 So, those of you who are out in the hall or those of you who are still on your feet, if you could let people know that we're beginning and encourage everyone to come and take a seat. I'm going to start with a couple of pieces of business and Jamie, do you need to start with any business? Okay, good. A couple of things. So, just quickly, I want to make two significant acknowledgments and I'll start with one while people are gathering. I think the role of the presentations of the art has been so important to the quality of the conversation that we're having and the sense of the experience that we're having. And I wanted to just acknowledge the work of the technical crew here that they pride themselves on never being seen, but they do exist and feel free to thank them when you see them, but we've got our technician in the booth, Vijay's there, Terina and her crew on the stage, so I just wanted to be sure and thank them. I want to also just a quick thing about the process. I think you're starting to feel it. I want you to trust it. We believe deeply in it and so I really appreciate your continued participation and active participation in it, but I think you can feel that the conversations are starting to acquire a kind of, there are themes that have arisen, there are questions that are now in the air that will ultimately need to be answered and there's anxiety which I love about what do we do with it when we leave here, what happens? Just take a look at the agenda and you'll notice that on Sunday, tomorrow, we spend quite a bit of time in that question of now what? We're in infinity based breakout groups, we're looking at what can we do, what are we going to take away from here, then we have individual opportunities to reflect on that. So continue right now to gather the questions please and then bring them into those breakouts tomorrow about, I heard this, I'd like to know more about that, there was a list that went by yesterday of resources, we'll get to some networks at this table. These things are being gathered and tomorrow will be the moment to capture what you're going to do as you leave. So maintain the space of being open to influence, I loved that formulation Liz. And then a reminder on the circle, we talked here about talking together, talking to each other. And on the circle, if you could make sure that your listening is active, I know many of you are taking notes on your computers, that's taking your notes, keeping your questions is great. Try to stay off your email, if you need to take a phone call or be on email, go ahead and leave the room, it's probably better than doing it in the room, okay? And so my last acknowledgement before we jump in is I just think there were people who weren't here yesterday and we are here for a second day, so I would like to acknowledge the traditional owners of the land on which this event is taking place. The Massachusetts and Wampanoag people, and pay my respect to their elders, past and present, and I invite you to do the same for one moment. Thank you. And then we have one other surprise in the agenda, which is that this table would like to start with the singing of the National Anthem. So you've seen how this works, the introductions will go this way at the request of one of the... Oh, no, you wanted to go this way. Oh, I thought you wanted me to go the other way. Okay, so we're going to pretend I'm timing you. Carl's much better with his timer than I am, so pretend Carl is timing you. And we'll do one minute each as we go around. Okay, I'm Melissa Walker, I'm the Healing Arts Program Coordinator at the National Trepid Center of Excellence in Bethesda, Maryland. It's on the base of Walter Reed National Military Medical Center. I've worked very closely with a lot of you, and most of you know that I have to say that the opinions expressed in a moment are mine alone and not those of the Department of Defense or federal government. I just want to say, as you guys all know, I'm usually pretty vocal, I've been very quiet. My brain has not been. I'm very fortunate, I feel very fortunate for the discussions that have occurred and what's about to happen. I want to talk a little bit about that landscape that came up and just remind you that I have been immersed in the clinical realm for the last eight and a half years through our wonderful partnership with National Endowment for the Arts and the work I've been doing with Captain McGuire. I have had exposure to artists coming both into the clinical setting and then out in the community setting. But this is very new to me. Also, I have to go back to something, Liz Lerman said yesterday about how the continuum is a circle and that a lot of the service members we work with and veterans are going to be coming in and out of the clinical space and into the community space and then back again. So I would like to address how we do that safely and how we work together and then also, and wonderful point made earlier, learn each other's languages. One thing I will point out is the name of this panel, Military Health Care Practicators VA and Art Therapist Perspective. So there are music therapists at this table as well. And if you're talking about us in an umbrella way we are creative arts therapists. I want to acknowledge that they're at the table and it's not just art therapists here. Hi, I'm Lisa Wong. I'm a pediatrician and a musician and live in the space of the intersection between art and medicine. I have worked with music therapists. I'm a musician myself that does medicine and ran an orchestra of medical professionals the Longwood Symphony for about 20 years. I'm still a member. But what I think is really interesting is that we all have a place at the table. The medical professionals who are artists, the artists who want to be working in healing spaces as well as the people who are learning to heal through their art. There is a space for all of that. There's going to be tension at the edges but it's where that tension lies where growth happens the greatest. And I think that's something that we have to just sort of accept and just listen a little harder whenever we get to those tensions. I think empathy and compassion comfort with ambiguity these are the things we're teaching our medical students as a sort of a preventive way of moving the field forward so the next generation will understand this and then we do. So that's where I'm coming from. Okay. So Captain Mora McQuire my current position is assistant chief for internal medicine at Walter Reed I'm also lead for integrative health and wellness. My entire life has been in the arts and I started underneath the piano when my dad taught voice lessons at home on Saturdays and it has never stopped my mom's artwork and her plays and and so much like Melissa my head is spinning a little bit because there's a heaviness but there's also an excitement and a lot of thoughts and ideas so I'm going to try to express myself as clearly as I can Lisa just mentioned something that I find interesting when we talk about these gaps or the intersection between arts and medicine and I think well if it's an intersection it's like saying oh well we're going to talk to you about patients. Like okay well I'm pretty sure patients are people like you know these are the exact same things and so I feel as though you know there needs to be a shift in the way we message things and that some paradigms need to be completely destroyed because they're not even true and it hurts and harms our ability to do some really important work so that I'll elaborate on it later so thank you. Good afternoon. My name is Dr. Michelle Stefinelli and I'm part of the VA caregiver program which is out of central office Washington DC and this program works with post 9-11 veterans, families caregivers and their families. I am really delighted to have been invited here by Jane and the group to really talk about the network and available services and partnerships that are already embarked with the Veterans Administration and the community and I'll address that in a little bit so thank you. Sorry Sarah before you go can I also say that there's nothing that I say today that represents the views of the DoD or the government. Thank you. So my name is Sarah Cass and I am retired from the military so I no longer need to give that disclaimer my views are mine and mine alone and nobody else is claiming them but I come here today sometimes feeling like an imposter but yet deeply interested in the work that's happening here I retired from the Navy two years ago after 23 years of service the last few years working specifically at the National and Trafford Center of Excellence with Melissa and Rebecca and Bill O'Brien from the NEA on this NEA Military Healing Arts Partnership that we now call the Creative Forces Network when I retire and prior to that I'm kind of excited to see all this come together because prior to that I worked at the headquarters for Navy Medicine on wounded warrior policy and helped bring re-entry to military bases across the Marine Corps and the Navy and it's exciting to see the great work going on with that but when I retired from the military I had a choice of what I wanted to do and what was most important to me was to bring the things that we're working in healthcare to help veterans service members and their families heal from these invisible wounds of war and I had seen the incredible power of the healing arts