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The Royal College of Psychiatrists Improving the lives of people with mental illness

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18/04/2016 15:55:05

A Life On Tour: Niall Connolly

Niall Connolly













Niall Connolly. Photo: Anthony Mulcahy

Niall Connolly is a modern troubadour. Over the last 15 years, he has toured extensively throughout Europe and the USA, playing hundreds of concerts in a wide variety of venues. He has played house concerts in Holland, folk festivals in Germany and cafes in rural Belgium. He has also taken the stage at prestigious events and venues such as CMJ in New York, the Olympia theatre in Dublin and Glastonbury. He has played support to some of Ireland’s most successful modern music acts, including Mick Flannery, John Spillane and Declan O’Rourke. His admirers include Lambchop’s Kurt Wagner (“I cannot remember when I heard such a moving collection of songs”) and Glen Hansard of The Frames/Swell Season fame, who recently tweeted his support. He has performed for movie stars (Gabriel Byrne and Daniel Day Lewis at The New York Irish Arts Centre Gala) and heads of state (including recently as a ‘warm up’ act for Bill Clinton). His recent tour blog offers a witty insight into some of these adventures.

After beginning his career in his hometown of Cork, Niall moved to Brooklyn, New York, in 2006. There he formed the Big City Folk Collective, providing a forum for a community of songwriters and musicians to perform and to hone their craft. During his time in New York, he has been instrumental in maintaining a live folk music scene throughout the city’s boroughs. The respect his fellow musicians and songwriters have for him is evident in their recording of a tribute album of his songs released in 2012.

Niall’s impassioned, vibrant and humour-laden performances have received wide critical acclaim, including from the Chicago Tribune and ‘No Depression’ magazine. He is also a respected recording artist. In 2001, his impressive debut album received warm praise from Hot Press magazine. Over time, his musical style evolved from the folk-infused lyrical songwriting of his 2003 album ‘As Tomorrow Creeps from the East’ to incorporate a fuller indie-rock sound, demonstrated on recordings such as 2010’s ‘Brother the Fight is Fixed’ and 2013’s ‘Sound’. A great admirer of Leonard Cohen, Niall’s songs exhibit a similar poetic fluency and emotional honesty. They also demonstrate a political awareness which calls to mind Billy Bragg and Steve Earle, a short story writer’s gift for condensed narrative, and a taste for spikey social commentary in the vein of Loudon Wainwright. While his songs are skilfully written and intelligent, they, like his live performances, are also warm and inclusive. His latest release, ‘All We Have Become’ (2015) is perhaps his most well-rounded album to date, incorporating songs from across his range of styles.

Niall is also a good friend of mine. I know him to be a robust and resourceful person who has carved out a career in a very competitive environment. I was interested in what he would have to tell us about the strains that life as a touring musician place on his mental health, and his experience in coping with the demands of such a lifestyle. Following his recent tour of the UK and Ireland, Niall took some time out to speak to me about his life on the road, and in music.


Niall on stage in Coughlan's, Cork
















Niall on stage in Coughlan’s, Cork, April 2016. Photo: Anthony Mulcahy.


JT: You have toured widely in many countries over 15 years. One of your early songs was called ‘Kindness of a Stranger’, about one of the encounters you had. How important has it been to you that strangers or relative strangers have lent a helping hand on your many journeys? Aside from practical help, how does this make a difference for you?

NC: I’d forgotten about that song! Touring for me is something of a tightrope walk. The safety net appears when I get on the rope. People are generally very open and kind to musicians. I wonder if it stems from people's respect for the gamble of a life less ordinary. It is such an unlikely way to live and in my experience of touring, people often connect with that and want to help.

People often tell me I am lucky or I am brave. I think it isn’t solely either of those things. Though the kindness of strangers certainly makes me braver and I know I am lucky. Still, it does take a lot of work to stay lucky.

