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The Cultural Factors That Affect The Mental Health of Musicians
The Cultural Factors That Affect The Mental Health of Musicians
The Cultural Factors That Affect The Mental Health of Musicians
Dedication
by
The thesis analyzes the various cultural factors that affect the mental
health of musicians. The use of historical and theoretical analyses
provides a background to mental health, while also providing a new
view on mental health in the music industry. The ontological approach
to mental health is meant to bring awareness to the social stigma of
mental health and inspire change. Understanding the historical and
theoretical framework of mental health and music shifts the attention
to the social essence of being human. By studying different cultural
factors, such as the culture industry and panopticism, we can
understand the impact that these cultural factors have on a multitude of
individuals and begin to reframe the way we think about mental
health. Raising awareness creates room for understanding, which
allows for the reevaluation of the societal stigma of mental illness.
Introduction
Throughout modern history, music has developed into an industry that has brought upon
many musicians into the starlight. The music industry has made billions of dollars yet has
invested miniscule amounts of money in the artists that generate profits. Oftentimes the social
factors of the music industry are casted aside and economic factors1 are the main priority. I will
be writing this thesis in a quasi-traditional way that will review previous literature and will focus
on the ontological2 perspective of the musicians within the music industry. I am bringing light to
the various cultural factors that affect the mental health of musicians, while also seeking to get a
I was inspired to write this thesis because of Mac Miller. I discovered Mac Miller’s music
in 2011 from a free song download provided by iTunes. The song was called “On and On” and
was about traveling the world and living the glamorous life of a musician. I checked out his
mixtape K.I.D.S and became a fan of his upbeat, chill, and rebellious music. I was starting high
school and his music perfectly fit the vibe of high school and made me feel free. Mac released
his mixtape Best Day Ever and album, Blue Slide Park, which were scrutinized for the subject
matter consisting mostly of partying, drug-use, and care-free behavior. After facing scrutiny for
his teenage-inspired music, Mac created the mixtape Macadelic and brought a refined
psychedelic sound to hip hop. He constantly discusses his use of drugs in this mixtape and dives
deep into his own mind, while expressing his thoughts about being in the limelight.
After releasing Macadelic, Mac released Watching Movies with the Sound Off, which was
his most introspective album filled with self-reflection and questioning the meaning of life. In
1
Economic profits are oftentimes at the forefront of the music industry. This causes social factors, such as mental
health, to be cast aside.
2
Ontology deals with the nature of being. My thesis will contain both implicit and explicit analyses on the various
cultural factors that shape the lives of musicians and ultimately study their essence.
the song Aquarium, he sings: “I'll always wonder what happened 3000 years ago / I like to toy
with the idea that we really know / Is what I do important in the grand scheme of things? / In my
head these dreams are dreamt, trust me we are kings.”3 Mac is contemplating the meaning of life
and how important his impact is on the world. When he released this album, I loved it because of
his raw introspective outlook on life. It was such a stark change from his previous music and
further cemented my love for Mac and his creative expression. Both Macadelic and Watching
Movies with the Sound Off were forms of Mac Miller exploring addiction and the fear of the
unknown. Since releasing Watching Movies with the Sound Off, Mac Miller released many
mixtapes and albums that had roots extending from jazz, hip-hop, and rock. His mixtape Faces
was a philosophical expression of life infused with jazz samples that dealt with the stories of
being human.
His next two albums, GO:OD AM and The Divine Feminine were perfect examples of
Mac infusing different genres together to create a beautiful and experimental sound. These
albums focused on raw hip-hop, life stories, and love. The infusion of alternative rock, hip-hop,
jazz, r&b, and soul showed a new side of Mac Miller and displayed his musical versatility. Mac
Miller took two years in between The Divine Feminine and Swimming, to create music and
isolate from the world through drugs and music. Mac was arrested for driving under the
influence in 2018 and was released on bail. His appearance in the news was surprising because
he was keeping his presence in the world and on social media to a minimum. He released his
final album, Swimming, in August of 2018. Swimming experiments with a new sound and
focuses on the themes of swimming or drowning. Mac’s experimentation with these themes
shows a darker and meaningful side to his music that is centered around his heart as the driving
3
Miller, Mac, writer. "Aquarium." Recorded 2013. In Watching Movies with the Sound Off. Mac Miller. Rostrum
Records, 2013, MP3.
influence. He created a fresh, funky, and sonic sound that told a story of life, addiction, isolation,
and depression. His last studio album before his death was his most comprehensive piece of
work that exemplified his true emotions and empowered us to float, when challenged with things
that may drown us. Mac Miller’s eloquent songwriting allowed an introspective look at life that
Mac’s charismatic soul and creative expression is why I have decided to write this thesis.
His music has had such a positive and empowering impact on my life. Mac Miller passed away
on September 7, 2018 from overdosing on fentanyl. When Mac passed away, I felt as if I lost a
friend because of his musical growth being present in my life for nearly a decade. He talked
about different aspects of life in his music that helped me become more introspective of my own
life. Mac constantly inspired me to be creative, so here is my creative expression inspired by the
This thesis is meant to bring awareness to mental health in the music industry and
discover ways to help musicians that struggle with their mental health. Mental health and
substance abuse are important topics that have been gaining exposure in mainstream media. The
increasing exposure of these sensitive topics allows there to be room for discussion and changing
the discourse in how we think about mental health and substance abuse. Through studying the
various cultural factors that impact mental health and musicians, there can be a shift of any
negative stigma towards the topic. Understanding the historical and theoretical framework of
mental health and music is beneficial because it steers away from the traditional medical model
There has been previous research done on creativity, mental health, and musicians that
has majorly focused on quantitative and qualitative analysis. The research done by various
individuals had added important information to discussing musicians and their mental health.
The historical context of mental health will allow a clear insight into how mental health has been
seen by those before us and how it is seen today. No matter how you look at it, the saliency of
mental health has been prevalent throughout our history and constantly been changing in the 21 st
century.
