Tsvia Horesh M.T.
Ramot Yehuda Zoharim Therapeutic Community
ISRAEL
Tel./fax 972 5436 510
The sirens of ancient Greece sang dangerous music. Nesting on a pile of human bones, on a rocky island off the coast of Sicily, the bizarre creatures, half bird-half woman, sang to the sun and rain; their song had the power to calm or to stoke the winds and to inflame men's loins. Their music was irresistible, the words even more so than the melody. They promised knowledge to every man who came to them, ripe wisdom and a quickening of the spirit. Many a sailor was lured to their shore -- where he'd pine away without food or drink, unable to break the sirens' spell.
The sirens' music tempted sailors by offering an illusion of power, joy and wisdom. The music was sweet and seductive; the danger of loosing one's connection with reality, even onto death, was apparent. But for the victims, the attraction was far more powerful than the concept of danger.
My clients are the modern-day sailors; the sirens can be seen as the drugs they abused for many years, substances whose sweet promises of joy, well being and transcendental experiences were found to be deceptive, only after addiction overtook the last vestiges of control they had over their habit.
The sirens, actually, sang "dangerous music". Many addicts talk about "using" music interchangeably with drugs, listening obsessively to music during periods of abstinence. Here, the symbolism of the sirens' music receives a duel meaning - not just the deceitful promise of the drugs, but, also, the powerful attraction of drug related music.
My clients are chronic substance abusers, undergoing a yearlong, inpatient treatment program in the Ramot-Yehuda - Zoharim therapeutic community, in Israel. Men and women, aged 19-50, with a history of drug abuse lasting anywhere from 2 to 30 years. The majority have lived a life of crime and spent time in prison, usually as a result of drug abuse, selling drugs, thefts, violence and prostitution. Many come from multi-problem families, with a history of various addictions, life in crime-ridden neighborhoods and easily accessible drugs.
The basic ideology of the therapeutic community is one of all inclusive, drug free, therapeutic care for the addict, as an individual and as a member of society, and is based on the assumption that drug dependency is a mix of educational, psychosocial, medical, emotional, spiritual and psychological factors, all of which must be addressed by treatment. It incorporates both psychodynamic and behavior-modification methods, in an effort to relate to the complexity of the issues of addiction.
Addiction can be looked upon as a psychological or medical pathology, but it is also a cultural phenomenon and - a culture in itself. The aim of treatment is to assist the addicts in leaving this culture and entering the culture of recovery. It is a long and difficult journey.
In his book "Pathways from the Culture of Addiction to the Culture of Recovery", William White writes about the role the culture of addiction plays in sustaining addiction, regardless of the etiology that led to the initiation of the person-drug relationship. And, in the late stages of addiction, the culture of addiction can pose the largest obstacle for clients entering the recovery process.
The culture of addiction is a way of life: a way of talking, thinking, behaving and relating to others, that separates substance abusers from those who are not. The culture encompasses values, places, rituals, symbols and music - all of which reinforce one's involvement in excessive drug consumption. A particular client may have initially started to abuse drugs in order to deal with emotional trauma, but it is clear that his addiction has shaped every aspect of his lifestyle, and that all these aspects must be examined in the recovery process. Many addicts have found it easier to break the physiological relationship with their drug than to break their relationship with the culture in which the drug was used. The failure to break the cultural relationship often precedes relapse.
Some of our younger clients cannot perceive their social life without pubs, clubs and rave parties - all sites where drugs and alcohol are consumed, all "danger zones" for the recovering addict. They cannot imagine going to a rock concert without taking - or drinking - something that will enhance their enjoyment of the music and enable them to feel part of the crowd.
Contemporary psychodynamic theories also recognize that much of the psychological dysfunction displayed by addicts is the result of drug abuse rather than the cause. It seems that some aspects of personality disorders, apparent in addicts' behavior, have developed secondarily as a consequence of substance abuse, whereas others are primary and stem from the interaction of early developmental wounds and experiences, with biological predisposition. (Kaufman, 1994). The addict is a person with an unstable personality without inner sources to deal with daily pressures. The drugs enabled him to deal with frustration, to disassociate from an oppressive and demanding reality.