both in the clinical setting as well as community engagement and wanted to help promote that and foster that and so that's why I work as a consultant to the NEA in helping to expand that partnership so thanks for letting me be here today so I'm Jeremy Nobel and I'm a general internist and also with the foundation for art and healing also a poet so I'm looking at this wonderful conversation from lots of perspectives so the foundation for art and healing is a non-profit it's been around 14 years and we explore and promote the idea that creative arts expression improves health and well-being and we do that in three areas one is awareness to people for whom it is not immediately obvious like the people in this room but I'm happy to say that most people find it an appealing idea and can rapidly move towards it when you actually put the idea in front of them so we do a lot of awareness work we also develop innovative programs of various kinds to actually bring creative expression opportunities to people and then we also do research and in many ways I think that is kind of the anchor of our identity as an organization to try to bridge growing neurophysiologic understanding about what's going on in the brain with creative expression and then what we can make available to people in their communities either directly or through groups the big and I'm here today 100% because of an accidental encounter with Bill O'Brien about six years ago it was a convening like this on a related topic on design and health care and Bill said you should come see what we're doing and I rapidly met Melissa and Captain McGuire and it's been a terrific partnership working with that great energy because there's so many clinicians around the table I thought I'd just share a little bit about kind of our newest initiative in focus which is really to look at loneliness and isolation as a public health challenge I'll say it I'll kind of make a bet now within two or three years you're going to be hearing about loneliness and isolation as the public health challenge that's going to replace obesity is what everyone talks about in PR which means it's like the leading edge of things and I think we're generally aware that loneliness and isolation is a challenge on the mental health or the behavioral health side through the classic triad of increased risk for depression substance abuse and suicide one of the reasons we started focusing on it was growing epidemiologic work that came out in 2014 showing that there's something about the lonely brain or the isolated brain that because of increase in response and reduction in immune response has a 30% increase of early mortality totally separate from suicide and substance abuse but because of cardiovascular risk heart disease and stroke and immune deficiency you know which leads to oncologic risk in a certain extent other disorders and so the net aggregate risk for lonely being lonely and isolated is equivalent to smoking 15 cigarettes a day and yet as a society we don't react to it we don't talk about it we don't put it to that level of awareness, attention and commitment of resource so we've taken it on we've launched the on loneliness project in partnership with AFTA and some others and we launched last May and so as I mentioned we do a lot of awareness generating and programs so to generate awareness we actually are doing an online film festival on loneliness and isolation now I didn't take the marketing course in medical school but we knew we shouldn't call it the lonely isolated film festival if we wanted to see it so so it's a creatively connected film festival and we'll talk more about it because I think it will lead to empathy and some of the other kind of activities we're talking about okay I'm Rebecca I am a music therapist for creative forces thank you Melissa for pointing out that clarification on the screen I work alongside Melissa am I being too soft I work alongside I work alongside Melissa at the National and Chuppet Center of Excellence also been working with creative forces on the expansion project which I'm very grateful for the opportunity and we'll be moving to California which is exciting next week to start developing this in other areas as a mass native and being at this college I've gone to grad school with and I did get my bachelor's of music therapy at Berkeley right around the corner did my grad school at Harvard University and I'm a music therapist I'm a musician and this is my community and it always will be it's my home and I think I only got here today but just by engaging in that anthem and hearing everyone at this table and everyone in the room sing I feel very connected right now more than ever from this morning even being a tardy participant to the to the convening just from that music making experience so I think that's a really that's a lot about community building through even you know a small few minute piece very powerful piece Hello I'm Brittany Costa I'm a musician I am an arts administrator and I'm in the military so I'm here today with Berkeley College of Music I found out about the convening from Rebecca so thank you I am the department coordinator there and we are trying to grow our program so that we can reach out more to the military and veteran community we're trying to expand because it's what we feel we need to do it's a very important community that should experience music therapy and it's already happening at Walter Reed and a lot of other veterans organizations and a lot of our students are expressing the wanting to be involved in that in that population so we're hoping to partner with more local organizations veteran hospitals other universities where they have a veteran student population to train our students with professional music therapy facilitators that way we are training our students to have the knowledge of that population the knowledge of how to work with that population and also contribute to the community by providing more music therapy outlets for them through that we're going to research and evaluate so that way we can provide data to establish more funding because foundations love data and we don't think that we need to prove the validity but western medicine thinks that we do so we're going to continue to do that and that way we can create sustainability through our programming so I want to on the other side my military experience I've been in for 11 years in the army band but I also did five years active duty in a military health care facility I'm Scott Engel a psychologist over at Fort Hood I do need to again sort of the caveat the views that I express are not the views of the DOD but they are supposed to be my own so now that that's on my side I am a civilian and I am not an artist so why am I here so that's an important question it's been somewhat uncomfortable at times and if my mother is watching at the sixth grade recital I wasn't really playing the clarinet I pretended so now it's out but I have the privilege of being the director at the intrepid spirit center at Fort Hood, Texas there are five in the country and we're very uniquely situated we are a private public partnership with DOD and the intrepid phone heroes fund we have four separate sections where we're treating the service member holistically we have a medical section a rehab section, a pain section, a psychological health section have over 50 assets within that footprint and somehow I get to be the director of that so it's quite a privilege we have recently partnered with NEA and are now expanding some of the BH services to include art therapy and part of the challenge that I face is intuitively understanding as a psychodynamically trained psychologist the value of art and the projection and the utility in art it's my staff that there's value added here so it starts internally and then just trying to understand that well eventually they're going to have to get on the boat or they won't be able to necessarily stay because this is where we're going but it's there's a richness to this that I think has to be explained to our staff so people understand it is getting our service members exposed to art therapy and then eventually building bridges into the community so they can get out of the bunker and get back into the community and be re-engaged I'll stop there Hi I'm Bill O'Brien I'm the Senior Advisor for Innovation to the Chairman of the National Endowment for the Arts and I come to this table with a sense of all my worlds colliding and I think it's worth laying out because I think there's a shift in value that I experienced that's worth me bringing forward at this conversation I spent about 15 of my first adult years as a theater making practitioner performing on stages in 48 states writing and composing music for national tours then becoming a producer for Deaf West Theater then about 10 years ago I came to the National Endowment for the Arts, witnessed the birth of Hal Round and was the theater and musical theater director for about three years and then for about six, seven years now I've been working on setting up a program innovation office and we look a lot at the intersection of art science nature of creativity in the brain that kind of thing so arts and health and military was the other thing that I was given a task to consider and I realize it all came together and one fell swoop up to NICO when I started to hear about the kind of patient centered care that