In the early 1900’s mental illness was looked as a form of “madness” and that it could be
treated as a disease. John Murphy provides a historical look at mental health and how the illness
something that is value-free or objective. Whatever is dictated as scientific is deemed true and
used as a basis for the “truth.” Throughout Murphy’s analysis on mental health, he uses the word
“madness”5 in lieu of “mental illness.” Scientists mainly used the term “madness” because
individuals with a mental illness were viewed as having a deficiency or absence of rationality.
Mental illness was seen as a psycho-physiological breakdown and scientists believed that it
disease was dangerous because hospitals were restarting patients’ psychic functions by using
4
Murphy, John W. Postmodern Social Analysis and Criticism. New York: Greenwood Press, 1989.
5
Madness is defined as insanity, which is the opposite of sane. Sane individuals are considered “normal,” while
individuals who are mad, are not “normal.” The term of madness is used in a derogatory way and alienates
individuals who do have a mental illness.
6
Murphy, John W. Postmodern Social Analysis and Criticism. New York: Greenwood Press, 1989.
In the 1950’s, the medical model for mental illness was questioned because of the
inhumane practices of psychosurgery and drug therapy. The medical model caused patients at
hospital wards to develop institutional neurosis.7 Patients became well acquainted with hospital
life, but in turn were not able to function outside of the institution. This was detrimental to the
patient because they would remain in the institution and be unable to live a “normal” life
detached from the institution. The hospitals created a sense of dependency that alienated the
patients further from society. Fortunately, in 1963, the Community Mental Health Centers Act
(CMHCA) was passed by John F. Kennedy. The Act “led to the establishment of comprehensive
community mental health centers throughout the country. It helped people with mental illnesses
who were ‘warehoused’ in hospitals and institutions move back into their communities.” 8 The
CMHCA focused on bringing a new way to treat patients with a mental illness. The Act focused
on community-based care and steered treatment away from the traditional medical model. This
transformation of the mental healthcare model allowed there to be a stronger focus on the socio-
cultural factors that impact mental health. As Murphy states, “The aim of a therapeutic
community, in short, is to illustrate that madness transpires between persons and can only be
remedied through constructive dialogue.”9 The care for mental health must originate from a
social understanding for there to be a remedy for those affected by mental health problems.
Having a constructive discussion about mental health is beneficial for society because the stigma
against mental health can be broken down and more people can seek help.
7
Ibid.
8
Nationalcouncil.org. "Community Mental Health Act." National Council. Accessed April 02, 2019.
https://www.thenationalcouncil.org/about/national-mental-health-association/overview/community-mental-health-
act/.
9
Murphy, John W. Postmodern Social Analysis and Criticism. New York: Greenwood Press, 1989.
Health Care Access
The transformative care was beneficial in changing the way mental health is looked at by
society and providing a holistic approach to mental healthcare. When analyzing musicians and
their access to mental healthcare, the access was limited and a challenge to obtain. In 2003,
Susan D. Raeburn and other researchers performed a study of convenience samples that surveyed
the health status of musicians. The study was done at music conferences around the United States
and had about 178 viable surveys returned. More than half of the musicians (58%) had access to
health insurance, but most insurance was obtained “from a non-music-related day job or through
a spouse or parent.” 10 Musicians get involved in their independent careers or are signed to a
record label and healthcare is not an affordable option given to the musicians. In cases of
musicians who have signed to record labels, they do not receive many benefits other than money
to record their music for the majority of profits going to the record label.
In a study done by Sally Anne Gross and Dr. George Musgrave, 2,211 (self-selected)
musicians took part in a qualitative survey about mental health and music. These study
participants consisted of prominent UK artists and 53 percent of them found it hard to get mental
health help due to stigma and access being the biggest factors.11 Despite some musicians having
healthcare, “mental health benefits often are arbitrarily and significantly limited.” 12 Mental
health benefits are often not the main focus of healthcare providers because it is not viewed as a
predominantly medical issue. The Community Mental Health Centers Act was proactive in
10
Raeburn, Susan D., John Hipple, William Delaney, and Kris Chesky. "Surveying Popular Musicians' Health
Status Using Convenience Samples." MPPA 18, no. 3 (September 2003): 113-19. Accessed April 2, 2019. Medline.
11
Gross, Sally Anne, and George Musgrave. "Can Music Make You Sick? Music and Depression A Study into the
Incidence of Musicians’ Mental Health." Music Minds Matter, November 2016. Accessed April 2, 2019.
https://www.helpmusicians.org.uk/assets/publications/files/can_ music_make_you_sick_part_1-
_pilot_survey_report_2019.pdf.
12
Raeburn, Susan D., John Hipple, William Delaney, and Kris Chesky. "Surveying Popular Musicians' Health
Status Using Convenience Samples." MPPA 18, no. 3 (September 2003): 113-19. Accessed April 2, 2019. Medline.
providing community-based care, but many of the Health Centers are not covered by major
health care providers because it is not deemed as medical treatment. The flaws of the healthcare
system are detrimental to the access of mental healthcare and further discourages musicians to
seek help. The for-profit healthcare system is not affordable for many musicians that were
interviewed at the conferences around North America.13 The high costs of healthcare and the
accessibility are some of the reasons that musicians are unable to get help for mental health
problems.
Stigma
The cost and access to mental healthcare are barriers for musicians trying to get help.
However, one of the largest barriers is that of the negative stigma that mental health receives. As
seen earlier in John Murphy’s analysis of mental health, it was seen as a disease that could be
treated with medicine and other extreme medical approaches. 14 There has been improvement to
mental healthcare and incorporating social aspects of care, but the stigmatization of people with
mental illness still exists. Arthur H. Crisp et al. performed a study that determined the opinion of
the British adult population concerning mental health. “The survey was carried out on behalf of
the College by the Office for National Statistics (ONS)” and had 1737 participants respond out
of 2679.15 There were seven disorders that respondents responded to and the most negative
responses were to schizophrenia, alcoholism, and drug addiction. Individuals with these three
alcoholism and drug addiction are prevalent throughout the music industry and often are results
13
Ibid.
14
Murphy, John W. Postmodern Social Analysis and Criticism. New York: Greenwood Press, 1989.