In making the transition from the culture of addiction to the culture of recovery, one has to learn to deal with cues and craving. Exposure to environmental cues associated with drug use can trigger cravings that cause cognitive and physiologic changes - increased thoughts of using and feelings of anxiety.
In the beginning stages of treatment, each client is encouraged to begin to identify his high-risk relapse factors - the personal cues, the "people, places and things" (as coined by the Narcotics Anonymous groups) associated with his substance abuse. High risk factors can include:
PEOPLE: active addicts, family relationships with elements of co-dependency;
PLACES where drugs are sold or used, personal haunts, neighborhoods and streets associated with use;
THINGS: drugs and the equipment used for consuming them; films, literature and music that either promote drug use or are personally associated with the experience of use.
Most addicts, in the early stages of recovery, experience strong emotional and physical pulls back to active addiction, and ambivalence to their commitment to recovery. During such a vulnerable stage, exposure to cues that can trigger craving, may start a process that, if not checked in time, can cause them to leave the treatment program and relapse to drug abuse.
The song of the sirens, at times of crises in treatment, can drown out the sound of reason, of the quest for life, and cause our "sailors" to sacrifice all their gains in the recovery process for the sirens sweet music.
Music and addiction
Let us put the recovery process to one side for a few minutes, and look at the relationship that people that abuse drugs have with music.
Many of my clients claim that they cannot live without music. They tell different stories regarding their experiences with music, the differences relating to divergent ethnicity, age, musical preferences, drug preferences and personality traits.
There is the music that was listened to in adjunction with drugs. (though some clients relate that they were usually so stoned they weren't interested in music at the time). Many addicts talk about "using" music interchangeably with drugs, listening obsessively to music during periods of abstinence. Music fills the emotional vacuum they feel without drugs, drowns out overwhelming thoughts and emotions, eases their passage into sleep and energizes them on waking up in the morning. Clients also talk about using music to avoid feeling - when faced with emotional conflict. Relying on drugs for these capacities, for so many years, they are unable to cope without external help, and music fills that need.
James Lull, in his book "Popular Music and Communication", discusses similar topics - how listening to music can enable one to escape from personal burdens and tensions, stimulate fantasies and feelings of mental and physical ecstasy, alleviate loneliness. Music helps to establish, reinforce or change moods. Anger, frustration, depression, restlessness, aimlessness, self doubt - these emotions lead one to seek music that mirrors the emotions, in an effort to seek validation -which is usually lacking in the addicts social milieu. Certain kinds of music are used to resist authority, assert personalities, develop peer relationships and learn about things parents and schools don't teach. This is applicable to adolescent addicts and also to older addicts, whose emotional and social development were arrested at the developmental stage in which the addiction began, usually adolescence.
Some clients will listen to any kind of music - whatever's on the radio. Others are experts in specific musical genres and will gladly explain what kind of music goes with each specific drug they used, and argue with their friends if one can really enjoy music while using heroin, and if so, at what stage of the addiction.
The idea that music can be dangerous - came up in a conversation with some of my clients last year. To my (naïve)- question: what kinds of music do they like to listen to, they each spoke about relapses that were music related.
They expressed relief that someone was interested in this acute problem, which had never been addressed in therapy programs they had attended in the past.
The following notes are initial thoughts regarding the concept of "dangerous music", and of possible therapeutic methods that can be utilized in rehabilitating the complex relationship that addicts have with music. The work is at a preliminary stage, and more research and clinical experience are needed.
The music that was pointed out as potentially dangerous was, basically, of 4 different genres:
Interestingly, many of the addicts describe an overlapping between their preferred musical styles, and their "dangerous music". They are drawn to listen to music that can, eventually, endanger them.
In interviewing my clients on their preferred choices of music, some generalities arose. People from different ethnic groups prefer different kinds of music:
Mediterranean music is the choice of addicts who are usually native born Israelis, whose parents came from Arab countries, such as Morocco, Yemen and Iraq.
