By Ali Sailer, MT-BC

As I approach my two-year anniversary of practicing music therapy with PBMTI this week, I’ve done a lot of reflecting on my experiences as a music therapist working in addiction recovery. What an incredible journey! The last two years have stretched me clinically and personally in ways I can’t even explain (although maybe I could through music). Having navigated the unique challenges that go along with working in the addiction setting, felt burdened, jaded, and helpless at various points in my career, and gone through ups and downs in my personal life, I’ve also learned and grown so much along the way as a music therapist and as a person.

This short reflection piece is the result of my experience as a professional in the field, experience as a person on her own journey to healing, and education on music therapy and addiction. It is a blend of clinical sharing and candid journaling. Some of my ruminations are lifted from a very insightful book Music Therapy and Addictions edited by David Aldridge and Joerg Fachner. Mostly, I hope that my openness about what I’ve learned from practicing music therapy in the context of addiction recovery will help others better understand the needs of this population and what music therapy has to offer.

I facilitate music therapy groups in various drug and alcohol rehabs in south Florida. The most important thing I’ve learned about addiction is that it is a dead end attempt at self-medicating emotional pain. Rather than effectively using other coping skills, addicts apply their drug like a “one size fits all” Band-Aid to avoid dealing with painful emotions. Eventually, the Band-Aid itself becomes the obsession and is reused again and again to cover up any and all uncomfortable feelings. Addiction is an inflexible coping strategy that eventually becomes a vicious cycle.

Since most addicts go to great lengths to avoid emotional pain, they also develop complicated defense mechanisms. Underneath, people battling active addiction seem to be emotionally fragile, mistrustful, and have low self-esteem at the root of it all. On the outside, however, they may portray false confidence and denial. The exterior and interior personas of a person in active addiction are at odds with each other and lack harmony. Therefore, clinical treatment can be difficult because authenticity and intimacy are the solution to healing.

Enter the power of music. Music therapy helps break through those complicated defense mechanisms in ways that traditional therapies by themselves might not. Music’s personalized, motivational, and holistic nature creates a safe space for therapeutic confrontation because clients tend to feel most comfortable being real when they are in touch with their preferred music. For example, I have found that a defensive nineteen-year-old in treatment for abusing psychedelics can feel far more comfortable exploring heavy issues in “Soundtrack to my Life” (Kid Cudi) than through traditional talk therapy without the aid of his favorite songs. People open up in the presence of their music.

Music therapy is especially effective in substance abuse settings because it is action-based. Music necessitates human response. In a recovery-based drum circle, a group of addicts are presented with a live music-making experience that depends on their responses to the music and to each other. In the “here and now”, they can make choices that will help them connect with others, build healthy relationships, and practice coping strategies via the music experiences. Here is a real opportunity for authenticity and intimacy: when music calls us, we must answer it. A professor in college once said something that I’ve never forgotten: How we are in music is how we are in life. Since musical behaviors can be compared directly with non-musical behaviors, the clinical goals that clients accomplish in music therapy are tangible to their wellbeing. Music therapy is a call to action.

That’s great, but what about when music triggers cravings? As a music therapist, I’ve struggled with this issue off and on. It’s no secret that music and drugs go well together and for many addicts they are powerfully connected. Electronic dance music (EDM), reggae, and rap are some of the major genres linked to the culture of substance abuse. I believe this is largely due to the associations formed than with the music itself, but the associations are still strong and unable to be ignored. So what’s a music therapist to do?

Recently, I picked up the book Music Therapy and Addictions (2010) edited by David Aldridge and Joerg Fachner. Unfortunately I haven’t found very many publications by music therapists on our work in addiction recovery, but this particular gem did offer some helpful perspectives. Ultimately, to listen or not to listen to “trigger” music seems like an individual decision. Some recovering addicts find that they need to give it up temporarily, some need to give it up entirely, and some become indifferent over time or discover that their musical palates have transformed while in recovery. It is a case-by-case situation.

I’ve concluded that while music can be triggering for people in treatment for active addiction, the fact that it is indispensible to many addicts presents the perfect occasion to reach them. If addiction is fixation on the Band-Aid, music can be a gentler, safer Band-Aid that replaces drugs as an alternative reward system. Additionally, when a client’s preferred music does not appear to be harmonious with his road to recovery, we may be able to highlight this discrepancy in order to attain insight. Whether it is a cause or reflection on a person’s recovery state, music in particular is an essential tool for addiction recovery when used carefully by a competent music therapist.

The last two years of practicing music therapy in the context of addiction have taught me quite a few things about the role of music in recovery, but I’ve also grown tremendously as a person. I’ve learned how to look past my own stigmas of addiction. I’ve learned that my clients are people with unique stories and challenges. If I am completely honest, I’ve learned that I am no different. I may not choose to cope with my emotional pain by abusing substances, but that doesn’t mean I’m not capable of self-medicating in other ways. I’ve become more familiar with the Twelve Step Program on a personal level and that has helped me better understand how to tailor music therapy interventions to support my clients’ specific recovery goals. I’ve also been challenged to improve my counseling skills because verbal processing is especially important in the addiction setting even when music is the primary vehicle for change.

Most of all, I’ve learned that the most important thing I can do as a music therapist working in addiction recovery is building rapport. Addicts can be cautious to trust others and believe that no one can possibly understand their emotional pain. This is especially important for music therapists who are not personally in recovery from substance abuse. Rapport building is the first goal for any therapist, of course, but in addiction recovery it is an especially vital goal since developing trust and healthy relationships are part of the solution to healing. Although several years ago I didn’t envision myself practicing music therapy in addiction recovery, it has truly become my passion. I am grateful for the journey I’ve had so far and look forward to what is ahead.