Akanksha Mete
Rap music, which traces its roots to African immigrants in the 1970s, is often used to lend a voice to members of these marginalised communities, usually with sociopolitical connotations (Crossley, 2005). Rapper Dave’s album, Psychodrama, is similar - what is exceptional is its format, wherein the album reflects his journey through a year of therapy, and individual songs constitute an individual therapy session.
The album is inspired by Dave's incarcerated brother’s experiences with psychodramatic therapy (Savage, 2019), a form of experiential therapy wherein the client roleplays real-life situations to externalise their feelings regarding past events, and contextualise them in the present (Casey, 2001). Dave’s therapist, who remains unnamed, appears on the songs “Psycho”, “Purple Heart”, “Environment”, and “Lesley”, and can be heard asking Dave questions, as well as detailing the progress Dave makes towards recovery.
This posts examines the actions taken by Dave's therapists, the efficiency of treatment delivered and its orientation. It further argues that it is the psychodynamic aspect of therapy, in addition to the catharsis from Dave writing the album, that is to credit for Dave's progress, rather than the psychodramatic technique itself.
The song “Psycho” is their first session, starting with the therapist asking David about his background, any issues he’s been dealing with, and finally, “Where should we start?” David's mental state during "Psycho" is confused and fragmented, with clear lack of emotional control, as we discover he suffers from manic depression. The role of the therapist is not to be overlooked here, as their clever use of open ended questions about Dave's complaints, and what led him to seek therapy, help establish a good rapport whilst simultaneously allowing Dave to freely verbalise his thoughts (Waldinger, Jacobson 2001). In accordance with the APA's Practice Guidelines for Psychiatric Evaluation of Adults, the therapist also places due emphasis on psychosocial, sociocultural history during assessment, as evidenced by their inquiry into Dave's background, and where he is from.
Following songs, like "Black", focus on early life conflicts, and the role of race in Dave's life, in direct response to the therapist's inquiry into his background. But as we move to "Purple Heart", the next song on which Dave's therapist makes an appearance, there is a lighter tonal shift, as Dave examines his interpersonal relationships.
On "Purple Heart", an emotionally dependent relationship with alcohol is heavily implied, evidenced by the lines, "...let's pour another drink and numb the pain." However, the rest of the song focuses on a passionate romantic relationship, as does his therapist's response. The therapist points out that one of Dave's best traits is his ability to find positives despite his challenges, thus reaffirming Dave's strengths and providing a foundation for further treatment (Waldinger, Jacobson 2001). While such empathy is ideal in therapist-client relationships, the fact that Dave's therapist fails to follow up on the alcohol abuse is problematic given the negative effect substance abuse may have on mental health.
On "Disaster", Dave hints at how stereotyping and public perception affect his mental health, which the therapist picks up on, seguing into "Environment" by asking, "What do you think people see when they look at you?" "Lesley", the final song on which Dave's therapist features, ends with the therapist expressing happiness in the progress Dave has made over a year, demonstrating growth and maturity. This progress is reflected both in "Lesley" - where Dave rants about how "wrong" the world's unfairness is, whereas the album began with him resigned and hopeless - as well as "Drama", where he confronts his issues with his brother without losing emotional control as he previously had.
Through these, we can argue that the therapist's therapeutic orientation leans towards psychodynamic - evidenced by their constant use of open ended questions to encourage talk in therapy - and cognitive behavioural - placing clear emphasis on Dave learning to "control" his disturbed thought patterns.
Therefore, when analysing the efficiency of Dave's therapist, we examine their efficiency during initial assessment, and efficiency of treatment overall. While their efficiency during initial assessment was high, as shown previously through their consistent compliance with both APA and Waldinger's guidelines for initial assessment, the same cannot be said as strongly for efficiency of overall treatment. This is because while research indicates that CBT and psychodynamic approaches are effective in combating depression, with remission rates of 52% and 68% respectively (Huber, et al 2012), little such empirical research exists supporting the efficiency of psychodramatic therapy. Research also exists supporting the role of music - and self expression - in reducing stress, as well as potentially depressive symptoms (Novotney, 2013), which Dave practiced through the process of writing the album.
Dave's therapist's approach was thus efficient on three counts out of four. But the album, as well as ongoing research, paint a highly optimistic picture for the positive effects of music and self expression for treating depression.
Bibliography
Casey, A. Psychodrama: Applied Role Theory in Psychotherapeutic Interventions.. (n.d.) >The Free Library. (2014). Retrieved Sep 25 2019 from https://www.thefreelibrary.com/Psychodrama%3a+Applied+Role+Theory+in+Psychotherapeutic+Interventions.-a074221526
Crossley, S. (2005). Metaphorical Conceptions in Hip-Hop Music. African American Review, 39(4), 501-512. Retrieved from http://www.jstor.org/stable/40033689
Huber, D., Zimmermann, J., Henrich, G., & Klug, G. (2012). Comparison of cognitive-behaviour therapy with psychoanalytic and psychodynamic therapy for depressed patients — A three-year follow-up study. Zeitschrift Für Psychosomatische Medizin Und Psychotherapie, 58(3), 299-316. Retrieved from http://www.jstor.org/stable/23871519
Psychodrama. London, UK. Retrieved from https://open.spotify.com/album/4GrFuXwRmEBJec22p58fsD
Savage, M. (2019, September 20). Mercury Prize-winner Dave: Seven things you need to know. Retrieved from https://www.bbc.com/news/entertainment-arts-49764402
Novotney, A. (2013, November). Music as medicine. Monitor on Psychology, 44(10). http://www.apa.org/monitor/2013/11/music
Waldinger, R., & Jacobson, A. (2001). The Initial Psychiatric Interview. Psychiatric secrets
(2nd ed.).