they were doing and I think the reason I wanted to bring this forward is that as a practitioner and as the experience that I've had as a pursuing art as a calling as a vocation there's a set of core values that I think we all sort of understood and there are things like freedom of speech the resistance of content shaping not allowing your art to be used as a reduced utility for some other purpose and I think if there's one thing that's been a really interesting shift in my mind as we work in a very patient centered person centered way it's to think again about who is an artist and what's the purpose of that art and when you really put it into a specific purpose where you are locking arms with a team of people and you are bringing arts to the table to confront a societal concern that a lot of people care about those values need to be reconsidered it's okay to be thinking about the art as a utility to be thinking about we're bringing arts into play as an important player in the role of the effort to confront the most vexing invisible wounds of war I think it's a very powerful thing it really reintegrated re-energized my sense of what art means to me who does it, where it happens that's a great place to begin and Sarah I'm gonna come to you one of the things that I've been I thought I was the imposter one of the things that has sort of risen in the earlier conversations there seems to be kind of three different areas have surfaced really in terms of the utility of this work so we all gathered out of a sense that this work is A happening and B matters, that's the whole room can share that but then I've heard this kind of divergence about how and why and the area that is striking me is that we've been talking about cultural diplomacy we've surfaced recently as the utility of art in the military as a tool of cultural diplomacy we've also talked about it as a healing tool and we've talked about it as civics literacy and and anybody can jump in but I wanted to ask you specifically Sarah this is it important do you think that we are clear at the outset are we doing all three at once do we need to be focused on whether which we're doing and which ones we're not doing how important is it to be clear from your perspective as we enter it I think it's really important that we're very clear of what our intention is at the outset that doesn't mean that there aren't sometimes unintended consequences of something that happens and I can give a very clear example from my time at the NICO when Melissa was engaged with our patients doing a mask making a therapeutic intervention and very clearly the intent of doing that is a very specific healing intention for an individual patient but one of the things that we did there is we started to display the masks in that center in a way that I think really importantly invited others into engaging in their own therapy they realized that when they walked into that studio and they saw the masks of other people that they were not alone with others and take that risk of engaging in therapy and so what started as an individual therapeutic encounter could be used in a way almost unintentionally to invite others into therapy and then I think the last part of that same thing that gets at sort of the civic discourse on this initiative is these same masks became sort of an interest to national geographic and a spread in national geographic was done highlighting some of the work with the masks that I think as I would have to sit there and justify the cost of this facility I would talk about the value of what happened in the facility of really helping to educate society about what 15 years of war looks like and I think that's incredibly important it's a lot of what I've heard here in this room the last couple of days but I think that at the very beginning we always go back to well why are we creating those masks and if we deviate from why we're creating those masks to start to be about civic discourse I think then we're making those patients, artists and that's not what's important and what's important to them is healing and so when we start where we start is I think critically important but I think we ought to be open to how they can be used in other ways Yeah, that open to influences that Liz suggested earlier Anyone have a follow on to that? Yeah I mean I could clearly carry you but I'm going to take us totally off road because I keep hearing these conversations about you know art as though it's a separate entity from the person so in other words it's kind of like oh there's a person they're breathing look at that did you see that or they're eating oh my god I can't believe it this is such a natural part of who we are right so for instance within Integrative Health and Wellness when people come I don't immediately assume that they don't take care of themselves I ask them how do you take care of yourself and it's the same thing I don't assume that you're not creative or an artist I'd like to know how you are because at the end of the day we're all storytellers even Scott you just told a story we all curate our lives we are all creative and every single time we make it into something else that's not helpful so let me ask you then as an artist which is my relationship to this work when I enter how do I express that both my sense of understanding that and my sense of my curiosity about the difference between your experience and how you're going to express it as an artist in my experience how do I enter in a way that doesn't say oh good for you you're eating and I'm so surprised that you breathe how do I enter in a way that we start from human so I guess it would depend on the situation right but again not with the assumption that you don't do these things because it reinforces that idea that it's something separate so art should be an inclusive term and not an exclusive one I mean there's a difference between being a professional artist an artist who kind of dabbles but we are all artists and we're all creative right and sometimes I was talking to Lisa earlier we use this term like the arts that's someone coming in saying oh tell me about medicine okay well medicine is like massive like somebody comes in well tell me about art okay I think sometimes our messaging is not clear and it actually interferes with what we're trying to do right so reminding people that we are creative and it is as natural as breathing and eating if I can I'm going to try to string two points from that so artwork is an extension of ourselves and from our therapist's point of view we use the art to communicate with the patient same with the music right so in the case of National Geographic I had to very carefully choose who was involved in that project and I think it's important for people to know that I didn't just pick a couple of names out of a hat they were less vulnerable they had to opt into it and feel comfortable with it and you also have to explain to them that they're then out there in society for people to judge but it also had the positive aspects in that people became more aware of art therapy as a way to treat these invisible wounds of war and it also allowed society to better understand what they were going through so it validated their experiences which was a beautiful thing and I think that plays maybe into the empathy part of this conversation that we're about to get into and then one more thing about this loneliness and isolation so these masks have created a community for the service members community has been strung through their event and then also it's shown up in our research so we researched about 400 of the masks we've had over 1400 created and we saw that and we correlated it to their incoming post traumatic stress disorder scores and their generalized anxiety scores and those service members who symbolized a sense of community either within their team or within the military or with their families they had a lower score so we are able to take that and know then that sense of community is a protective factor and so loneliness and isolation not a healthy thing and the arts they're a great and beautiful way to create that sense of community and we've actually seen service members create teams they're actual artist teams working together outside of the clinical realm so it does happen so I just think this is such an important conversation for us to have and I just add on to that as a clinician I had the opportunity of visiting you in Washington just a few weeks ago and as soon as you are up close and looking at a mask you can start to understand having not even met the veteran some of the things that they're going through and just looking at those masks they speak so loudly that that increased my empathy and increased my really feelings to see the kinds of struggles that are expressed through a simple mask and I think that is building a community I think it's difficult for us to be thinking that the clinicians are on one side and the patients are on another and which ones are the artists I think it's as many opportunities we have to either make art together or to discuss art together that breaks down the barriers of three different dimensions that we're trying to blend a bit today which is there's the clinicians there's the patients and then there's the artists as though they were separate and as artists civilian artists with no experience with the military entering this conversation how do we enter in