Young immigrants prefer heavy metal and rap from the former Soviet Union, most of who came to Israel 10 years ago or less.
Rave, techno and house are chosen by the majority of the younger clients, in their early 20's, regardless of their ethnic background. Much has been written about the "rave generation" - the mass parties, the "clubbing" culture, the music and drugs (ecstasy /MDMA and LSD). I have found that the danger such music holds for the recovering addict seems to be in a different category than the other genres. The lack of lyrics, the lack of performing musicians one can identify with, the cultural setting of such music - set it apart from other drug related music and raise different psycho-social issues. Because of the scope of this paper, I will limit myself to describing the effects of heavy metal and Israeli Mediterranean music.
How are these genres of music connected to drug abuse?
Try and remember how you feel when you listen to heavy metal music. Or, better yet, listen to some now. Whatever emotions aroused while listening to the music, most of us, hopefully, have the capability of dragging ourselves back to the reality, and the responsible behavior expected of us, in the present situation of reading a professional article. Many addicts don't have those capabilities, or else, they are not easily accessible. After listening to a song of the heavy metal group "Metalica", I asked my clients to write down what feelings, memories and thoughts came up. They wrote: street fights, heavy drinking, I don't give a damn… fooling around, wild behavior, hiding behind masks, it calms me down, and - what am I doing here (in treatment). The client who wrote that last remark said that while listening to the music, he had felt the impulse to get up and leave - the program, his gains in therapy, his hope of a new life. He was shaken at how fragile his recovery was.
Research that has been done on the effects of heavy metal music on adolescents reinforces some of my clients' reactions. Jeffrey Arnett from the University of Chicago, interviewed adolescent boys on their involvement with heavy metal music.
He found that some boys tended to listen to such music when they where in a negative mood, and that the music had a purgative effect, relieving their anger. The music was "used", like a tranquilizer, to relieve anger, to gain control. Other boys reported that when listening to the music with friends, it induced greater aggression, and put them into the mood to do violent acts. Arnett sees the popularity of such music as a symptom of alienation, the music being a reflection - and not necessarily the cause - of recklessness and despair.
Much of mainstream society's opposition to heavy metal, punk and rap music is related to the explicit lyrics, which include themes of sex, violence and drugs. It is interesting to point out that the majority of my clients do not know English and so can't understand the lyrics, apart from a few repetitive words. They relate, on the whole, to the rhythm, instrumentation, and general atmosphere of the song. I have also noticed that in many CD's of contemporary heavy metal groups, the inserts do not always include the texts of the songs, but only sinister-looking images of the rock-stars. It is usually difficult to understand the lyrics from the singing itself. These facts raise questions of the relevance of the "explicit lyrics" to the listeners' reactions to the music.
Let us move on to another genre of popular music that can be dangerous to addicts. Israeli Mediterranean music is a hybrid genre created in Israel by Jews from Arabic speaking countries. The music was, in the 1970's, thought to be culturally inferior by the mainstream, European-orientated culture and media. The music developed as an "underground" alternative, giving voice to the themes and musical heritage of the lower and working classes. The music is essentially either western music overlaid with middle-eastern ethnic "colors", and the Arabic mellismatic form of singing, or authentic Turkish, Yemenite or Iraqi music with Hebrew texts.
The strongest connection the addicts have is with the sub-genre nicknamed "crying songs". The lyrics and music of these songs evoke feelings of melancholy and despair. My clients relate that in times of depression, they are drawn to choose music that mirrors their mood, and while identifying with the words, and the memories the song evokes, sink into feelings of self-pity and worthlessness. One man told the group that in the past, when feeling down, during periods of abstinence, he would listen to such songs in his room, alone. His mother knew that such behavior was a sign that he was on his way to a relapse. Another client related his repetitive pattern: he would choose a song that reminded him of his former girl friend, in order to evoke pleasant memories of their time together. While listening to the song he would identify with the lyrics, which usually spoke of abandonment and lost love. He would recall that, actually, his girl friend left him for someone else. He would then become overwhelmed with emotions of despair and hopelessness. His only way of dealing with these emotions was to block them out with drugs. And yet another client would turn the volume way up when listening to such music - so that his family and neighbors would know that he was depressed. It was the only way he knew to ask for help.