Touring and consistently finding the kindness of strangers does give me a great lust for life. I so frequently get to see people at their best. In these dark times, I keep my eyes open to the everyday, random acts of kindness that people offer each other.
You have also spoken to me about the many stresses and strains of touring. A recent Guardian article made reference to this (though I felt somewhat conflated mental health problems with career dissatisfaction/existential angst!). What in your experience are the main problems that arise from being on the road? What are the best ways to deal with them? And the not so good ones?

The problems of touring are similar to those present in everyday life for everyone. But they are exacerbated by the nomadic aspects of life on tour. Poor diet, lack of exercise and sleep, too much drinking, loneliness, and financial stress can easily join forces and cause issues on tour. And the adrenaline of performance and the comedown that comes with it are additional factors.  Any combination of these can cause mental discomfort, if not mental health problems.

I try to be aware of all of these aspects. I try to be as prepared and as well researched as I can for tours, though of course there are aspects of tour, as with life, that are out of my control. A key issue is that I need to be ‘on’ when I am on stage. So much effort has gone into getting myself to the gig on time in any given city, that I do try to make sure that my mind is sharp while on stage. I plan my tours in as much detail as possible before I leave. I try to drink less than I want to. I walk as much as I can. I spend money on accommodation- sleep is not a luxury! I also pack (and sometimes use) a pair of running shoes- running serves the double purpose of providing exercise and also an opportunity for some time alone to reflect during the tour.

Does it get harder or easier over time?

I’ve gotten better at recognising where problems arise for me. For example, hangovers and travel are a horrible mix. I try to make reasonably healthy choices along the way. So physically, touring has actually become easier as I have gotten older, as I have become a bit more organized and developed a small bit more "sense".  A small bit! The hardest aspect of touring for me is being away from my wife. I hate being away for prolonged spells.

You have met many accomplished musicians from many different backgrounds. Have you noticed any common personality traits? What do you think are the characteristics that make it more likely a musician, particularly a touring musician, will endure or succeed?

Nearly all of the very successful people I have met are genuinely very nice people. They are shielded by confidence and belief in their work. This is not to be confused with arrogance- the belief is more in creating music rather than in themselves. Many of them seem very aware, and wary, of the more tenuous aspects of success.  They tend to be very interested and invested in their creativity. Most also chose their battles wisely. They are not afraid to say no to inappropriate gigs. Learning to know when to say ‘no’ is an ongoing lesson for me. 

Niall Connolly NYC















Niall oversees his kingdom of New York. Photo: Art-Heffron


What about the life of a full-time musician in Brooklyn/New York? What are the main changes that have happened in the last 10 years do you think? Have any of them been for the better? We would be interested in the role you feel the internet has played.

Venues are closing and changing hands with alarming frequency. Despite its reputation as a centre for creativity- or perhaps alongside this- the city seems to also have an endless appetite for banks, coffee chains and chemists. For example, Greenwich Village in Manhattan is now littered with chain stores.

The internet has certainly made booking and promoting gigs easier, but it has made the gigs themselves harder. We live in the age of distraction. In Brooklyn, like in any big city, people have so many options to choose from in every aspect of their lives. Even when people do choose to go out, and come to a gig, so many appear chained to their devices. In my experience, this is markedly worse in the US than in Ireland or Germany, for example. While video never quite killed the radio star, the smartphone seems intent on killing or at least maiming live performance.

The internet has also made it easier for people to record and distribute music, but it has also devalued it immensely. At one point, I had stern words with a friend for giving away CDs on tour. I used the argument that if it is not with $10 or $15 to you, the artist, why would anyone listen to it? We, the musicians, have to put a value on our work.

The internet has changed all industries. The music industry has changed and continues to change, so I need to be industrious, and become my own industry.

Many of our readers are interested in the link between mental health and inspiration/creativity. The cliché of the perpetually tortured artist doesn’t always hold up to scrutiny when examined closely: Will Oldham, who I featured some time back, made some interesting points on this, and Van Morrison has said he rarely feels inspired to create unless he has peace of mind. I know you are a big admirer of Tom Waits, who made arguably his best work when his personal life was most stable. Can you give us your perspective on this topic? What are the ideal conditions in which to write or compose, or is it different for each song?

