Date of Award

January 2019

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Joy Hirsch

Second Advisor

David Sells


Drumming is an ancient nonverbal communication modality for expression of emotion. However, there has been limited exploration of its possible applications in clinical settings. Further, the underlying neural systems engaged during live communication with drumming have not been identified. We investigated the neural response to live, natural communication of emotion via drumming using a novel dual-brain neuroimaging paradigm to discover its unique neurophysiological mechanisms related to drum behavior and cross-brain coherence, and as compared to talking. We then investigated the application of a drumming intervention in an incarcerated, halfway house population to characterize intervention feasibility, elucidate the phenomenology of social and emotional effects of group drumming, and identify its possible benefits for treatment engagement and community reintegration. For neural response investigation, hemodynamic signals were acquired using whole-head functional near infrared spectroscopy. Dyads of 36 subjects participated in two conditions, drumming and talking, alternating between “sending” (drumming or talking to partner) and “receiving” (listening to partner) in response to emotionally salient images from the International Affective Picture System. Results indicated that increased frequency and amplitude of drum strikes was behaviorally correlated with higher arousal and lower valence measures, and neurally correlated with temporoparietal junction (TPJ) activation in the listener. Contrast comparisons of drumming greater than talking also revealed neural activity in right TPJ. For the interventional investigation, a group drumming program was implemented once a week for eight weeks for incarcerated participants in a halfway house. Twenty-eight participants were randomized to either the drum group or treatment as usual. Interviews and a focus group were conducted to assess the experienced benefits of the group drumming intervention, and halfway house retention rates were compared across groups. Retention rate was significantly higher in the drum group than in the treatment as usual group. Qualitative analysis elicited three themes: group drumming 1) functions therapeutically as a method of coping with difficulty, 2) offers opportunity for connection through building relationship and experiencing communion in a setting where isolation is the norm, and 3) provides an environment for personal growth, particularly toward re-humanization and self-empowerment. Neural findings suggest that emotional content communicated by drumming engages right TPJ mechanisms in an emotionally and behaviorally sensitive fashion; interventional findings suggest significant therapeutic potential in social and emotional domains that can have quantifiable impact on recovery process. Together, findings suggest that drumming may provide access to neural mechanisms with known sensitivity to social and emotional conditions that facilitates therapeutic aims. Informed by this research, drumming may provide novel, effective clinical approaches for treating social-emotional psychopathology.


This thesis is restricted to Yale network users only. It will be made publicly available on 07/15/2021