a place of understanding that we're part of this continuity of this unity because it was a bit ago and then I have a question coming to you I just wanted to touch based on a couple of things with Jeremy and Melissa and everybody was talking about with the VA caregiver program we're an evidence based program and during the RAND study in 2014 they did identify that 53% of the caregivers definitely feel isolated and with that being said that they're looking for the social support so with that going up to the next level we have a program which is the peer support mentoring program which is the peer support mentoring program and where caregivers teach other caregivers on a national level and because of the outcome study we have found that local peer mentoring one on one face to face has more of an impact and just to give you an idea of what's happening to bring it closer together peer mentors volunteer around the nation at over 50 organizations so there's probably some organizations in your community that you're not aware of and also they walk the walk and that's one of my sayings that we reflect on because you can't walk in my shoes walk the walk and that's where they really are promoting their education, their knowledge and really sharing their experiences and what I'm also getting at also is that there is some of the mentors expressing through art therapy through music therapy and as a matter of fact one of my mentors is a pretty much a subject matter expert dealing with PTSD and art and wrote a book so I'm really glad to see that this is coming together and is there a place that we could find that list of 50 and we can gather we don't need to go through the list now but there's a place that we could get that information and put it into the report here so that people have it great Did you have a response to that? Yeah just something to piggyback off that comment when we were in creative forces we went and held a state arts agency meeting in San Diego around Veterans Day last year and one of from combat arts one of the artists who's in the community working on bases she's not an art therapist she's very eager to say that she's not an art therapist and she works closely with leadership as well and she said the biggest thing that's helped me was how do you access she said one of the biggest things that helped me was getting those peer veterans who help her to bridge the gap between what she doesn't know her gap in knowledge and what the needs are of that population so she doesn't have necessarily therapeutic training she's not a credential art therapist it's supplemental so it's not an art therapist at that base yet so instead of having no art they're using their community artists in a way that they can bridge that gap and peer mentoring was a huge part of that just from my experience working in San Diego in the nonprofit sector before I moved into creative forces and started working in DC I've had some great experiences with community musicians Hollywood's right up the road from Pendleton so I had a lot of eager Hollywood musicians wanting to partner some of those partnerships went really well and I would say for you know everything that goes well those few that did not and really what I saw was exploiting the veteran it was very problematic so I think it's as long we can be inclusive what you were saying Dr. Wong but it's informed inclusivity people have to be informed information sharing talk more about the things that the elements of what was wrong what went wrong I mean I think we want to make sure that we're surfacing mistakes as well as the so on a spectrum everything's a spectrum everything's continuum right so on so on a spectrum let's start with I always start positives so what went really well programs like music or with Arthur Blum and he works on base at Walter Reed and he brings he works with patients there with musicians and musician trainers with patients who have a strong clinical team and he takes them out to perform at Kennedy Center for an open audience of you know their peers you know the community the civilian bridging that divide to a spectrum where we have some people from Hollywood who are working with service members to record their song and end up exploiting that with people who shall remain nameless Billy Ray Cyrus and it's out in public it's it's okay it's out in public it was on CNN where they had this song that was written in a music therapy context and much shifted and then made a music video that was blasted across the nation to a much more severe into the spectrum where there is a songwriting workshop that highlighted a service member who wrote a song called I can't see the sunshine about his experience in combat losing friends losing battalion members and then after that was you know newscast the service member ended up killing himself and the headline read music therapy veteran gauging music therapy commit suicide so now that was not music therapy but again it was not informed and that's not that it wasn't informed by the songwriters it was just not informed by the media I want to get to you Scott can I pull you in on this because yesterday you raised a question very directly about what doors what triggers what and how to manage those and so maybe we could talk a little bit as a table about the management of this no no I appreciate that opportunity you know our patient population is very fragile and just moving to get treatment is courageous the warrior ethos sort of prohibits active seeking of care there are efforts to change the culture and it happens very incrementally and I think the intrepid spirit center platform is helping raise awareness and allowing folks to step forward and receive care I think that you do find inherently therapist providers that's my soldier you know we that's our soldier you know we're going to be very careful referring out into the community because we know the perils of potential challenges that may be encountered and that is perhaps also due to a lack of understanding as to where are the boundaries how do things exist within the art community we're just in the process now of engaging in that we have an art therapist on the ground and after our PTSD groups our individuals will go to yoga or they'll go to art therapy and the benefits that are seen again as a psychodynamically trained psychologist is so rich and it's beautiful and it's amazing but there are service members that really they struggle with some of the bringing this material to life a one quick example is that in some of the art there was a weapon set suicide and there was a gun to a person's head in his and we didn't get that information until 48 hours later that's concerning that's a challenge so we have to be communicating we have to be talking and we have to understand the risks and we may be talking about different patient populations as well as folks that are out in the community seeking art as a rehabilitative community engagement aspect so when I talk about our patients I'm talking about folks that are actively engaged in treatment and so there are significant risks in the population that may be different than some of the folks you guys see in your studios great did you want to come into that yeah I think we're all very the clinicians are very conscious of the safety issue and we're very conscious that in the broad population of people who have any level of distress is some subset of them who have significant level of distress and it's our obligation to be attentive to the fragility of that subpopulation at the same time that's often diagrammed out as a pyramid there's a base of a pyramid with people of mild risk factors you know kind of struggle with something may not even know they have an issue and then you have middle of the pyramid of people who might have it in a mild way and then people at the top of the pyramid that have severe issues this is true for whether it's diabetes or heart disease or a mental health issue we have to get much more careful and precise thinking about programming particularly to the vulnerable population where we are on the pyramid because you can actually make a mistake in either direction you can say oh creative arts expression is so precious it needs to be just targeted the people who have the most significant distress in tightly controlled therapeutic environments well that runs the risk of not exposing or allowing people to benefit from the amazing ability of the arts just create conversation build resilience a hundred sense of connection all those wonderful things so we have to find our way and so it's a very timely conversation because if we don't get it right people kind of move to one direction or the other they get quite polarized about it and then it slows things down to both of those points you said communication and I think that to enter into that space with a service member or a veteran it's going to be very important to say art is a very powerful thing and this is going to innately and naturally bring up things for you and be aware of that both the person facilitating the art but also the veteran or service member themselves and to have resources and safety nuts within your community or your local area set up in case they do get to the point where they need to go back into the clinical space and a good example of that is an art therapist we work with Donna Fort Belvoir who she assists her with many of the patients that she's treating