I think it is certainly true that our experience of the world is different when we are at our wit's end, even exhausted, and it is certainly possible to create something different in that frame of mind. However, I don't ever seek that out, for it is equally true that I will experience the world differently when I am fully rested! Or after reading a great book, seeing a great film, or having a great conversation with an old friend.

As for writing- I gather ideas constantly. I eavesdrop. I keep my eyes open. I take notes. I write a lot on trains. The songwriting itself, the music part, well for that I need privacy or the illusion of privacy. Even my best songs are awful till they are good. My wife and I rent a railroad apartment in Brooklyn- it is long and narrow, so I can go to one end of it and pretend she can't really hear me strangling a song into shape.

I know you listen to an impressively broad range of music. How did your own tastes develop?

I started deliberately seeking out and listening to music at about 13. I liked REM, Nirvana, James, the Frank and Walters, the Sultans of Ping, indie pop, grunge and some of the more melodic punk stuff. My sister had some Dylan, Cohen, Waits, and I started delving into that too. Later, I worked in the music library in Cork for a spell. I broadened my listening somewhat there but I was, and still am, essentially drawn in by melody and words.

Can you select a few songs, ideally from different genres, which have been inspirational to you over the years?

Ahhhh... where to start?  This is an almost impossible task. So I won't overthink it and will just type what comes to mind.

Gillian Welch- Everything is Free Now
King Creosote and Jon Hopkins- Bubble
PJ Harvey - Sheela Na Gig
The Frank And Walters - Landslide
Ger Wolfe - the Curra Road/ She Scattered Crumbs/ One Star Left in the Window
Avro Pärt - Spiegel im Spiegel
We/Or/Me - The Dusty Roads
Will Oldham - I see a Darkness
Leonard Cohen - Famous Blue Rain Coat/ Alexandra Leaving
Roesy - Take It With Me (Tom Waits Cover)
The Straight Story - Soundtrack
The Pixies - Where is My Mind?
Hawksley Workman - Safe and Sound
John Spillane- Who Will Burn Brightly?
E.W. Harris - Only Wind Up Dead

What do you listen to most on the road?

I've been listening to a lot of podcasts lately. Those are great for solo travel. As I can switch off and still learn something. I actually listened to my first Audiobook in its entirely on the last tour. "Deep Down Dark: The Untold Stories of 33 Men Buried in a Chilean Mine". That was good for perspective!


23/02/2016 17:56:41

Electronic music - Dr Paul Whelan

Pablo Del MonteDr Paul Whelan is an honorary consultant psychiatrist at the National Psychosis Unit, South London and Maudsley Foundation Trust.  He qualified in Medicine at the Royal College of Surgeons in Ireland and undertook his psychiatric training in general adult and old age psychiatry in London.

Paul is also a DJ and producer, working in electronic music. His interest in dance music started in medical school, and early in his medical career he DJ’d under his own name, forming the band ‘Electro Convulsive Therapy’ (the name being a reference to both the style of music he was making at the time and his chosen medical speciality). His records have enjoyed commercial success - he has performed live on BBC Radio One and he was featured in a BMJ article on doctors in music in 2006. Paul is largely self-taught, although he has studied electronic music composition. Now based in London and using the name Pablo del Monte, he recently set up East Recordings, a specialist house music label.

I interviewed Paul for the blog and he provided some insight into this perhaps lesser-known musical genre.

For this blog, I have come across several doctors who are also musicians. You have had quite a unique experience, in that you have enjoyed commercial success from your music, as well as successfully pursuing your medical career. Has this made your decisions about which career path to follow easier or more difficult over the years?

First off, thanks for asking me to do this interview.  Yes, it has made it very hard in that I had to make a decision to leave music just at a point when we were on the point of considerable success so that I could focus on my membership exams.  I know a number of doctors work part time, and I do currently, but I didn’t feel at that point in my training I could do both.  Medicine can be quite all-consuming as a career and it can be very hard to find the correct work-life balance.

What drew you to electronic music? Have you completely immersed yourself in this or have you an interest in other genres?

