Music Therapy as a Treatment for Substance Abuse with At-Risk Children and Adolescents: Part II
By: Deborah Bradway, MT-BC
Population Served: At-Risk Youth
Why Music Therapy?
There are both social and physiological reasons why music therapy successfully addresses a young person's desire for cigarettes and other harmful, but pleasure inducing substances. To understand this, it is helpful to look at the positive opportunities that music therapy can provide in relation to the needs of children who continue to live in poverty, experience neglect, and often endure psychological and/or physical abuse. It is not a mystery that children of this population need to develop self-esteem. However, a music therapy group not only allows for the development of self-esteem through successful educational and social interactions, it also enables the child to use the group as a support system, a replacement for what has lacked in family structure and rituals. Music is structure within itself, and has been used to mark rituals throughout time for as long as man has known music. Also, it is important to remember that toning (the release of tension and anxiety through the voice), is the body's natural regulation mechanism for healing, both emotionally and physically.
In addition to the use of the voice, drumming and breathing (in a music relaxation context) are also effective ways of adjusting the body's systems on a physical level. Reduction of blood pressure, a slowed heart rate, reduction of adrenalin flow, increased oxygen flow, regulation of neurotransmitters, relief from mental anxiety, release of muscle tension, regulation of cortisol levels, and regulation of other natural body chemicals play a role in the body's ability to integrate and control impulses, and rehabilitate from many states of depression. Lack of impulse control frequently leads to a shortened attention span, which, along with depression can effect a child's ability to engage in educational tasks efficiently and successfully.
In short, children who have been traumatized or neglected suffer from physical states that (in most cases) could be addressed naturally, instead of with prescribed medications. Much of what we see as addictive substance problems in youth, often starts as an attempt to self-medicate as a defense mechanism to preserve the body from trauma. Due to a lack of health care and education level in parental care, these children have emotional issues which result in physical issues. It is common that their issues are not addressed until they are obvious, they have evolved into physical conditions or learning disabilities.
Many pilot projects studying neurological development have recently released word of increased educational abilities in children who participate in music. Reputable and high visibility music and education organizations such as the National Association for Music Education, National School Boards Association, National Association of Music Merchants, American Music Therapy Association, National Academy of Recording Arts and Sciences Foundation, State Commissions of Drug and Alcohol Abuse, and many universities with world renown neurologists have shown on a consistent basis how music increases brain function.
So, the question is, why aren't at-risk children and youth (who carry cigarettes and knives to school) improving on academic test scores when they receive special arts education programs designed to teach instrument performance or music appreciation. The answer: A child who uses substances and carries weapons to survive doesn't need to know Mozart's Sonata Allegro form. In addition, becoming smarter is seen as threatening to their peers and is perceived as endangering their own well being. Their ego is not strong enough to endure the pressures of performance, nor have they ever experienced the type of structure through family interactions that support diligent individual practice of an instrument (which is what renders satisfying, positive results). It is important to keep in mind that youth with trauma and/or little structure in their lives often have difficulty focusing their attention on intellectual tasks. This is something that can be addressed with music therapeutically: increasing the attention span is a preliminary stage to the intellectualization of other technical music and educational subjects.
To engage in music or any other form of intellectuality, many steps must occur in music-making on a therapeutic level, enabling self-acceptance, acceptance of others and their cultures, adjustment of authority perceptions, support systems set in place, trusting and respectful relationships built, reduced tension and anxiety states and a ritual time set in place for release of anxiety, communication skills developed, and finally, an understanding and relationship with the concept and rewards of love. The last item mentioned may be the most difficult, yet the most necessary element to obtain. If a child has not been shown unconditional love at birth or shortly after, and has been traumatized by abuse and/or neglect, it is likely that they will be addicted to this pain pattern until something can enter "through the back door", so to speak.
When a person engages in a music environment structured with therapeutic interventions, a safe space provides an opportunity to explore the concept of love and self-love through the music. The sound, complexity and simplicity of vibrations, emotions encountered, and the instrument as a safe, inanimate object to practice interaction with, all serve as the vehicle for change. Change occurs after one has experienced repetition of symbolic, then concrete successful transactions. The environment and the musical interactions inherently allow the person to feel love and integrate it on a physical level. This population of children may not regularly experience a personal relationship with the concept of love, and frequently block it, for fear it may feel good and may be taken away. This would be far too painful to endure on top of everything else, so blocking it is a natural defense mechanism. Understanding the concept of love is necessary for engagement in caring and respectful interactions with society, as well as the development of motivation to participate with society in a positive manner.
Another question posed: Why haven't music teachers or school psychologists been able to reach the majority of this population efficiently? This answer is complicated, and meant in no way to reduce the value of teachers or counselors in the school system who provide crucial roles in education. The first thing to become clear about is that music teachers do not receive training in therapeutic techniques of music in the current music education bachelors or masters degrees offered in universities across our nation.
The other piece to address in this question has to do with a school counselor's use of verbal therapy. The cultures commonly assisted in this at-risk population are Hispanic, Asain/Pacific Islander, and African-American. The values within these cultures have a tendency to disrespect and/or fear verbal psychotherapy. Generally, high resistance is met when attempts are made through verbal intervention. Another important element to take into account about verbal therapy; one tends to seek it after a strong sense of self has been developed, and the ego can withstand judgment of societal views about participation.
However, all of these cultures, which represent a large portion of our population in the United States, revere music as a highly respected part of the culture. As a matter of fact, it is such a central focus in some, that musicians are regarded as heroic in their society. Some cultures are identified primarily by their music. Most adolescents consider musical taste as an important element in socializing with each other. As we can see, there is a strong connection between identity and music.
It seems that our society's perception of music prepares the participant with a low resistance factor from the start. But there is another reason why music is effective in reaching a population with a reputation for having high defenses. When one engages in music, the inner life world of the individual and their social ability to interact comes "out on the table" in the musical group interaction. Defenses are lowered by the music, and the individual usually becomes "softer" or more sensitive in exchanges. Music has a power over the body, a language that possesses an inherent nature to make us feel.
In Closing, when you intend to take something away from a needy child with minimal home life support, it is always wise to offer something in replacement. Substances often serve as the material that exacerbates an illness on one level, but is seen by the young person as an element that plays a part in a feeling of safety and 'holding it all together' (mental health). Asking this population to give up substances is like taking away the only perceived support, and a sense of personal control in their chaotic environment.
As researchers know, statistics show smokers quitting, alcoholics becoming dry, and crack users becoming clean is a hard battle to fight. Instead of a band-aid approach, with relapses that occur in using, let's take this one step deeper. Address the fear that transformed the lives of children by providing an alternative that they can relate to and feel heard. In addition, give them a replacement that is also perceived by the body as pleasure.
If we can teach alternatives at a young age, for those who have not yet started to use substances or are in experimental stages (including adolescent females who are pregnant or who are at high risk for pregnancy), we have an opportunity to shape the future. It is imperative that in this attempt we provide pleasure for pleasure as an exchange. Aspiring to be 'that artist up on the stage' only works for those who possess the self-esteem to follow through on dreams. These youth will continue to seek pleasure to reduce pain. Let's give them a support system, successful experiences, a sense of self-worth, a new place to call home.
Let's give them the pleasure they were looking for in the first place.
Contact Deborah Bradway
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