15
Crisp, Arthur H., Michael G. Gelder, Susannah Rix, Howard I. Meltzer, and Olwen J. Rowlands. “Stigmatisation
of People with Mental Illnesses.” British Journal of Psychiatry 177, no. 1 (2000): 4–7. doi:10.1192/bjp.177.1.4.
16
Ibid.
of mental health problems. In a study by Johannes M. Just, musicians had the highest mortality
rate (38.6%) caused by drug and/or substance abuse among celebrities.17 Musicians turn to drugs
and alcohol to cope with mental health issues because seeking help is heavily stigmatized by
mass media and access to mental healthcare is obstructed by the bureaucratic process of large
healthcare providers. According to the study done by Crisp et al., “people with alcoholism and
drug addiction were frequently rated as to blame for their disorders and capable of helping
themselves.”18 The consensus of respondents viewed people with any of the seven disorders as
hard to talk to. When analyzing the survey responses on depression, “19% responded that they
could pull themselves together, 23% that they would not eventually recover, and 23% that they
are dangerous to others, yet only 16% thought that they would not respond to treatment.”19 The
results from the study of various disorders further exhibits how there is a prevalent stigma
against mental health and the issues that arise from a mental illness.
In addition to stigma, there are other psychological and social factors that come into play
when examining the mental health of musicians. David J. Sternbach20 provides insight on the
lives of musicians at an earlier age and how isolation plays a role in a musician’s life. He notes
that musicians who are in school and playing instruments usually practice in isolation, so they
can improve their craft.21 Since most young musicians are going through constant socialization
17
Just, Johannes M., Markus Bleckwenn, Rieke Schnakenberg, Philipp Skatulla, and Klaus Weckbecker. "Drug-
related Celebrity Deaths: A Cross-sectional Study." Substance Abuse Treatment, Prevention, and Policy 11, no. 1
(2016). doi:10.1186/s13011-016-0084-z.
18
Crisp, Arthur H., Michael G. Gelder, Susannah Rix, Howard I. Meltzer, and Olwen J. Rowlands. “Stigmatisation
of People with Mental Illnesses.” British Journal of Psychiatry 177, no. 1 (2000): 4–7. doi:10.1192/bjp.177.1.4.
19
Ibid.
20
David J. Sternbach was a professional music performer, private studio and classroom teacher, and has practiced
psychotherapy with musicians for over twenty years.
21
Sternbach, David J. “Stress in the Lives of Music Students.” Music Educators Journal 94, no. 3 (January 2008):
42–48. doi:10.1177/002743210809400309.
processes, their musical isolation promotes introversion and a sense of individuality. Young
musicians tend to be more introverted and have less opportunities to engage in social interactions
because of their isolated practice. Sternbach continues to discuss the other psychological factors
of excessive criticism, which is largely present in the lives of young musicians. Oftentimes, there
is criticism from instructors and peers that is internalized by young musicians, who then become
their own critic. The overly self-critical attitude is developed at a young age in the musician’s
In the UK Minds Matter study, Sally Anne Gross and Dr. George Musgrave discovered
that prominent musicians in the United Kingdom are reflective and highly self-critical of
themselves and their creative work.22 The self-critical attitudes of musicians begin at a young age
and have a negative impact on their mental health. One of the reasons why musicians have these
attitudes of critique is because it has become a basic operating style in dealing with any
frustrations that are music-related. Sternbach states that “musicians are taught to be highly self-
responsible.”23 Musicians are socialized at a young age to be independent and isolate themselves
throughout their musical practices. These social characteristics transcend their young lives and
are internalized to become bad habits when analyzing mental health. Many musicians are self-
employed or work in their own creative space. Working in their isolated creative space is
beneficial for their musical creation, but it can cause musicians to feel on their own when it
22
Gross, Sally Anne, and George Musgrave. "Can Music Make You Sick? Music and Depression A Study into the
Incidence of Musicians’ Mental Health." Music Minds Matter, November 2016. Accessed April 2, 2019.
https://www.helpmusicians.org.uk/assets/publications/files/can_ music_make_you_sick_part_1-
_pilot_survey_report_2019.pdf.
23
Sternbach, David J. “Stress in the Lives of Music Students.” Music Educators Journal 94, no. 3 (January 2008):
42–48. doi:10.1177/002743210809400309.
24
Gross, Sally Anne, and George Musgrave. "Can Music Make You Sick? Music and Depression A Study into the
Incidence of Musicians’ Mental Health." Music Minds Matter, November 2016. Accessed April 2, 2019.
Another cultural factor that can impact the mental health of the musicians is the family
environment they grow up in. Ks Pavitra et al. conducted a study that compared the stress and
mental health of creative versus non-creative populations. There were forty writers, forty
musicians, and forty control group participants that were randomly selected. The majority of
writers and musicians had history of mental health problems present in their family compared to
the control group.25 Although this finding is not indicative of causing generational mental health
problems, it is important to consider the breadth of mental health in the familial structure. David
J. Sternbach discusses the familial environments that can affect a musician’s mental health by
describing the toxic family style that he has studied in his field of psychotherapy. A toxic family
environment consists of accidents being perceived as avoidable, low tolerance for frustration,
and a high level of indignation about life.26 This environment is a breeding ground for anxiety
and further causes musicians to be self-critical of themselves and their creative works.
Musicians face many challenges that can affect their mental health, but some studies have
postulated the idea that creating music can help in the sublimation 27 process of the individual.28
In 2001, three researchers studied musical creativity and suicide to determine patterns found in
the deaths of 19th and 20th century creatives. Antonio Preti et al. focused mostly on composers
https://www.helpmusicians.org.uk/assets/publications/files/can_ music_make_you_sick_part_1-
_pilot_survey_report_2019.pdf.
25
Pavitra, Ks, Cr Chandrashekar, and Partha Choudhury. "Creativity and Mental Health: A Profile of Writers and
Musicians." Indian Journal of Psychiatry 49, no. 1 (2007): 34. doi:10.4103/0019-5545.31516.
