Sex, Drugs and Rock n’ Roll

September 6, 2011

In my job, I try to incorporate as many different interventions as possible.  Doing this challenges me to have new ideas, and it’s great for patients who have been in inpatient psych units for many weeks.  In a previous post, I mentioned that in “my” unit, I do two groups a week.  It’s a small place, and group sizes vary depending on the demographic at any given time, but I always do a drumming group one of the days, and a song or melody-based group the other day.

On the non-percussion days, I do a variety of different types of groups, but one of my favorite sessions to do is based on lyric analysis.  For those of you who aren’t MTs, lyric analysis is when you take a song and break down lyrics for discussion.  Each person has a different interpretation of what a song means, and conversations between and among can be very profound.

When people on the unit are there for a detox or a drug/alcohol related offense, I tend to use “trigger” songs to my advantage.  I try to choose songs that push the envelope a little, because the people are in a safe place, where triggers aren’t something that can be acted upon.

Some of the best received lyric analysis groups were done with the following songs:

Piano Man – Billy Joel

This song is typically thought of as a jolly “drinking song,” but when you actually look at the lyrics, you might be surprised at how melancholy they are.  As a group, we sing and/or listen to the song, discuss each character in the song, and group members share any similarities they see between the characters and themselves.  I mediate discussion between the patients and at the end of the session, frequently people who originally thought of Piano Man as a happy bar-tune, come to a different realization and have said that they’re glad we analyzed it, because now it’s one less trigger for them in a relapse situation.

Alcohol – Barenaked Ladies

This is a great one.  Listening to it, you might think that it’s a pro-drinking song, but when you read the lyrics, it’s clear that the song is sung tongue-in-cheek. “For while I cannot love myself, I’ll use something else.”

Angel – Sarah MacLachlan

A really emotional song with lots of lyrics up for interpretation. “Let me be empty and weightless, and maybe I’ll find some peace tonight.”

Hurt – Johnny Cash (orig. Nine Inch Nails)

This song makes people cry quite a bit so I keep tissues on the table just in case.  It’s about the ruin that can occur with drug use.  “I wear this crown of thorns upon my liar’s chair, full of broken thoughts I cannot repair.”


Some other trigger songs that people have suggested are: “Free Bird,” “Margaritaville,” “Comfortably Numb,”Cocaine” and “Truckin’,among many others.  Not all of these songs are appropriate for lyric analysis, and some are definitely and concretely about the pros of recreational drug and alcohol use, so use your best judgement.


In a substance-free place, if people begin to think of a trigger song as associated with symptoms of their disease as opposed to something that once enhanced their fun when they were “off the wagon,”  it shows how valuable just reading a song’s lyrics can be.

On the other hand, last Friday a man, E., came into my group with a giant white gauze bandage on his left wrist/forearm.  He, very seriously, suggested we listen to “Knockin’ on Heaven’s Door,” by Bob Dylan.  I had taken everyone else’s suggestions, and felt it was only fair to allow E. to listen to this song, even though the little voice in the back of my mind questioned it.  It was a choice I made in the moment that I stewed on all night, but eventually I came to the conclusion that his suicidal thoughts were his reality, and if I can’t meet a person where they are with music, what good am I?  E. was in a safe place, in a psych unit being monitored by doctors, nurses and counselors.  What better place to listen to such a mood-appropriate melancholy tune than where he was at that moment?

If you have any thoughts on the matter, please feel free to comment below – I’m always interested in others’ opinions and feedback.

On a lighter note, J., my “frequent flyer non-group-appropriate patient” from this post is back on the unit.  Today my name was Mother Mary instead of Joanne, and he was Ironman and “Our Lord and Savior” (simultaneously) instead of an archangel, but the spiel was the same, sans the mermaid story.  Some things never change…


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