These are some examples of the ways addicts use - or misuse - music.
Looking back on our discussion of environmental cues and high risk factors, we can begin to understand the role music has as a component of the culture of addiction, and the so-called "danger" it presents in the transition to the culture of recovery.
The music stimuli evoke emotional and physical responses not just because of the music's properties, but because music recreates a mental and emotional representation of the essence of the moment when it was first heard. The memory evoked can be of negative experiences or emotions, or of actual drug use. The established links between certain types of music and the euphoric recall of drug intoxication, reinforced through thousands of repetitions, serve as powerful connections to the culture of addiction.
How can we understand the addicts' susceptibility to the sirens' call, why are they drawn to listen to music that they know can endanger them? And, how is music different from other high-risk relapse factors?
Addicts may choose to listen to certain kinds of music as an attempt at self-healing, as a quest for integration of past pains and experiences with their present life, or as a search for emotional and spiritual catharsis. They are used to turning to external factors to manipulate their mood and emotional state, using drugs and music, to this purpose, interchangeably. The drugs they used blocked out almost all emotional activity, bringing them to a state of, what they call "living dead". Listening to music, they feel alive, connected to their past and present emotional repertoire. But something goes wrong, during what could have been a positive experience. The addicts' weak ego structure cannot deal with the overwhelming flood of emotional memories of pain, abuse and rejection. They figuratively "drown" in the oceanic feeling of regression, and reach out to the kind of acting they know best - substance abuse or risk seeking behavior.
In relating to the issue of dangerous music, in our music therapy groups, the first stage involves assessing the existence and intensity of musical cues from the culture of addiction. We explore the links between the clients' musical preferences and their drug-using identity and experiences.
The ancient Greeks had ways to deal with the sirens' dangerous music. Circe, the sorceress, advised Odysseus on how to deal with the danger when sailing by the sirens' island. She told him to order his sailors to plug their ears with bees wax, thus preventing them from hearing the music.
This is equivalent to the isolation techniques that involve protecting the client from exposure to certain kinds of music that are so integrally bound to drug use as to make it nearly impossible to diminish its power as a conditioned stimulus. I believe that this technique is appropriate in the beginning stages of treatment, when the clients are just overcoming the physical stages of detoxification, and are experiencing withdrawal symptoms, among them an overwhelming flood of negative emotions. At this stage, clients are usually not fully committed to their recovery and can be easily dissuaded by exposure to drug-related music.
In many inpatient treatment centers, this method seems to be the only technique in dealing with the issue of dangerous music. The music the clients are allowed to listen to is monitored by the staff, whose policy is usually to censor rave music and Mediterranean "crying songs", because of their strong connection to drug abuse. No attempt is made to deal with the threat this music presents to the addicts. When the clients finish the treatment program, they are left to deal on their with the sometimes crucial effects such music may have on their emotional well-being.
Odysseus himself, feeling more privileged than his sailors, didn't want plug his ears. He wanted to hear the sirens' music but knew that he was not strong enough to hold back while listening to it. Circe suggested that he have himself tied to the mast, and to instruct his sailors not to heed to his pleas to untie him, when he looses his sense of danger under the influence of the music. On the contrary, they were to see his pleas as a sign that they must lash him even tighter to the mast.
Odysseus was willing to face the danger but both he and the sorceress knew that he needed external boundaries to contain his self-destructive tendencies.
By listening to each clients' dangerous music, in the safe, containing environment of the music therapy group, we provide the figurative "ropes", tying the addict to reality, holding him from drowning in the music's emotional ocean. The client is encouraged to share, with the group, his memories and associations evoked by the music. Many times, people will disclose personal stories that they had not previously revealed in therapy.
But in order to enable the client to develop his own holding and containing powers, we turn to Orpheus for inspiration.