26
Sternbach, David J. “Stress in the Lives of Music Students.” Music Educators Journal 94, no. 3 (January 2008):
42–48. doi:10.1177/002743210809400309.
27
Sublimation is a term coined by Sigmund Freud and can bets be explained as channeling any frustrations or
irrational impulses into a creative form. If a musician is frustrated, they can transfer their frustration into their music
and displace their libido, whilst doing something that they love doing.
28
Freud, Sigmund, Todd Dufresne, and Gregory C. Richter. Civilization and Its Discontents. Peterborough, Ontario:
Broadview Press, 2016.
The musician works with sound and could possibly be argued to be working in a realm
one step closer to the Self, even to those parts of the Self that are the source of conflict
and upset. This might help the musician to sublimate emotional conflict to be free of the
The musicians tend to be closer to their sense of Self because they are constantly working on
their music and using their creativity to sublimate any feelings of conflict. Musicians had lower
suicide rates than the other groups of creative individuals, which suggests that musicians have a
better creative outlet to sublimate their struggles. However, Preti et al. also discovered that the
sublimation of suffering can be unsuccessful and cause musicians to further surround themselves
with anguish and torment. Being able to sublimate negative feelings into music is helpful but can
also worsen the mental health of the musician and lead to severe mental disorders. The
sublimation process for musicians is a double-edged sword and ultimately isolates the musician
further into their own creative process. The increasing isolation within a musician’s mind is a
key factor in analyzing mental health and must be understood to further help musicians
In the Music Minds Matter study, Sally Anne Gross and Dr. George Musgrave used a
qualitative approach that sought out to understand musicians’ minds. Of the 2,211 respondents,
69 percent reported they experienced depression and 71 percent had experienced panic attacks
and/or high levels of anxiety. 30 The majority of musicians are suffering from mental health issues
that oftentimes not discussed in the realm of the music industry. Musicians find solace in the
29
Preti, Antonio, Francesca De Biasi, and Paola Miotto. “Musical Creativity and Suicide.” Psychological Reports
89, no. 3 (December 2001): 719–27. doi:10.2466/pr0.2001.89.3.719.
30
Gross, Sally Anne, and George Musgrave. "Can Music Make You Sick? Music and Depression A Study into the
Incidence of Musicians’ Mental Health." Music Minds Matter, November 2016. Accessed April 2, 2019.
https://www.helpmusicians.org.uk/assets/publications/files/can_ music_make_you_sick_part_1-
_pilot_survey_report_2019.pdf.
production of their music but are facing mental health issues because of the music industry and
mainstream media. A musician’s career takes place in an “atmosphere of constant criticism, with
social media providing a never-ending flow of opinions from fans, journalists, friends, bloggers
and fellow musicians.”31 The constant criticism received by both external and internal influences
results in the musician having profound feelings of anxiety and depression. People involved in
creative artistic professions have suicide rates that are three times higher than any other
profession.32 The social nature of music performance puts a great demand on musicians and
causes musicians to have relational difficulties when it comes to social activities. The pressures
from the music industry and society strongly impact the mental health of creative individuals and
producer Yvonne Ellis said: “If you’ve got a creative spark in you and you’re a musician, you
need to use it. Because if you’re not being creative then it can make you ill, it can make you
depressed.33 Engaging in creative acts is beneficial because it is a form of sublimation and can be
aimed towards positive results if practiced at an early age. Art provides a sacred and spiritual
outlook on life, that juxtaposes the imperfect world. There needs to be more effective ways in
We need both good art and good science. Science and art, creativity and mental illness
may all be trivialized, however and we may do more harm than good to those “afflicted”
31
Ibid.
32
Preti, Antonio, Francesca De Biasi, and Paola Miotto. “Musical Creativity and Suicide.” Psychological Reports
89, no. 3 (December 2001): 719–27. doi:10.2466/pr0.2001.89.3.719.
33
Gross, Sally Anne, and George Musgrave. "Can Music Make You Sick? Music and Depression A Study into the
Incidence of Musicians’ Mental Health." Music Minds Matter, November 2016. Accessed April 2, 2019.
https://www.helpmusicians.org.uk/assets/publications/files/can_ music_make_you_sick_part_1-
_pilot_survey_report_2019.pdf.
with either creativity or mental illness if we promote romantic association that over-look
best evidence.34
Due to the lack of education on mental health issues, romanticization tends to occur and create
because it can normalize mental health issues and belittle any problems stemming from mental
health. There is rarely anything “beautiful” about experiencing a panic attack, anxiety, or
depression. These are serious issues and campaigns need provide awareness of mental health, but
also attempt to reduce discrimination of individuals who are facing issues with mental health.35
Sally Anne Gross and Dr. George Musgrave concluded that mental health issues need to
to create a positive environment for musicians seeking help, and that mental health support
services be affordable and easily accessible.36 The UK organization, Music Minds Matter, has
taken steps in providing easily accessible mental health support for musicians and influenced
action on implementing a mental health curriculum in education. In 2018, Raluca Matei et al.
studied 2,212 classical musicians and they experienced acute anxiety (13%), depression (17%),
and sleep disturbances (14%), which hindered their musical performance.37 The aim of the study
was to design, implement, and evaluate a music education course meant to focus on health
promotion. The course offered in the United Kingdom focused on increasing musicians’ health
34
Pavitra, Ks, Cr Chandrashekar, and Partha Choudhury. "Creativity and Mental Health: A Profile of Writers and
Musicians." Indian Journal of Psychiatry 49, no. 1 (2007): 34. doi:10.4103/0019-5545.31516.
35
Crisp, Arthur H., Michael G. Gelder, Susannah Rix, Howard I. Meltzer, and Olwen J. Rowlands. “Stigmatisation
of People with Mental Illnesses.” British Journal of Psychiatry 177, no. 1 (2000): 4–7. doi:10.1192/bjp.177.1.4.
36
Gross, Sally Anne, and George Musgrave. "Can Music Make You Sick? Music and Depression A Study into the
Incidence of Musicians’ Mental Health." Music Minds Matter, November 2016. Accessed April 2, 2019.
https://www.helpmusicians.org.uk/assets/publications/files/can_ music_make_you_sick_part_1-
_pilot_survey_report_2019.pdf.