in a non-clinical setting in the community and they do ceramics together and she explains to them listen this is not therapy time but if something comes up to you during this during this experience we can we can talk about it back in the in the space and the other thing I need to say is that I think that you bring up a very good point and it was in the reentry conversation earlier too that a lot of these service members they feel like if they do open up in the clinical space they're going to lose their their job or rank or security clearance and so they are a little more comfortable sometimes outside of that realm opening up and so we have to remind ourselves of that but then I've worked with another organization who made sure and I know this doesn't always work because I heard it yesterday that there was a creative arts therapist in their room during the workshop and they wove art and music and writing through the theme of the workshop but the creative arts therapist wasn't there to interject or they were part of the process and that was a train the trainer situation where the veterans were actually helping lead and then they trained the other veterans through the future workshops and it felt like I said there was a safety net it felt it was all inclusive and it felt very safe can I switch topics for just a second I know we can come back to it if there's something unset or we can get to it on the on the outer circle but I want to raise another thing that comes right out of this and Brittany I think I'm going to poke at you for a second if you don't mind we've heard a lot thus far which I've found very provocative about reframing the notion of the vet as a victim the vet as a patient that needs help and that the arts can come and help and reframing that to how do the arts and the strengths and the training and the purpose driven life of a veteran how do those things come together to create value and so in this conversation where we focus so much about coming into help can you talk about your own experience of where you feel art and your experience as a veteran come together I can try so I think a lot of what Melissa was saying is very important that everyone has their own experience and some people value having another veteran in the room kind of help them collaborate accept experience things together and some of them don't want that at all I've been around veterans who cannot be in uniform anymore and they can't be around people in uniform and treatment won't happen unless everyone in uniform leaves the room and I've had cases where I had to go home or bring civilian clothes to work with me change the civilian clothes and then go meet someone at a cafe off base or whatever because they weren't they were just not able to communicate or speak to me in any way if I was in uniform I had to pretend I wasn't in the military so I think there's different situations and everyone has their own experiences and that's always that's something that's good to understand and value and anyone who is working with the veteran or military community that's a good thing to be trained in I guess but on the flip side it is good to have a peer veteran around with you to kind of translate or to have that language so there is no barrier I want to get at one other thing that we had talked about first and then we can go wherever we have time to go and I'm going to point this at you Dr. Wong we've also talked a lot about the difference between the professional artist and the veteran and we have talked about the fact that many are both and we've talked about the projects that involve practice where the veterans are actually the creative artists in the project and then where the project is created by artists who represent the experience of the veteran is there a distinction in your mind in terms of the value or the role of either of those places to stand whether it's engaged participation of the veterans in the creative process or more yesterday we talked about it in terms of audience more as the receivers or whose stories are being represented is there a value difference there or different effective ways to deploy them what would you say is going on in that I think both of them are very valid I think Liz Lerman referred to the process to the product and I was thinking about that actually in terms of Musicor with Arthur Blooms group where those musicians are PTs but they are musicians first and they will practice for 8 to 10 hours a day or they'll jam for hours during which time as a neuroscientist or physician you're seeing that their executive function is improving and their occupational therapy is not necessary because they're practicing fingering on their guitar or their piano and all of those things are happening in the process of something beyond themselves and I was thinking about that as you know just overall what are we doing as we are looking for a purpose driven life I was talking to people yesterday who are saying our life doesn't stop as being veterans after the war what is going to go on for the next 10, 20, 30, 40 years of our life and where does our direction go with our new identity or our built identity that's true for all of us who have had a trauma of any sort but the arts is one of those things where you can never win you never get to the absolute pinnacle of art because art is always beyond you and it gives you something to strive for at all moments even if you play the same concerto it sounds different next year when you have a different life experience or if you're in a play 100 times around the country each performance is different and I think that's going back to the point of we are all a single population and just helping reintegrate that we're all moving in that same population is what's really key and another question about mutuality I think captain if you don't mind is there equivalency in your mind between the skills we've heard the different skills we've used the term warriors and artists in this conversation are you feeling that we're on we're in the Liz Lerman balance place in terms of the skills that the warriors bring to the conversation and the skills that the artists bring to the conversation is that balance even important as we're entering these projects and how are we doing as a field in your experience of us with that oh my gosh so it's interesting that you use the word skills and so I will answer your question but probably not actually answer it and just answer the question that I think I heard you say I deal with skills all the time I mean that's what health and wellness is about is providing people with those skills that they need to be healthy and well right so the skill of self-awareness because it is a skill right sometimes it takes us to places that are very uncomfortable but the more you do it sometimes the easier it gets right so those are the skills and I totally agree that it really is the process I mean that is at the end of the day exactly what it's about for instance at Walter Reed we have artists in healthcare who work on the inpatient unit right they are you know they're not creative arts therapists so they don't intentionally kind of evoke traumatic memories but they're artists who've received specialized training and so they are literally just there to acknowledge that moment and capture it that's it it's a single data point you don't need to do anything with it if you don't want to there's no product maybe there is maybe there isn't and so those are the skills that I think everybody needs right and so for instance when we were singing because Melissa and Rebecca and I sing from time to time I'm an alto and the beautiful thing about being an alto is that you can't be an alto by yourself right you can't you can be a soprano by yourself right you can't be an alto by yourself right so I mean those around us are really important for us understanding who we are and I think that also speaks to the community piece I don't know if that answers your question but it starts to I my question was probably a little bit more concerned about whether or not in this particular conversation we have equivalency in terms of which which are more important and I and so I'm getting at this dynamic of we come into help as artists we come into help and so our skills are being brought into the equation and hearing at this table actually the work is already going on and we can come in to serve it is probably the better place to come in so I think this touches on what I was wanting to say earlier which is some of the people that I've seen who have been in this space for a while from the art side places like in part if anybody's seen the video it's that they do blacksmithing and pottery with people who have gone through the credit forces program it's at Fort Belvoir there's a hot shop heroes glass blowing and I I saw this in the second piece of KJ's yesterday and I and I want to talk to her about that because this also happened the writing program that we've been doing for about five years where initially where we're very eager to get into the drama and there was some good background and James Pennebaker psychologist who's done expressive writing that really focused on trauma but as we got into a conversation with him we started to think maybe our role is meaning making sense making and we can actually and this is the content shaping thing that I was alluding to earlier let's go ahead and steer ourselves