Orpheus, known for his creative, musical powers, found a way to deal with the sirens' music, saving his men and himself. Sailing by their island, he tuned his lyre and began to sing; and his persuasive voice overcame the allure of the Sirens. Vanquished, the Sirens from that moment lost all powers to do harm and were changed to rocks. One of them threw herself into the sea in vexation. Her body was tossed on to the shore by the waves, and a tomb was erected for her on the very spot where later the city of Naples rose.
In one of my group meetings, we attempted Orpheus's method in dealing with the danger the Israeli Mediterranean "crying songs" posed for the group members. I proposed that after listening to the song, we would improvise music that expresses the emotions evoked by the song. They chose to listen to one of the singers most identified with this genre - Ofer Levi, singing "The Road of Temptation". The song has a Turkish melody, and was recorded during a live performance.
The Road of Temptation
Words: D. Zigman
Music: traditional Turkish
Singer: Ofer Levi
I pray to God, give direction to my life
I've lost control, the road tempts me.
I meet my friends, they're all talking about me
I've ruined my life, why, my God?
Yesterday I had everything, everything was beautiful
Today I'm alone, don't recognize myself
I had all I wanted, I lost everything
I got carried away by drugs
On a sunny, spring day my soul is cold
My heart is frozen, my love
I tried to talk, I wanted to tell you
About the bitter pain in my body
How long will I suffer?
I've broken my vows to you, God.
While listening to the song, I could see from their body language that my clients were very moved, some of them showing signs of distress. When the song was over, I asked them to close their eyes, to stay with the emotions the music aroused, and to notice what memories it evoked. After a few minutes, I invited them to choose instruments. The transition from listening to the song, to choosing instruments and playing themselves, was not easy. There were feelings of unrest that led to talking and fooling around. I had to assert gentle authority and help them settle down, without loosing the feel of the song. The instruments they chose were: guitar, garmoshka (a small Russian accordion), 2 darbukas (Egyptian drums), a wave ring, domino, double cowbell. The guitar player has played professionally in the past; the rest of the group members have no musical experience, apart from 2 former improvisation group sessions. The improvisation lasted 7 minutes.
The beginning was tentative, even though the guitar played a constant rhythmic and harmonious base. The drummers had difficulty in staying with the slow, flowing rhythm of the guitar. I joined in with a hand drum in order to stabilize the rhythm, feeling that it important to guide them towards a stable rhythmic container. The eventual result was an almost hypnotizing, repetitive flow of sound. I directed the entrances and exits of the players. The domino kept a stable rhythm; the garmoshka played a poignant melody.
In the discussion that followed, I asked the people to relate to the emotions evoked by the song, and to their feelings during the improvisation. The atmosphere was tense; some people spoke about their painful memories, while other chatted with their neighbors, laughed or fiddled with their instruments. Feelings of doubt, that maybe the song took them so deep that there was no safe way out - began to creep up on me. Soon there were outbursts of anger, insults and what seemed to be a regression to behavior reminiscent of the culture of addiction. This was not their usual behavior. The clients, having been in treatment for 7-8 months, had, for the most part, internalized the behavioral codes of the recovery culture. It seemed clear that the music we heard was responsible for this regression.
When I asked what was going on, and shared my feelings with them, they calmed down. One man said that this is how he behaves when overwhelmed by negative emotions. I pointed out how easy it was to revert to the addictive behavior, to the aggressive, disrespectful ways of relating to each other, when exposed to music that reminded them of their past.
It's interesting to note that the improvisation itself was not sufficient to purge the negative emotions evoked by the song. The aggressive behavior began after the improvisation, and escalated while group members were trying to share their difficult memories. The moment of recognition - that this music not only affects their emotions but also controls their behavior - was a moment of revelation.
The domino player, who had been the main aggressor minutes ago, said that he hates Ofer Levi's music, and tries to avoid hearing it. It brings up feelings of pain and anger that have been part of his life, since childhood. "I feel angry, but I'm not angry at any of you. There's no one that I'm angry at" he said. He apologized for his behavior and said that his rhythmic manipulation of the domino, accompanying the melodic music of the guitar and garmoshka, enabled him to express and release his anger.