37
Matei, Raluca, Stephen Broad, Juliet Goldbart, and Jane Ginsborg. "Health Education for Musicians." Frontiers in
Psychology 9 (2018). doi:10.3389/fpsyg.2018.01137.
literacy by enhancing motivation and self-efficacy. The increasing of health literacy is important
because it can improve broader socio-economic living conditions and provide a better
informing musicians of public health policies, and ensuring that health services are achieving
population health outcomes. There have been very few analyses of health education classes and
this study brought to light the importance of teaching health education to musicians. The course
of health education was offered to musicians in college, pursuing their undergraduate degree.
The musicians who partook in the class were more aware of the physical and mental health risks
of being a musician. The study was unable to show any changes to the musicians’ health
promoting behaviors due to the one-year analysis of the course. The implementing of health
education into a musicians’ curriculum is beneficial in creating awareness on mental health and
mental health awareness into education is integral in changing the way mental health is viewed
by society. Mental health needs to be discussed, taught, and destigmatized in order to provide
sufficient care for musicians and anyone struggling with mental health issues. Implementing
mental health into education is one step in ending the negative stigma against mental health and
38
Matei, Raluca, Stephen Broad, Juliet Goldbart, and Jane Ginsborg. "Health Education for Musicians." Frontiers in
Psychology 9 (2018). doi:10.3389/fpsyg.2018.01137.
Chapter 2: A Theoretical Analysis of Musicians and Mental Health
The music industry is a dynamic cohort that consists of record labels, marketing
professionals, streaming services, musicians and many other individuals and institutions. In the
United States, the music industry generated 19.6 billion dollars in revenue.39 Musicians only
pocket twelve percent of the revenue from the music industry, which is rather miniscule. The
musicians are the cause for the music industry’s success, yet they are usually exploited for their
work and valued only as an asset to make more money for the owners and CEO’s of major
record companies. The musician is seen as a commodity by the music industry, which alienates
them from their work and society. This form of alienation causes artists40 to experience mental
The alienation of musicians can be attributed to the effects of the culture industry on
society. Adorno and Horkheimer state that the culture industry is an apparatus that utilizes
movies, and other forms of media. The reproduction of mainstream culture causes an individual
to consume these cultural themes and become docile participants within capitalist society. The
culture industry alienates the individual, while also actively trapping the individual within a
cultural reproduction loop. 41 Cultural goods aid in the process of reification that surmounts from
constant portrayal of capitalist ideals throughout our lives. Objects are transformed into subjects
and subjects are turned into objects, deeming the “new” subjects as passive consumers. The
reification process can be seen when analyzing the culture industry because the mainstream
39
Fuller, Steve. "U.S. Music." Statista. 2018. Accessed April 05, 2019. https://www.statista.com/topics/1639/music/.
40
The words “musician” and “artist” will be used interchangeably throughout this paper.
41
Adorno, Theodor W., Max Horkheimer, and Gunzelin Schmid Noerr. Dialectic of Enlightenment: Philosophical
Fragments. Stanford, CA: Stanford Univ. Press, 2002.
culture is being reproduced and consumed by the passive subjects. The passive consumption of
the culture industry’s ideals further solidifies the ideology of capitalism and ensures that any
and submissive consumer who constantly is trying to fulfill their desires of wanting what is
portrayed in the cultural industry. One of the most commonly reproduced cultural ideals is that of
the work ethic. In capitalist society, an individual must work hard to obtain success, even if the
hard work leads to stress, sickness, and even death. The mass-produced cultural goods reinforce
the work ethic, while also showing the ideal life of an average American.43 In creating an image
of success, individuals continue to work hard for their idea of what a “perfect” life is based off
their consumption of popular cultural goods (mainly movies, tv shows, and music). The reality of
working hard all day is tiring, so people naturally desire to take a break or escape the reality in
which they live in. One way people attempt to escape reality is through entertainment, which in
turn reproduces the capitalist ideals of the work ethic, nuclear family, etc. The individual traps
themselves within a cultural loop that is reproduced by the culture industry and the reification
process.
The culture industry effects everyone in society to a certain extent. Some musicians
actively reproduce mainstream culture through their music, yet the culture industry still impacts
them negatively by exploiting their art and controlling the content that they create. The culture
Foucault uses the idea of a Panopticon, which is meant for external surveillance, to explain his
42
Reification is a theory developed by Hungarian philosopher, György Lukács and analyzed further by Theodore W.
Adorno in Dialectic of Enlightenment: Philosophical Fragments.
43
Cultural ideal: Working hard will ultimately lead an individual to working a successful job and living happily in
love with a heterosexual family.
The major effect of the Panopticon: to induce in the inmate a state of conscious and
permanent visibility that assures the automatic functioning of power. So to arrange things
that the surveillance is permanent in its effects, even if it is discontinuous in its action;
that the perfection of power should tend to render its actual exercise unnecessary; that
this architectural apparatus should be a machine for creating and sustaining a power
relation independent of the person who exercises it; in short, that the inmates should be
The panopticon was created by Jeremy Bentham and meant to institutionally control prisoners’
behavior. The main purpose of the panopticon is to follow the principle that power should be
visible and unverifiable. The prisoners will be reminded that they are being watched by the
towering building in the center of their cells, yet they will not know if they are being watched or
not. This unverifiable presence of being watched causes the prisoner to disassociate themselves
The theory of panopticism indicates that the gaze of the prison guard is internalized by
the prisoner, which causes the prisoner to be their own guard. This theory is extended to society
because there is an anonymous power that controls our everyday lives. This anonymous power
has been created by the culture industry and has been internalized by individuals living within
society. Foucault mainly focuses on applying his theory of surveillance to prison, school,
hospitals, and the workplace. Throughout these institutions there are methods of coercion that are
reinforced throughout society. These coercive methods induce conformity to the population,
while reproducing binaries of bad and good, normal and weird, nature and technology, etc. The
theory of panopticism can be widely applied to other institutions and structures found in
44
Foucault, Michel, and Alan Sheridan. Discipline and Punish: The Birth of the Prison. London: Penguin Books,
1977.