to be where we can feel comfortable if there is going to be something deep and heavy survivor guilt or some other existential issue in this setting I'd rather the creative arts therapist be the one kind of managing that and I noticed that in KJ's piece where reentry which I love and I've you know known as it was being built but really experiencing again it was very moving but I did notice you know that there was a lot of anger there was a lot of PTSD kinds of issues and then the subsequent piece that she was really thinking about creating to have a conversation with Navy medical people was a much different kind of set of tone and themes the Navy chap you know every time he opened his mouth I'm like now what's he going to say and I think this gets back to this thing that keeps it coming up over and over again about sorry I looked at outside the circle about stigma and I think you know for me what I've really gained an appreciation of is that if you think about it in terms of Eugene O'Neill some people have heard me say this a lot but his sense of his life purpose as being pulling back the veil on the mysteries that drive the human condition I think if we really understand that the time experiences has given people who have gone through that an unfair advantage in pursuing that work then we're not looking at it as an illness we're looking at it as meaning making an insight and when we come into these spaces safely if we could just be thinking you know a safe way to come in is to steer insight towards the kinds of proactive things that they're groping for rather than rumination on the kinds of things that we might find fascinating but might not be the healthiest thing for us all to sit in and pause and we're going to go to the circle but Sarah you have the first question so let's go to that who's got the mics and Sarah go ahead and make your comment I'm sorry to cut you off but we're running out of time the only thing I was going to kind of piggy piggyback onto what Bill was saying and I think it's so important in why this dialogue that we're having together as a community is so incredibly important is because we're saying they're talking as healthcare providers about what's happening but less than 50% of the people who are suffering from PTSD and traumatic brain injury actually go into the healthcare setting and so they go into communities and that is why this is such an important dialogue because healing happens out in the communities and the more we can learn together and learn from each other how to address this is so important so I just wanted to really point that out because we're only talking about those who come see us and there's a lot more you have the microphone and thank you for that that's a good introduction to what I was going to say just now you asked a question about going within the community to the veterans and helping right so this is the the thing that for me personally as a veteran when I went to carpet bag they weren't helping me with art they created a space where I could be heard and they were listening that's what it was for me it was an art I was sitting in a circle with people who appeared to care and had a mutual understanding because the question in the center of the circle was related to being a veteran or knowing or associating with someone that was a veteran and every story that was told was that and when it came to me I was able to share my story so it wasn't an art it was a listening and someone was listening and waiting to hear me finally okay hands up and I just want to encourage people this is the part of the process where some of you have been sitting in the listening mode for a really long time at this point more than a day and you're sitting on things that need to get into the room so I really want to encourage those of you who haven't yet to share the things that are you're even afraid to share or are unformed and have the opportunity to do that sometimes they call this about step up your participation and step up your listening so if you're someone who tends to participate step up your listening and if you're someone who tends to not participate we really need that from you because you're holding things that need to get into the room so go ahead so as someone who's participated okay you made the announcement after so don't this is not about gaming you said that so I did one thing you said Melissa thinking about the safety net around us I know we've talked about that a lot I think in there is there an implicit assumption that there is that safety net and I know a lot of us have communities that we work with that creative arts therapist might not be there right doesn't have to be so I guess my question is how as community service providers what are the resources that we should be looking into as potential safety nets if there's not a creative forces therapist in the area where do we go as someone when we cross that line and someone needs more support where do we lead them I don't actually know if I can because I will be endorsing but I'm going to whisper something in her ear and also let her complete her thought no I'm just kidding I think some of it Melissa I think how is it that the most performance is happening with the I think that some of it has to do with the training ahead of time Sam and it's again about intention it's about being prepared for those sorts of things and not waiting until you need it to know where it is so I think when you're going into a situation being you know a lot of times we call it in medicine we call it informed consent understanding of what they're about to engage in so that they can choose whether or not to do it or not and be prepared having those resources I think across multiple communities there are lots of different places that are federal that will support that be that the Department of Defense or Veterans Health Centers and vet clinics and all the different things that exist out there but there are also a lot of non-profit organizations for healthcare Given Hour is a great organization I can go ahead and support I didn't even know that but there are a number of them and I think that if you're in a community and you're starting to do this work you should know where your safety net is before you engage so that you know where to go to know where your safety net is I totally agree with that I think that if you just let them know you're there the VA, the MTFs and then the resources in the area hey I'm in your area and I'm working with the people that are not supposed to be but could be coming to you if you create a dialogue with them and let them know where do I go if something comes up start that relationship with them I think that would be good Jeremy, so I'll stay on this very practical theme of what we could provide as guidance to groups like yours and certainly agree with everything that's been said there's also a growing awareness that some of the core skills you need when you're in the community I'm talking about working at the base of the pyramid, people are mostly okay most of the time, but could get triggered by something even though they're not severely distressed UCLA arts and health program has kind of been looking at this for a while and they've developed a training program a 20 or 30 hour, I don't know exactly what it is, training program mostly for artists who want to work in various group activities to just train them with facilitation skills recognizing something that may be a problem and refer out and so again, let's stay away from the binary which is either someone's really sick and then they need a therapist or maybe we just ignore them or provide fairly non-provocative conversations and the risk you run with a non-provocative conversation is it'll miss it it'll miss the opportunity to really connect and share and so I think we're going to see ways to put safety into these scenarios and some of it could be these relatively almost certificate programs because there's an enormous amount of positive energy from the art world, the artists want to get involved and by the way it's not just for veterans it's with older adults, it's with caregivers it's with minorities, there's a lot of trauma out there and if we require that you have to be a licensed therapist to deal with trauma we're going to be behind. While you have the mic just a quick question on your research around loneliness, what I was hearing and connecting to and I want to make sure I got it right is that community is actually a kind of treatment for loneliness the elements of this work that create community are actually at the core of the loneliness If the illness so to speak metaphorically is loneliness what's the antidote and it's connection and connection at an authentic level and it very much ties to what we've been talking about today in half. And Michelle was hoping for the mic but I have one behind me too. Oh, good. Sorry, Nolan. Okay, I think I heard Sam your question about how to partner out a little bit I think that you have to use the creativity that you have as individuals and not only start from like a local setting for example get a seat on the presidential board of the department of higher education in your towns in your state then move out to the American legions, the vet centers and then also establish a task force committee and bring in invite the community into your organization and it really works. Great, thank you. Is it working? That's