Substance Abuse:
Mental Health and Music:
Interview with Dr. Patrick Gunderson


Substance Abuse:
Mental Health and Music

Interview with Dr. Patrick Gunderson
by Sue Basko

Patrick Gunderson is a psychologist and musician. He works with young adults in a mental health program that uses music as a therapeutic tool. This is the first of a 3-part series about issues that affect many in music and the other creative arts: substance abuse, depression, bipolar disorder, and anxiety. This first part is about substance abuse.

Please also see Part 2: Depression: Mental Health and Music


You’re a psychologist, right? Tell us a bit about what you do.
I always fancied myself a musician, but I suppose I'm a psychologist by trade. I work with adolescents in an outpatient day program at a behavioral health hospital in the suburbs of Chicago. This entails intensive group therapy focusing on a multitude of therapeutic issues (e.g., depression/anxiety, bullying, relaxation and mindfulness training, emotion regulation, self-victimization), frequent sessions with the family, and expressive therapy such as movement and art. Teenagers who come through this program struggle with depression, anxiety, behavioral issues, chemical dependency, suicidal thoughts, and many other issues. I run a music group, where the kids are invited to bring in their own instruments, lyrics they have written, and songs they would like to share or perform with the group. I use this opportunity to discuss the therapeutic value of music, dissect songs with them, and introduce them to a variety of new and old music that they may not otherwise have the opportunity to hear. At any given time during this group, you will hear singing, drumming, guitar-playing, rapping, and the occasional complaint (which is pretty rare).

Although I am not a licensed CADC  (CADC stands for Certified Alcohol and Other Drug Abuse Counselor), I work with many adolescents who struggle with addiction. My goal is to create as many opportunities as I can for them to use music as a way to heal and progress. I am quite fond of making playlists, so I often encourage them to create their own playlists of artists/groups that inspire them to get clean and to make changes in their life. Many times they'll burn me cds of their playlists, which I'll listen to on the way home from work. I feel it gives me a unique perspective on how they're growing and trying to move forward. It also gives me a chance to suggest new artists and songs that they can add to their "therapeutic music repertoire" (I coined that phrase, but feel free to use it).

I also have a small private practice, where I work with children, adults, couples, adolescents, and families.

Tell us about your education and training, how you got to be a psychologist.
I went to DePaul University for my bachelors degree and Marquette University for my masters and doctoral degrees. I have a Ph.D. in clinical psychology, which took about seven years post-undergrad to attain. Throughout my training as a graduate student, I worked with many populations in a variety of treatment settings doing therapy, supervision, diagnostic testing, and neuropsychological evaluations. Some of my favorite experiences include doing in-home family therapy and working in a school for 2 to 5-year-old children with various mental health and behavioral issues.

I think there is a trio of problems that tend to be the ones that affect people in music and film: substance abuse, bipolar disorder and depression. Do you think this hypothesis has merit?
I see it as a quadruplet of problems because I think that people in this field also struggle with intense anxiety. In the wake of Amy Winehouse's death were discussions primarily about her substance abuse and very little about her mental health. I have to believe that anxiety played a huge role in her frequent inebriation at shows. A good friend of mine, who followed her career rather closely, told me stories about her intense stage fright. Such a talented artist with such a tortured soul.

I think many people in music slip into drinking alcohol either too much or too often because it has a social element to it. Often they are performing in bars, too. Can you touch on this?
There is most definitely a social element to alcohol, but by the time true addiction sets in, people can be drinking in isolation. In the field of music, people may certainly be influenced to drink if their fellow band mates are drinking or if drinking has become something that is routine at practice. That being said, I don't know if it necessarily has to do with being in a bar. The social element of drinking likely comes into play long before and far outside of a live performance. Then again, drinking is a choice. I spent much of my late teens and most of my twenties practicing in basements and performing in bars with a variety of musicians, many of whom did not use drugs or alcohol. I have also been involved musically with people that do use drugs but abstain during practices and performances so that they can concentrate and stay focused.

When does alcohol become a problem?
For an individual, it's a problem when there is "abuse" and "dependence" (for specific diagnostic criteria, see: http://www.alcoholcostcalculator.org/business/about/dsm.html , and particularly when it begins to affect other areas of their life, such as their job, their family, and their overall mood. For bands, it's a problem when they sound awful on stage... and don't realize it.