society.45 The feeling of always being watched by an anonymous power is heightened greatly in
various musicians’ lives. Panopticism plays a significant role in impacting a musician’s mental
health because they must live up to certain expectations, while also behaving a certain way and
producing money for the music industry. Musicians are in the public-eye and everything they do
surveillance negatively impacts the mental health of musicians by instilling an overexerting work
ethic, blurring the lines between dreams and reality, and suppressing the creative nature of an
system that causes the musician to follow the culture industry’s ideal of working hard, which
makes the musician unhappy in a career that they seemingly love. The pressure that the record
label and fans put on artists causes them to overexert themselves by creating music that will
conform to a certain sound and make money. In doing so, the creativity of the artist is suppressed
and most of their time is spent in the realm of necessity. 46 The realm of necessity is a realm in
which an individual spends working, so they can pay for their house, food, and other vital needs.
Despite music being a creative expenditure, musicians must live up to a certain standard of
Foucault shares the idea that increased visibility is a trap to an individual. In today’s
digital age, the internet has exponentially increased the public visibility of individuals. This
visibility alienates the individual by creating a virtual self that is separate from the real self. It
also allows more people to watch an individual’s every move and influence an artist’s actions.
45
The family structure acts as an anonymous power that we internalize to behave a certain way. We police ourselves
based on our parents’ rules established within our household. Not being able to follow these rules, will result in
punishment, so we behave correctly and coercively follow the common ideas of good or bad.
46
Tucker, Robert C., Karl Marx, and Friedrich Engels. The Marx-Engels Reader. New York: Norton, 1978.
The role of the prison guard is internalized by musicians and they fall into a dangerous alienated
state of living up to a various number of expectations. Alienation caused by this visibility allows
there to be more control over the general population and promotes assimilation through
The internalization of the culture industry’s ideals and norms is partly due to the
institutions that profit off musicians. In Heather McDonald’s piece on the music industry she
states that: “Record labels typically set the terms and conditions of artist contracts in their favor.
In the case of newly signed artists, record labels can control the type of music they record which
can include everything from the way the music sounds to the song lyrics.” 47 The sheer control
that record labels impose over their artists is restricting the creative aspects of music as an art. A
record label will have an artist make a song that tops the charts, and which follows a predictable
pattern for mainstream pop songs. This controlling factor expressed by the record label limits the
artist’s capabilities and exploits them for a profit. After creating a mainstream song, artist’s face
scrutiny for “selling out” or changing the sound that their fans fell in love with. Their new sound
is one that is favorable to most mainstream music listeners and will bring in the most revenue.
The creative process of the artist is hindered and causes the artist’s fan base to criticize their
work. Despite the record labels’ control on artists, musicians are still able to create music that is
unique, but their music will not be as promoted as mainstream pop artists. The music industry’s
main goal is to make a profit off their musicians, so no matter what genre a musician makes
music for, it all comes down to the amount of revenue brought in.
47
McDonald, Heather. "Why Record Labels Have Such Tremendous Influence on the Music Industry." The Balance
Careers. October 23, 2017. Accessed April 05, 2019. https://www.thebalancecareers.com/what-is-a-record-label-
2460614.
Work Ethic
With money being the focal point of the music industry, the work ethic is heavily
ingrained within musicians’ minds. Artists want to make their fanbase, record label, family, and
friends happy with their musical creations so they put in copious amounts of work. The
expectations for artists are at an all-time high, so the artist truly never leaves the realm of
necessity. Musicians are constantly trying to please others, including themselves, so they are
always working and attempting to create music that will be enjoyed by all their listeners.
Musicians are some of the most creative individuals in this world but being constantly
Work ethic is constantly reinforced through various socialization processes that infect the
imagination of an individual. Adorno and Horkheimer give an example of German fascists who
say the word “intolerable” on the radio. The next day, everyone in Germany is using the word
“intolerable” because it was said by those in power and was a new word to them.48 This example
shows how the importance of the work ethic has easily infiltrated the minds of individuals
throughout all forms of media and advertisements. Individuals will constantly be thinking about
work and daydream about escaping reality. One way that individuals escape reality is through
reinforce the capitalist ideals of a work ethic and create more false needs for the audience. 49 The
false needs expressed by an individual in society are meant to reproduce the world of everyday
48
Adorno, Theodor W., Max Horkheimer, and Gunzelin Schmid Noerr. Dialectic of Enlightenment: Philosophical
Fragments. Stanford, CA: Stanford Univ. Press, 2002.
49
One popular motif in various entertainment sources is the idea of “true love.” This common trope is constantly
portrayed in movies, music, and many other cultural goods. People escape reality and then attempt to bring the idea
of “true love” into their reality, but it is often not the same feeling as portrayed in the fictional rendition of such. The
fictional account of a cultural motif distorts our reality, yet we use this fiction to escape our own reality. This causes
us to be stuck within a loop of dreaming of our ideal reality and conforming to the culture industry’s covert
assimilation of the populace.
perception. Adorno and Horkheimer state that “the world outside is a seamless extension of the
one which has been revealed in the cinema.”50 This seamless extension of films into reality blurs
the line between what is dream and reality and leaves a breeding ground for uninformed
assimilation. The entertainment industry creates a fantasy world where the individual can escape
to and forget about constantly working in their own reality. However, this escape from reality
transforms the individual into resisting any thoughts of reforming or changing their reality.
Individuals will take the easy way out and become complacent within the system that controls
them. Musicians tend to try and challenge the system that causes them to conform because they
spend more time being creative and thinking curiously about their reality.
