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Psychological Issues and Treatment Strategies in Popular Musicians: A Review, Part 1

Susan D. Raeburn
From: Medical Problems of Performing Artists: Volume 14 Number 4: Page 171 (December 1999)

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Abstract: Twelve years ago, Medical Problems of Performing Artists published articles from my 1984 study of stress and coping in professional rock musicians, which described high levels of stress, anxiety, and substance abuse as occupational hazards for musicians.1,2 A sadly unchanging aspect of the popular music topography since then has been the continuing number of musicians who have died premature deaths due to substance abuse or accidents, often with comorbid psychological problems. Indeed, in 1996 Rolling Stone magazine published an article called "Rock and Roll Heroin" chronicling the latest rash of drug overdoses or drug-related suicides among young alternative rock musicians.3 I was reminded of this dismal state of affairs last year while listening to a compilation tape made many years earlier, and was taken aback to hear a favorite song from the rock group, INXS. A year earlier, in November 1997, I'd read that the 37-year-old lead singer, Michael Hutchence, had hung himself in a hotel room in Australia. The Associated Press account said, "He was in a -severe depressed state' because of his relationship with his girlfriend . . . and the effects of substances he had ingested. The coroner said Hutchence had consumed vodka, beer and champagne the night before, and a blood analysis detected cocaine, the antidepressant Prozac and other prescription drugs."4 This was painfully reminiscent of previous experiences along those lines. An early inspiration for me to work with musicians was the heroin overdose of one of my favorite singer/songwriters, Tim Buckley, in 1975 at the age of 28. At the time, I wondered why no one seemed to be methodically examining this recurring phenomenon. Ironically, Tim Buckley's son, Jeff, an accomplished singer/songwriter in his own right, drowned in a channel of the Mississippi River in 1997 at the age of 30.5 Although there was considerable speculation in the press, apparently Jeff Buckley was sober at the time of his death. In addition to alcohol and drug abuse, a wide variety of psychological problems often contribute to negative outcomes for musicians' health and careers. Aside from premature deaths, these negative outcomes more often take the less dramatic form of reduced quality of life or disrupted careers. Depression and anxiety disorders seem to be among the most prevalent and disruptive of psychological problems along with substance abuse/dependence and thereby command a central focus in the present discussion. However, as with other populations, psychological problems affecting musicians run the full spectrum of the disorders, and a truly comprehensive discussion is well beyond the scope of this paper. At least today it can be said that there are those of us trying to systematically understand and intervene on the more lethal aspects of the rock-and-roll lifestyle. As this review demonstrates, there are positive changes developing within various segments of the popular music community that aspire to influence the industry culture as a whole as well as the decisions of individual musicians.

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