Description of Intervention

As people start feeling more empowered in how to treat what medical conditions they experience, many have started looking to non-traditional or complementary and alternative medicine (CAM).  Some studies show that 34%-94% of the United States population have tried CAMs for various conditions for treatment and/or prevention (Runfola et al, 2006).  Yoga and meditation are among two of the most popular and fastest growing methods of CAM.  Yoga saw a 5% increase of use and meditation saw a 10% increase from 2012 to 2017 (Clarke et al, 2018).  Tibetan Singing Bowls are a fantastic, versatile tool that draws from both of those practices as well as music therapy. 

There are various applications for the use of then Singing Bowl or Dhwani Patra; healing, treatment, purifying space and mediation, among others (Subedi, 2016).  Most all applications involve striking the side of the bowls with a fist or a leather-wrapped or wooden mallet.  Depending on the application, there are single or multiple bowls used and the positioning of the bowls can also differ.  If you are using the seven-bowl set, each bowl is musically tuned to coincide with the seven chakras; low F with the Root chakra, C with the Sacral chakra, G with the Solar Plexus chakra, D with the Heart chakra, A with the Throat chakra, E with the Third Eye chakra, and B with the Crown chakra.  Each of these chakras effect different energy forces including Will, Vital Energy, Emotion and Desire, Life Forces, Creative Energy, Intuition, and Spiritual (Subedi, 2016).  The placement of the bowls is also important.  Each bowl is placed near or on top of the correlating chakra.  If the bowls are used singularly, the bowl is placed near the area to be addressed.  For example, if the individual wants to use the bowls for sinuses, the bowl would be struck and placed near the sinuses and held there until the vibrations and sounds complete, then withdrawn from the individual and stuck again, this time placed on the other side of the individual.  This process is repeated until all areas of the individual are addressed (Subedi, 2016). 

Singing Bowls can also be utilized in meditation.  One breathing exercise involves the use of two bowls.  This is best performed with bowls differ in size and tone.  The goal is to focus on being present.  As one bowl is struck, the individual should breathe in and as the other bowl is struck they are then to exhale.  Gradually, the length between strikes increases, allowing the individual to gain deeper relaxation and become more centered (Subedi, 2016). 

Historical and Cultural Origins

While the origin of Tibetan Singing bowls is vague, the western use became popular in the 1970's when more eastern philosophies were studied and applied for alternatives to traditional western medicine.  As Jon Kabat-Zinn and Mindfulness-Based Stress Reduction (MBSR) became more accessible, so did the use of Singing Bowls. 

Philosophical and Theoretical Foundations  

Singing Bowls are often associated with other forms of sound healing and meditation.  There is extensive evidence that chronic stress and disease impact the mind as well as the body (Trivedi and Saboo, 2019).  There is also evidence that confirms the positive impact of sound vibrations on physical and emotional health.  Sound healing takes a medley of different sounds without any particular melody or rhythm.  The resonance through the audio vibrations impact the body while hearing the sound impacts the mind (Trivedi et al, 2019).   This is particularly important when addressing chronic stress on the body. 

When we are in our flight-or-fight mode, the body's sympathetic nervous system releases hormones, activating increased heart and respiratory rates.  This can increase the likelihood of experiencing many health issues such as heart disease, diabetes, addiction, and other health issues.  In order to counteract these, the body needs a relaxation response that includes lowering blood pressure, reduce anxiety, and promote overall well-being (Goldsby et al, 2017).  So how can Singing Bells help with that?

There are a couple theories of how the bells interact with body and mind through synchronization.  Eva Jansen theorizes the association of vibration on water and how it relates to the human body, since human are 80% water.  The vibrations from the bowls causes a mild internal massage to our cells, which can be replicated by physiotherapist with specialized equipment (Humphries, 2010).  It is thought that healthy organs vibrate at their own rhythm and frequency and unhealthy organs natural state is disturbed.  Synchronization happens when, according to Jansen, the singing bowls "recreate the original harmonic frequency, and stimulate the body to rediscover its own harmonic frequency, by making it vibrate to the frequency of the bowl so that when it is synchronized, it can vibrate independently" (Humphries, 2010). 