Creativity
The study done by K.S. Pavitra et al. analyzes the relationship between creativity and
mental health. Pavitra et al. introduces the study by stating that: “Creative imagination, creative
motives and creative products are unique to human beings and are the source of their cultural
achievement… Creativity may prove to be the key to success or failure in human beings' quest
for knowledge, in their journey beyond the bounds of the sure and seen and in exploration of the
unknown.”51 The study focuses on the creativity expressed by writers and musicians and how
mental health effects their lives. Pavitra et al. makes the case that emotional instability can be
both detrimental and advantageous to creativity. The study claims that the emotional instability
allows the artist “to escape the powerful social and cultural constraints that mostly favor
conformity and convention.”52 This is an important aspect of her argument because artists are
50
Adorno, Theodor W., Max Horkheimer, and Gunzelin Schmid Noerr. Dialectic of Enlightenment: Philosophical
Fragments. Stanford, CA: Stanford Univ. Press, 2002.
51
Pavitra, Ks, Cr Chandrashekar, and Partha Choudhury. "Creativity and Mental Health: A Profile of Writers and
Musicians." Indian Journal of Psychiatry 49, no. 1 (2007): 34. doi:10.4103/0019-5545.31516.
52
Ibid.
seen to break free from conforming through their creative expenditures. Despite their emotional
instability, they can create, whilst actively going against the culture industry. Pavitra et al.
studied how often creative individuals will seek help for their mental health compared to a
control group of individuals who are not directly involved in a creative career. They discovered
that seven out of eleven people from the control group had sought psychiatric help, whereas only
two out of 80 creative individuals had sought psychiatric help for their mental health. This
staggering difference in seeking help for mental health concerns can be because of the popular
notion that you have to be a “little mad” to be creative. Another reason is because of the negative
stigma that mental health has from its portrayal in various sources of media.
Mental health is prominent within artists in the music industry but is constantly
stigmatized by our society. In 1996, one of the largest and most detailed studies on mental health
stigma was conducted by the National Opinion Research Center. This study was part of the
General Social Survey and measured the public attitudes that people had towards mental health.
different vignettes depicting people with mental illness. The respondents generally
viewed people with mental illness as dangerous and less competent to handle their own
affairs, with their harshest judgments reserved for people with schizophrenia and
The study showcases that the general public has a negative stigma towards people with a mental
illness. Mental illnesses are such a stark contrast compared to people’s perceived ideas of
53
Parcesepe, Angela M., and Leopoldo J. Cabassa. "Public Stigma of Mental Illness in the United States: A
Systematic Literature Review." Administration and Policy in Mental Health and Mental Health Services Research
40, no. 5 (2012): 384-99. doi:10.1007/s10488-012-0430-z.
happiness, that they must stigmatize it. In doing so, those with mental illnesses are alienated and
further shut out from being an active participant in society. Musicians are alienated by society
because of their mental health issues, but also because of their creative minds.
When musicians are alienated by society and by their own music career, they begin to
internalize social attitudes against them and become trapped within their own conflicting
thoughts. In Jenny Valentish’s article she addresses the effects that societal stigma has on
musicians. Artists tend to “internalize public attitudes and become so embarrassed or ashamed
that they often conceal symptoms and fail to seek treatment.”54 The concealing of mental health
issues by the music industry is extremely dangerous for musicians and leads to their own
entrapment within their mind. More pressure comes from anxiety and perfectionism because
musicians are constantly criticized for their musical creations.55 The internalization of societal
stigma and negative critiques is rather destructive to the mental psyche of the musician.
Musicians create a source of entertainment that allows individuals to escape reality, but
this causes great stress to the musicians. The internalization of the culture industry’s work ethic
motivates an artist to create several musical creations that will be enjoyed by their fans.
However, this work ethic is an overexertion of the musician and instills factors of criticism and
stigma that largely impacts the mental health of the musician. The inherent visibility of the
musician causes them to want to escape their reality, which leads us to the question: How do
musicians cope with all these cultural factors impacting their every move? There can be the
argument that musicians can assimilate into the culture industry and escape through other
54
Valentish, Jenny. "Perfectionism and Poverty: Why Musicians Struggle with Mental Health." The Guardian. June
19, 2018. https://www.the guardian.com/music/2018/jun/20/perfectionism-and-poverty-why-musicians-struggle-
with-mental-health.
55
Ibid.
cultural goods, such as movies or tv shows. However, the reality is that most musicians will turn
to using drugs and /or alcohol to cope with the pressures that they face from society.
Most musicians turn to using drugs and/or alcohol to escape reality and the pressures
placed on them by society. These substances are easily accessible within the music industry and
have a detrimental effect on musicians. Substance abuse is one of the leading causes of death in
musicians. In 2016, the cross-sectional study of 220 drug-related deaths of celebrities from 1970-
2015, discovered that the largest group of celebrities that died from drugs and/or alcohol was
musicians at 38.6%.56 Musicians start to use drugs and alcohol because they are constantly
surrounded by the substances at shows and parties. The factor of peer pressure is the greatest
influence on musicians’ choice to abuse these harmful substances.57 Doing drugs and alcohol is
labeled as a “cool” activity to partake in by many of those in the music industry. Although the
artist may not be into drugs or alcohol, the external influences play a significant role in
convincing an artist to try the substances. Simply trying out the substances can lead to the artist
to crave more because of the feeling that is produced by the substances. According to the
produces euphoric effects that cause the brain to crave more of the substance.58 The euphoric
feeling produced by drugs leads artists to partake in doing drugs. Despite drugs being expensive,
the artists usually have enough money to fund their use of the drugs. This causes a dependency
56
Just, Johannes M., Markus Bleckwenn, Rieke Schnakenberg, Philipp Skatulla, and Klaus Weckbecker. "Drug-
related Celebrity Deaths: A Cross-sectional Study." Substance Abuse Treatment, Prevention, and Policy 11, no. 1
(2016). doi:10.1186/s13011-016-0084-z.
57
New Beginnings. "Drug Abuse and Musicians - A Cruel Trend of Addiction with Musicians." New Beginnings
Drug Rehab. Accessed April 05, 2019. https://www.newbeginningsdrugrehab.org/resources/opiates-and-musicians-
a-cruel-trend-of-drug-abuse-and-musicians/.
58
Ibid.