a great comment I'd just like to tag into that plus the previous comment so the question kind of precedes this idea of resource there's a need for resource and so the point that I have observed is that there's resource on both sides of the arts community but there's also a resource on the military side and this is why I think connection is so critical I often share this idea that what you're really trying to do in bridging the two communities is really and I did a short piece for Jane create an organic ecosystem that becomes self-fulfilling and self-sustaining but this is where I think from a structural perspective and I'm just going to label it local arts agency because it could be really anyone someone has to kind of from a community perspective say who's going to take the initiative to start drawing this organic ecosystem together, right? so that if I'm out there an artist doing something I have a resource I can go to and say yes to your question about endorsement it doesn't become an endorsement issue then it becomes an awareness of where those resources are if I find myself in a gap, right? the second point of this about the connection is that once you do that it enables the military to peep into that and see how their resources could also be tapped on the other end of the perspective, right? so I think this whole idea of creating an organic ecosystem where it becomes self-fulfilling and also self-sustaining and structurally those things can be easily I think implemented but that's more of a long-term community engagement connection perspective and tomorrow when we get into these breakout groups the degree to which you guys can detail some of the networks that you know or some of the programs that you know that's going to be helpful to capture tomorrow's breakouts. Yeah, Dr. Wong. Just briefly on the civilian side here in Boston we have something called the Boston Arts Consortium for Health it's a sort of a grassroots group of about seven years of age now but we have people from Berkeley School of Music New England Conservatory, the Museum of Fine Arts the medical schools and universities and so we're all sharing knowledge the neuroscientists know stuff that the clinicians need to know the city of Boston is looking into its departments to see what arts programs are in their own departments and in addition there is a program at the VA called My Life, My Story where they're getting the stories of the veterans and just slipping it into the charts of the patients it's a non-clinical story but it gives somebody a lot more insight and empathy into that and so I think the whole thing about getting stories and across a wide network is it's something that's really replicable in other communities Great and Rebecca I just wanted to point out that the Boston Arts Consortium for Health is the acronym of Bach since we're talking about acronyms today music narratives I just wanted to kind of go back to the continuum and a comment that you were saying before Dr. Wong at the table about whether it's artwork that's really informing psychological health and behavioral health rounds or whether it's those musicians and music corps that are practicing or in music therapy practicing something in their motivation the arts are very powerful also very motivating and just really understanding how we inform ourselves in the medical community but how an art exhibit a display those strategic selected masks that were put into national geographic like you said that comment that a simple mask which could be complex or simple can paint a picture and you really get to know that person and I think just tying into our artistry as visual artists theater dancers musicians poets writers the power of performance and how we can use performance to really inform that gap we were talking about in the previous panel the military civilian gap but how through the power of performance we can inform each other we can inform veterans as participants or audience members and we can just inform communities at large Judy I just want to say that I'm Judy Smith from Access Dance Company in Oakland that I think there's a really big resource that's being missed here and it's the disability community especially for veterans with disabilities and my experience is that the veterans are not taking advantage of information and the wealth of knowledge available through independent living resources and other disability organizations because a lot of us have been living with this shit for 30 years 40 years and we know a lot about how to navigate disability and how to navigate accessibility so I would encourage people to start looking towards the disability community because you know we were in Siberia in 1995 and having some issues getting my wheelchair batteries charged and decided we'd put them in a fiat and drive them around for the day and then swap them out at night and just Bonnie who's one of our original founding members said disability is actually the mother of invention very nice yeah this one who's back there sorry thank you thank you Judy I'm Madeline from the Flynn Center I wanted to thank this group it's really been the session that's blown it up out of the edges for me because I've been thinking a lot and having hard time commenting because I don't feel like an expert in the military or veteran community I have my father's veteran but I drag him to modern dance I've already got that so this was really the session that made it feel like this works for every community not just military and veterans and what Judy said one thing we're working on at the Flynn is working on accessibility with different communities in the disability different populations in the disability community and one thing we've been working on is audiences kids and adults on the spectrum and one thing we've noticed that is is that all the adaptations and things we've done have made it wonderful for these populations but more inclusive for all of our audiences and so it's really become universal become that ecosystem that you were talking about that organic ecosystem that's growing and so I really wanted to thank everybody for this session that's starting to seep it out and all of those other disenfranchised communities that were as arts presenters, as artists are trying to connect with I'd like to ask the group a question this table started with the land acknowledgement which we had done yesterday and then sang the national anthem and I'd love to hear responses yeah Colleen Jennings-Rogensack from Arizona State University Gammage it was really interesting to me I'm a Rotarian and so every Friday we have lunch we sing the Star Spangled Banner but I used to always sit next to Dmitri Dorbachevsky he's a classical violinist from Paris, his father died in the camps he and his he escaped, his brother escaped, the rest of the family was killed and we would sing that song and then Dmitri would whisper in my ear we got to the end with Liberty and Justice for All and he would whisper almost whenever I hear the Star Spangled Banner I hear Dmitri whispering my ear and it's both a comment of condemnation but it's also a comment of hope that we're not there yet but we're going to get there so I want to thank you for letting us say that but I know we all come to the Star Spangled Banner with a lot of different feelings yeah and that's what I want to bring them in Kita has her hand up anybody behind me and Margaret that was a very difficult moment for me personally as an indigenous person I love the beauty of the song I come from a family of singers so the difficulty of that peace technically resonates with me very highly but it was very difficult and I think I was probably the only person in the room who did not stand you didn't who was physically able to stand and who did not stand because that was a moment of conflict for me personally just to I acknowledge what you're saying and I have that moment inside too although I did stand and I love to sing it but the last time I sang it was last month in my own community during a large four handover march against the immigration ban and as we ended the march and took over the entire Dartmouth green holding hands so a gigantic circle a young man in a beefed up truck drove by with his windows open blasting that song which we instantly all began to sing with him I'm Rob Richter from Connecticut College and we do the Star Spangled Banner I can't remember the last time I've heard it or sung it and so it was jarring for me and seated next to Kita I almost wanted I debated standing it was sort of do I it was it was a decision that had to be made and looking around the room and in a hand to heart and I have my hands in my pocket and I'm like am I being inappropriate so it was an interesting thought provoking moment Captain McGuire can I ask you how did these comments or I mean this must come up and resonate for you what would be your comment about it again these are my own personal thoughts your personal thoughts don't represent it anyway I actually love it because you know someone mentioned I think earlier today the hesitant, oh maybe it was Maurice the hesitation in expressing views that were contrary to the way they're presented through the military and that it might be unpatriotic and I thought to myself there's nothing more patriotic than pushing and questioning and saying hold on a minute no way, hell no and so for us it is I do, I love singing we sing