Rap music, which traces its roots to African immigrants in the 1970s, is often used to lend a voice to members of these marginalised communities, usually with sociopolitical connotations (Crossley, 2005). Rapper Dave’s album, Psychodrama, is similar - what is exceptional is its format, wherein the album reflects his journey through a year of therapy, and individual songs constitute an individual therapy session.
The album is inspired by Dave's incarcerated brother’s experiences with psychodramatic therapy (Savage, 2019), a form of experiential therapy wherein the client roleplays real-life situations to externalise their feelings regarding past events, and contextualise them in the present (Casey, 2001). Dave’s therapist, who remains unnamed, appears on the songs “Psycho”, “Purple Heart”, “Environment”, and “Lesley”, and can be heard asking Dave questions, as well as detailing the progress Dave makes towards recovery.
This posts examines the actions taken by Dave's therapists, the efficiency of treatment delivered and its orientation. It further argues that it is the psychodynamic aspect of therapy, in addition to the catharsis from Dave writing the album, that is to credit for Dave's progress, rather than the psychodramatic technique itself.
The song “Psycho” is their first session, starting with the therapist asking David about his background, any issues he’s been dealing with, and finally, “Where should we start?” David's mental state during "Psycho" is confused and fragmented, with clear lack of emotional control, as we discover he suffers from manic depression. The role of the therapist is not to be overlooked here, as their clever use of open ended questions about Dave's complaints, and what led him to seek therapy, help establish a good rapport whilst simultaneously allowing Dave to freely verbalise his thoughts (Waldinger, Jacobson 2001). In accordance with the APA's Practice Guidelines for Psychiatric Evaluation of Adults, the therapist also places due emphasis on psychosocial, sociocultural history during assessment, as evidenced by their inquiry into Dave's background, and where he is from.
Following songs, like "Black", focus on early life conflicts, and the role of race in Dave's life, in direct response to the therapist's inquiry into his background. But as we move to "Purple Heart", the next song on which Dave's therapist makes an appearance, there is a lighter tonal shift, as Dave examines his interpersonal relationships.
On "Purple Heart", an emotionally dependent relationship with alcohol is heavily implied, evidenced by the lines, "...let's pour another drink and numb the pain." However, the rest of the song focuses on a passionate romantic relationship, as does his therapist's response. The therapist points out that one of Dave's best traits is his ability to find positives despite his challenges, thus reaffirming Dave's strengths and providing a foundation for further treatment (Waldinger, Jacobson 2001). While such empathy is ideal in therapist-client relationships, the fact that Dave's therapist fails to follow up on the alcohol abuse is problematic given the negative effect substance abuse may have on mental health.
On "Disaster", Dave hints at how stereotyping and public perception affect his mental health, which the therapist picks up on, seguing into "Environment" by asking, "What do you think people see when they look at you?" "Lesley", the final song on which Dave's therapist features, ends with the therapist expressing happiness in the progress Dave has made over a year, demonstrating growth and maturity. This progress is reflected both in "Lesley" - where Dave rants about how "wrong" the world's unfairness is, whereas the album began with him resigned and hopeless - as well as "Drama", where he confronts his issues with his brother without losing emotional control as he previously had.
Through these, we can argue that the therapist's therapeutic orientation leans towards psychodynamic - evidenced by their constant use of open ended questions to encourage talk in therapy - and cognitive behavioural - placing clear emphasis on Dave learning to "control" his disturbed thought patterns.
Therefore, when analysing the efficiency of Dave's therapist, we examine their efficiency during initial assessment, and efficiency of treatment overall. While their efficiency during initial assessment was high, as shown previously through their consistent compliance with both APA and Waldinger's guidelines for initial assessment, the same cannot be said as strongly for efficiency of overall treatment. This is because while research indicates that CBT and psychodynamic approaches are effective in combating depression, with remission rates of 52% and 68% respectively (Huber, et al 2012), little such empirical research exists supporting the efficiency of psychodramatic therapy. Research also exists supporting the role of music - and self expression - in reducing stress, as well as potentially depressive symptoms (Novotney, 2013), which Dave practiced through the process of writing the album.
Dave's therapist's approach was thus efficient on three counts out of four. But the album, as well as ongoing research, paint a highly optimistic picture for the positive effects of music and self expression for treating depression.
Bibliography
Casey, A. Psychodrama: Applied Role Theory in Psychotherapeutic Interventions.. (n.d.) >The Free Library. (2014). Retrieved Sep 25 2019 from https://www.thefreelibrary.com/Psychodrama%3a+Applied+Role+Theory+in+Psychotherapeutic+Interventions.-a074221526
Crossley, S. (2005). Metaphorical Conceptions in Hip-Hop Music. African American Review, 39(4), 501-512. Retrieved from http://www.jstor.org/stable/40033689
Huber, D., Zimmermann, J., Henrich, G., & Klug, G. (2012). Comparison of cognitive-behaviour therapy with psychoanalytic and psychodynamic therapy for depressed patients — A three-year follow-up study. Zeitschrift Für Psychosomatische Medizin Und Psychotherapie, 58(3), 299-316. Retrieved from http://www.jstor.org/stable/23871519
Psychodrama. London, UK. Retrieved from https://open.spotify.com/album/4GrFuXwRmEBJec22p58fsD
Savage, M. (2019, September 20). Mercury Prize-winner Dave: Seven things you need to know. Retrieved from https://www.bbc.com/news/entertainment-arts-49764402
Novotney, A. (2013, November). Music as medicine. Monitor on Psychology, 44(10). http://www.apa.org/monitor/2013/11/music
Waldinger, R., & Jacobson, A. (2001). The Initial Psychiatric Interview. Psychiatric secrets
(2nd ed.).
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