The guitar player said that during the song, he could smell the rice his mother used to cook for him when he lived at home. He felt a wave of warm feelings for his mother, which surprised him. He said that he harbors a lot of anger towards his parents and feels ashamed of them.
He was, during the past few days, even debating whether or not to invite them to the family therapy sessions which were going to take place soon. The positive memories of his mother challenged his conflict and ambivalence.
Regarding the aggressive atmosphere in the group, he said that if they had been active drug abusers, hearing that song, and if there had been a packet of heroin in the room - the result would be fistfights and stabbing. It was a miracle that they could channel such negative energy into improvising music.
The garmoshka player was a young man, whom I will call Tommy. He was known among his friends as a "clown", his behavior characterized by much adolescent-like acting out. He said that the song took him back to the neighborhood he grew up in. He described a closely knit society, where the people all knew each other. Ofer Levi's music in the air, the women cleaning and cooking inside, the guys sitting outside, eating sunflower seeds and smoking hash. The atmosphere was one of potential violence and reckless behavior. The memory was nostalgic but tinged with pain and fear, bringing up traumatic events from his past. He told us that the main emotion he felt was stress and unrest. In the past, when feeling this way, he would take a friend's car and drive it, recklessly … that was the only way he could calm down.
It seems that by merging with the guitar music, Tommy could connect with and express the sadness that was under the unrest and aggression he usually felt and acted on.
The song evoked a total reminiscent mode of being ( smell, pictures, sounds, memories and emotions), and threatened to drown the people in an overwhelming emotional ocean. They responded by acting out their anxiety and negative emotions. Only after interpreting the connection between the song and their behavior, could they really look at the underlying emotions, and appreciate the purging and organizing effect the improvisation had on them.
In creating their own music, the group members had to adhere to the musical elements of time, rhythm, structure and dynamics, which required them to activate their ego capacities for focusing, relating to exterior boundaries and the behavior of others, decision making and concentration on the here and now. Into this structured container, they each brought their own personal pain, fear, love and anger. Joining with their friends, they together created a total musical experience, hopefully loud and strong enough to, at least partially, drown out the dangerous music of the sirens, as Orpheus did so many years ago.
My role in the process was similar to that of Circe, the ancient sorceress that advised Odysseus on how to deal with the sirens. Circe symbolizes one who knows the secrets and dangers of the unconsciousness. I, myself, am not endangered by the music we listen to, and am aware of the perils it holds for my clients. My duty is to initiate the encounter between the addicts and their dangerous music; to supply a safe musical/emotional container in which they can "face the music" and the emotional turmoil it evokes, and to guide them through the difficult encounter to a safe shore, to an ability to control their musical experience, rather than to be controlled by it.
Two of my clients, of their own initiative, have been working on finding an alternative musical repertoire for themselves, choosing music that is not connected to their drug abusing past. They feel empowered by this independent project and hopefully, the personal growth accomplished through the musical work, by way of mastering the experience of "dangerous music", can be applied to other parts of their lives.
Music, for addicts, has powerful destructive and healing potential. It can be abused, as drugs are.
It can be misused and lead one into a vicious circle of dependency and self-destructiveness. But music has the potential to heal. By assisting addicts in rehabilitating their music-listening habits, they can learn to face their dangerous music, and begin to incorporate music into their lives as a source of enjoyment and enrichment.
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(1994) Psychotherapy of Addicted Persons, The Guilford Press, New York London
Kohut,H. & Levarie, S.
(1950) On the Enjoyment of Listening to Music, Psychoanalytic Quarterly, 19:64-87
Lull, J. ed.
(1987) Popular Music and Communication, Beverly Hills, Calif., Sage Pub.
Unkefer, R. F., ed.
(1990) Music Therapy in the Treatment of Adults with Mental Disorders, New York, Schirmer Books
White, W.
(1996) Pathways from the Culture of Addiction to the Culture of Recovery, Center City, Minnesota, Hazeldon Pub.