Artists abuse substances that can ultimately lead to their demise. The largest age group of
musician deaths ranges from 25-40 years old. The increase in prescription drug use has had a
negative effect on musicians. Since 2000, the deaths by prescription drugs have nearly doubled
and consists of over 50 percent of celebrity deaths.59 The increase in prescription drugs is
because there are multiple over the counter opioids that artists use. When artists are unable to
obtain the opioids over the counter, they turn to drug dealers to get their substances, but this
poses a risk that has affected many musicians in the 21 st century. The drugs that are sold by drug
dealers are often synthetic and contain an illicit version of fentanyl mixed with heroin. This
synthetic substance poses a legal threat to the inexperienced user and has adverse effects
compared to pharmaceutical opioids. The illicit form of fentanyl is nearly 30 times stronger than
heroine and has taken the lives of notable musicians; Prince, Tom Petty, Mac Miller, and various
others.
Substance abuse and mental health coincide with one another and have begun to be
addressed in certain countries like the United Kingdom. There is an organization called Music
Minds Matter, that has a help line for artists that suffer from mental health problems and
substance abuse.60 The help line was created by the nonprofit, Help Musicians U.K., in response
to many musicians not receiving much help from other suicide prevention hotlines.
Matthew Johnson, the front man of the Leeds-based rock band Hookworms, referring to
Britain's best-known suicide-prevention hotline [Samaritans]. “The problem I've had is,
when I've tried to explain my problems, and I've had it with therapists too, they say, 'Oh,
59
Just, Johannes M., Markus Bleckwenn, Rieke Schnakenberg, Philipp Skatulla, and Klaus Weckbecker. "Drug-
related Celebrity Deaths: A Cross-sectional Study." Substance Abuse Treatment, Prevention, and Policy 11, no. 1
(2016). doi:10.1186/s13011-016-0084-z.
60
Marshall, Alex. "An Ear Musicians Can Bend." New York Times, Jan 27, 2018, Late Edition (East Coast).
http://libproxy.sdsu.edu/login?url=https://search-proquest-com.libproxy.sdsu.edu/docview/1991562935?
accountid=13758.
your life must be wonderful.' They don't particularly understand the pressures you might
be under.”61
Johnson points out the common idea that musicians are living the best life and are not susceptible
to mental health issues. More artists, such as Zayn Malik and Adele, are starting to talk about
mental health issues in the music industry. There remains a societal stigma against mental health,
but the more that the issue is addressed, the more awareness can be raised. Music Minds Matter
“aims to provide a caring ear to the large proportion of people in the music industry with mental
health problems.”62 Callers can receive advice on mental health services, debt, legal matters, etc.
Help Musicians U.K. is investing nearly 1.4 million dollars in the initiative to help musicians in
61
Ibid.
62
Ibid.
Conclusion
The mental health of musicians is an important topic that can be understood through
studying the culture industry and its influence. The increased visibility of musicians leads to
alienation and internalization of common cultural norms, such as the work ethic. This
internalization process is detrimental to the mental health of the musician because it will cause
them to trap themselves within their own realm of necessity and constantly aiming to please their
supporters. The entrapment of the musician leads to their desire to escape the stressful reality, in
which they reside in. The musician’s inclination to escape reality is easily fulfilled through the
increased accessibility of drugs and alcohol. Using these substances as an escape from reality
create an overstimulation of dopamine that keeps the brain craving more of the substances. In
turn, this craving results in addiction and can eventually worsen the mental health of the
musician. The musician depends on the substances to escape their reality, but they face various
harms of sickness and death. The stigma of mental health and addiction needs to be addressed in
mainstream society or else musicians will continually partake in substance abuse. However, it is
a challenge to address the topic of mental health and addiction because billions of dollars are
made from the selling of drugs. The main motive of organizations and institutions in a capitalist
society is to make a profit, often with disregard to the negative consequences that effect the
general populace. The United Kingdom has made steps to help musicians seek help for their
mental struggles by creating the help line, Music Minds Matter. Helping musicians with their
struggles with addiction and mental health can also benefit their supporters. Johanes M. Just et
al. believes “that successfully treating a celebrity’s addiction might have a positive effect on the
drug related behaviour of her or his followers.”63 The topic of mental health and addiction is
gaining exposure and beginning to change the way individuals think about the topic. By studying
different cultural factors, such as the culture industry and panopticism, we can understand the
impact that these cultural factors have on a multitude of individuals and begin to reframe the way
we think about mental health. Raising awareness creates room for understanding, which allows
63
Just, Johannes M., Markus Bleckwenn, Rieke Schnakenberg, Philipp Skatulla, and Klaus Weckbecker. "Drug-
related Celebrity Deaths: A Cross-sectional Study." Substance Abuse Treatment, Prevention, and Policy 11, no. 1
(2016). doi:10.1186/s13011-016-0084-z.
Afterword
A possible project to bring awareness to mental health and the creative process of
element. The project would seek to understand the daily life of a musician and the external and
internal influences that impact the individual. The musician that is being interviewed can be an
individual who went to a music college, such as the Berklee College of Music, Juilliard, Curtis
Institute of Music, etc. Interviewing an individual that goes to or went to a prestigious musical
college would be ideal to understand the overarching social and economical aspects of being a
musician. The questions that can be asked of the musician can consist of various themes:
1. Finding a balance between work life, school life, and social life.
2. The impact that social media has on the musician in creating a virtual self.
3. The culture of the school and how drug and substance abuse play a role.
5. Feeling a sense of euphoria from creating music and how music can be an escape
from reality.
The documentary would closely study the cultural factors surrounding musicians
involved in the music industry. There would be a qualitative approach to the project that would
focus on an ontological study of the musician. The project would focus on a single musician,
which would raise the question of its validity. However, the in-depth analysis of a musician will
be beneficial for providing a better comprehension of the lives of musicians. The process of
interviewing and learning from a musician will allow for an awareness of the environment that
surrounds musicians. Bringing awareness to musicians and their personal lives will deconstruct
the image of the musician as being a god or divine figure and aim to view musicians as human
beings. Living the life of a musician is not always glamorous and there must be an understanding
of the cultural factors that can impact the musician within the music industry.
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