all the time I'm always looking for an opportunity to do it I'll sing anything and of course we start all of our ceremonies and with the Star Spangled Banner it's just a part of the military culture but it's very true that a lot of people don't actively think about what that experience is like for other people I had something to say, that's why I'm hoping I'm going to take it from you for the moment for someone who hasn't spoken yet here and then we'll go there so from the perspective of an army musician I've been singing the national anthem for 11 years and it came to a point in my career where it was like brushing your teeth something that you do every day it's like a ritual and it just happens and there's no feelings and it's off the cuff it just happens so it was natural for a long time and it was I mean if you are in uniform and you don't salute and you don't recognize the flag during the anthem or whenever you're supposed to recognize the flag or render a hand salute it's like burning a flag it's totally taboo you don't do it you will get pinned down for it and then I was a first responder in the Boston Marathon bombings and the next like three days later I was forced to sing the national anthem at Fenway Park down the street with a crowd of people around me and they announced that I was one of the first responders in the form and I'm just having all of these emotions because of what I had just been through and since that day has just never been the same for me so I struggle with being a person in the military and also being in the civilian world with when I hear that and it just it will never it will never be the same again and I'm sure a lot of the veterans in the room have the same experience can I get the mic here so one here one here and then we'll go back there and over there real quick I've got a similar question about about the liminality of being in the civilian world and being a veteran that you you're still connected to the military through your past but you're also living in the civilian world and so you have no real present claim on being military and every time that I hear the Star Spangled Banner my question is do I put my hand on my heart do I salute you know what am I where's my position in this you know and of course as a scholar and a critical thinker I've also got all of the implications of what the Star Spangled Banner is you know for native for African-American for all of the all of the different implications that it has over the colonialist and so there is it stirs up a lot of emotion but at the same time it is an automatic response at this point and it's something that I grew up with and it's something that as a military person every single day at 6.30 you were standing waiting for you know for Reveille to go off and to stand at attention and all of these things that happened that kind of build these automatic responses in your body and so it is it's a liminality, it's a position of liminality that I haven't quite digested yet so over here I didn't expect this issue to come up here but it's one of the hardest issues of my personal transition from service member 22 years in the uniform to being what I am today and one of the things as a retiree we can wear our uniforms and things and our ribbons and I have made a decision to never wear the uniform again I've dedicated my life to serving in the uniform and out of the uniform in the military yet I don't feel I should ever wear the uniform again I keep one in the closet for my funeral if I I don't know why but I do the other point about the national anthem it was just a professional ritual it was never a thought it was something that is part of the culture and the oath of that now I'm outside of my oath I have since internalized that song and I have faces of soldiers that I had known loved and fought with that died and that song now is a testament to them not necessarily what it was about the country or its founding so to me that's a tribute song to three specific people and that helps me get through that song and then honor it so I touch my heart because I'm touching them without doing a ritual the reason I struggle with hierarchy is it's singular and when it flips it's still singular and I think what we're hearing here is that each of us it was so much more than a singular so when things happen which of our which how do we handle the multiplicity of who we are you didn't leave the room Kinta you stayed in the room and that to me is the expression of community it's not that we're all going to do the same thing at the same time in precisely the same way it's that we agree to be in here and work that out I'm Jewish raised by an adamantly ecstatic Jewish father who at Christmas time he would say okay don't sing the Christmas carols there then he relented he said okay you can sing but don't say the word Jesus this took like four years then I'm old enough in many people some people remember when the Pledge of Allegiance they added under God now my father totally believed in God but not in school so then we had to not say that part but we could say the other part but I see that as an education in nuance and a commitment to participation so for me the fact that people in this room wanted to sing that was such a beautiful thing and I felt I could stand I didn't need to sing but this is the practice of living in this other circular horizontal world to allow us to be those multiple selves I think my views on service and freedom have changed a bit since leaving the Army ten years ago and I just have kind of grown to wonder those who defend freedom what those freedoms are who those freedoms are for I was part of the veterans for Standing Rock group that went to North Dakota in December and thank you and it was a very powerful experience and it felt like a hallowed ground it was I don't even know how to explain it it was community on another level that had never experienced before one thing I noticed quickly was how patriotic the Native Americans the Lakota I mean I met Indigenous folks from all over the world but they were extremely patriotic I mean I saw more Marine Corps hats at Standing Rock than any other veteran group or place I've ever been in what I felt was this idea of coming together and what community means so I felt that when we did when we did that here but this idea of questioning it makes me with my personal experiences wonder like is that good or bad or right or wrong and I'm trying to make peace with the idea that questioning is okay I wanted to share that I was surprised that came up and that we were going to sing I'm sorry that the song came up and that we were going to sing it and we sang it I personally sing it and put my hand in my heart because my dad served in the military and he was in Germany for four years and he was in the Marine Corps Reserve but I wanted to say that I want to honor every single opinion on what happened in this room and it is an example for me the stark what hit me in talking about this is this is a very clear stark example to put in more political terms what Liz just said of this is exactly the form the kind of forms we need to create out in the community outside of our arts community where it's okay to not have the same opinion we're not screaming at each other but I completely respect the opinions I've heard and so for me it's United States of America love it or leave it, no love it or change it to your point several times over the past day so it did to and also to Colleen's point it gave me some hope because that's the kind of discourse we're possibly can because healthy democracy needs all these different voices it was hopeful I just want to thank you all for this experience of being in community and I just wanted to add that David your question about the experience feels to me like one of those exercises of what it means to make art together that singing in that moment is an enactment of a ritual in which again we have all had so many different experiences but a catalyst then to bring us together in that very process of differentiation and sharing so thank you for that can I just say one thing really quickly the interesting thing is the original plan was for Rebecca and Melissa and I to sing and then Lisa said oh I've got my violin like we'd even picked out the key that we were going to sing in we weren't envisioning it as a sing along right so then when everybody stood up I was like oh well isn't this interesting and I do think it's interesting I think it happened for the exact reason that it should have and I think it also speaks to the beauty of this event today like this has been I go to these events a lot this has been one of the most significant and genuine experiences that I perhaps have ever had within the arts and military conversation it is just and it is hopeful because of that genuine quality that people can say exactly what they want you know that's patriotism and it's just it's been a beautiful experience thank you everybody we're going to break here it's just me we have to we have to break here so continue this conversation with each other but part of the reason that I wanted to make sure we discussed it is because it's really at the core a part of how we're diverse in this room even though we all agree on the value of art there are lots of different opinions about many things related to the subject so thank you all for engaging the conversation thank you for your attention