People sometimes get kicked out of bands or bands break up because one person is drinking too much. Is there anything other people can do or say to let another person know their drinking is a problem?
In my opinion, people need to be honest and say it like it is. People don't necessarily have to be blunt or derisive, but they shouldn't sugar-coat it either. If you're in a band with people you respect, both musically and interpersonally, you need to be prepared for feedback. Sometimes, bandmates will not like your musical ideas. Or your lyrics. Or your arrangements. Sometimes, bandmates will not be happy with how much someone drinks, especially if it's affecting their ability to write and perform music. I think a simple way to say it is, "We're concerned about you, we're concerned about our music, and you're part of our music." For many musicians, substance abuse in the band is more of a nuisance than anything. However, as irritating as it can be, musicians need to be empathic towards their artistic companions and do what they can to be supportive. Perhaps I'm sounding cliché; that's not my intention. I'm just super biased, as I've been in far too many bands that did not break up amicably. The ones that did, though... those people are some of my best friends to this day.

Let’s talk about drugs: prescription, OTC, or illegal. What’s popular now?
Well, marijuana hasn't lost any popularity, and it seems to be easier and easier to get a hold of. In the last ten years, there has been a dramatic rise in psychotropic medication abuse. These are medications usually used to treat mental health issues, such as amphetamines and antidepressants. Narcotics (e.g., Vicodin, Oxycontin) are also used frequently. Drugs in pill form are convenient because they're easy to conceal and they don't have a scent.

With teenagers, we are hearing more and more about something called "spice," which is a blend of synthetic chemicals that mimics the effects of marijuana and is, at this time, 100 percent legal. Also, it doesn't show up on most drug tests. Recently, it has been found to cause seizures and loss of consciousness. (For reference, see this CNN article: http://articles.cnn.com/2010-03-02/opinion/fay.ban.k2_1_thc-k2-marijuana?_s=PM:OPINION)

There is a saying that when you are using a certain drug, everyone you know uses it. I think this is true, because a person using a drug bases their friendships on getting it, using it, etc. How can a person be reached if they have their whole support system built around this?
This is an excellent question, and an issue with which many teenagers in particular struggle. People are generally resistant to the idea that they will have to "find new friends" in order to stay sober. Some of these people they've known for years and are their closest peers. There's a huge fear of being ostracized once you're sober. I encourage the teenagers I work with to flat-out ask their friends for support. For example, are there friends who will, without a doubt, support their decision? Are there friends who would be willing to stay sober when they're with them? Are there any friends who may also be interested in reducing their drug use? It's difficult for me to wholly support the 12-step model, due to its rigidity. I'm a pragmatist; things just aren't that black and white for me.

Here's the rub when it comes to music: A musician faced with the demand to leave a band because of its association with drug use may have to leave behind something that was inspirational and, quite possibly, their primary way of coping. What if this creates a temptation to give up music or put it aside? I encourage the people I work with to "build new associations" for their passions. For example, if a particular song or group makes a person "miss" smoking marijuana, I help them find a new place or situation in which to play that song. One time in a music therapy group, we had people dancing and shouting along to a song that elicited painful memories for one of the group members. A few days after this group, she said that she found it easier to listen to the song because there was now something else - something silly - to remember.

What about people who think a certain drug makes them more creative?
Marijuana is often believed to be a creativity enhancer. While studies have indeed linked marijuana use to increased activity in the creative part of the brain, they also indicate that marijuana causes short-term memory loss, increased depression and anxiety, and psychosis. Not too long ago, I worked with a teenager who used marijuana so frequently that he developed paranoid delusions that his mother was trying to poison his food. Eventually, he had a psychotic break. Upon a month or so of sobriety and intense therapy, the delusions ceased.

I find it hard to believe that any substance can bring out creativity that doesn't already exist. People simply need to find productive ways to rid themselves of their inhibitions. Frank Zappa, for example, prided himself on not using drugs and never being under the influence as he composed and performed music. He is arguably one of the most creative musicians to have lived and, not arguably, one of the most prolific. He released over 60 albums before his death, and over 20 albums were released posthumously.

-- Patrick Gunderson, PhD.
patrick.r.gunderson@gmail.com

Please also see: Part 2: Depression: Mental Health and Music

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