touched through so many things you and I would love to dive deeper in the future. So if you ever have time, I would love to have you back.
Dr. Behel: Yes, I would love to come back. Thank you so much for having me.
Michelle: You're welcome and pleasure having you and I wish you the best on your upcoming soundcheck too.
Dr Behel: Thank you
Happy Listening! Michelle
Make sure you never miss a new blog post!
Sign up here to receive notifications for all new posts!