Edwin Neher looked at brain waves and how the bowls effected those.  He found that beta waves are produced in normal state of the brain and that alpha waves were made in the brain during states of rest and meditation.  He also found that while the brain was in half sleep, theta waves were present and in deep sleep there were delta waves.  While utilizing singing bowls, the meditative state were found to be nearly identical to those of alpha waves.  This was an early indication of physiological and psychological effects the bowls have on the body (Humphries, 2010). 

Literature Review of Intervention

My interest in Singing Bowls involves their use in people recovering from substance abuse.  Some of the most common triggers that lead to relapse is anxiety, depression, and everyday stressors.  Helping those in recovery learn to deal with these is key for sustained sobriety.  These are two studies that address how singing bowl meditations can be a beneficial intervention. 

"Effects of singing bowl sound meditation on mood, tension, and well-being: An observational study," by Goldsby, T. L., Goldsby, M. E., McWalters, M., & Mills, P. J. (2017) examines the effects of Tibetan Singing Bowls on mood, anxiety, pain, and spiritual well-being.  The authors wanted to see if using the high-intensity, low-frequency tones found in singing bells would be able to induce a deep relaxation response during a sound meditation (Goldsby et al, 2017).  In this study there was significant improvements in tension, fatigue, anger, confusion, and anxiety.  There was also a decrease in physical pain by those that reported experiencing pain prior to treatment (Goldsby et al, 2017).  A big limitation of this study was that it was an observational study without a control group, however this study lays groundwork for further investigation. 

"A Comparative Study of the Impact of Himalayan Singing Bowls and Supine Silence on Stress Index and Heart Rate Variability" by Trivedi, G. Y. & Saboo, B (2019) examines how singing bowls can enhance well-being and improve relaxation versus just meditative silence.  Previous studies have shown that MBSR has demonstrated improved well-being and decreased anxiety through improved physiological homeostasis (Trivedi et al, 2019).  In this study there was positives in both the Singing Bowl group as well as the control group of just doing silent meditation.  But in the Singing Bowl groups there was found to be a deeper, more restorative and consistent relaxation.  This lead to a statistically important decrease in stress measures and increase in heart rate variability (HRV), or the time between heart beats.  Higher HRV denotes better emotional regulation (Trivedi et al, 2019).  One of the limitations of this study was the small sample size and the relative physical health of the participants.  The participants of the study were free of chronic diseases and were not taking ongoing medications.  By expanding the size of the study and considering pre- and post- surveys of mood, there could be additional uses of this intervention.          

Training Necessary

Currently there are no governing bodies to regulate or certify the use of singing bowls for treatment.  There are plenty of online sites that offer training for a fee, but there are also many YouTube videos and MBSR sites and journals that can assist in training as well.  Before one was to use this intervention in practice, it would be advised to contact a local Buddhist temple to find any recourses or workshops available for training.  Since the practice is relatively unregulated, it is not advised to use an unvetted website for distance training.

Self-Care

This practice is ideal for social workers self-care since there are many adjustments and modifications that can be used for short or lengthy meditations.  It can be accessed with only an internet connection and easily done during a 20-minute break. 

Applications in Practice

The use of Singing Bowls does have a couple limitations.  It is not advised to be used when someone is in active psychosis.  There is also considerations to be made if the client has a history of epilepsy, heart conditions, or skin conditions or allergies.  However, it is an excellent tool to add to people's recovery tool box.  For people in recovery it is important that they learn different tools to address triggers, and different forms of meditation are key since everyone has different experiences. 

This practice aligns with the NASW code of ethics principles of service and competence.  The primary goal of the practice is to help people in need.  As mentioned, this tool is valuable and almost utilitarian in nature.  It can be applied in different situations or to address different areas of concern.  It's ideal for people who have a leaning towards audio learning or relaxation.  The practice also aligns with the principle of competence, since the practice does involve learning different methods for different applications, the social worker is always learning and expanding their knowledge.