I was drawn to electronic music the very first time I heard it.  I don’t know why but I prefer the sound of synthesisers to guitars, for example. I had four piano lessons as a kid (and gave up) but aside from that I’m not trained musically.  There are distinct advantages to me with regard to electronic music in the sense that I can write music using a sequencer in a computer without having to play it on a keyboard.  In fact, I rarely touch a keyboard. I do listen to other genres though. 

As well as DJ-ing, your involvement at Brick Lane Studios must have provided you with an insight into the world of business and marketing. You mentioned to me that healthcare services, in particular the NHS, may have something to learn from independent, start-up type businesses- can you tell us how?

As mentioned, I left music previously to finish my post-graduate medical training and I only started making music again three years ago.  In the interim two things happened in music: the internet boomed and cheap music-making software became available.  There is no price barrier to making professional music now and, as such, the number of people doing so has exploded exponentially.  At the same time music is being consumed in a very different way (i.e. streaming).  The net result is more people making music but less revenue available. 

As such, it is only those people who can successfully market themselves who can make a living from making music nowadays.  An artist has to be very social media savvy.  Businesses too.  Obviously the primary role of the NHS is to provide healthcare, but I think we are missing a trick, especially so in relation to public health medicine, by being less effective at social media than other sectors.  That said, the trust I work for (South London and Maudsley) is better at it than most, and I’ve noticed a trend in academia for increased use of social media.

I still don’t have the empirical evidence, but I do believe a disproportionate amount of psychiatrists are interested in music and the creative arts. Is there any link between making music and the choice of psychiatry as a medical specialty do you think?

I tend to agree.  Psychiatry is as much an art as it is a science.  Psychiatry is the medicine of thoughts and emotion.  Therefore it doesn’t surprise me that people who are more drawn to the creative arts choose it as a specialty.  But I wish I had a more concrete answer too as I always get asked this question at job interviews!

You mentioned your interest in the neuroscience of music and a recent piece here dealt with this to some degree. Have you come across any particularly interesting material in this area? How do you think research in this area might help move things forward in a practical way?

There have been huge strides in the field of cognitive neuroscience, i.e. the study of emotions, in the last decade.  We listen to music for a number reasons but primarily because it makes us feel (be that happy, or the cathartic effect of a sad song) and to feel connected to the world the people in it through cerebration or dance.  Music therapy has been around for years and Oliver Sacks book ‘Musicophilia’ covers this.  Music, at a very fundamental level, is sound vibrations and there is an interesting article on the American Psychological Association website about music being used to heal a range of health conditions through this mechanism.

I have a number of loose theories about music, but if I try and answer your question specifically and scientifically then I suppose research would need to clearly map the physical, cognitive, emotional and sociological process involved in experiencing music, drill down into which of these are therapeutic and then design trials to test these hypotheses in order to derive evidence-based music-based treatments- EBMBT, anyone?

Can you select some pieces of electronic music that may have healing properties? Or just some favourites to share with our readers.

I’ve selected four pieces that all have in common the elements that comprise good electronic music: they speak emotion with no words, simple repeated musical phases and textures.

The world’s first-ever ambient album, “Music for Airports”’ by Brian Eno.

Techno may not be your bag but I challenge you not to be moved by Maceo Plex’s “Conjure Dreams”.

The beautiful afro house of Henrik Schwarz’s “L’abeille”.

My friend from Dublin, Glen Brady’s “Once was Glamour” on my own label, East Recordings is a fine example of chill-out.

I can’t speak to their therapeutic properties, but “Music for Airports” certainly works for me whenever I get a bout of insomnia!

Paul will be performing at an electronic music event in East London on March 12th.


08/01/2016 10:23:42

The Ballad of Shirley Collins

Shirley Collins
Shirley Collins MBE is an English folksinger who was a significant contributor to the English Folk Revival of the 1960s and 1970s.  


In 1954, at a party hosted by Ewan MacColl, Shirley met Alan Lomax, the famous American folk collector. Together, they made a folk song collecting trip in the Southern states that lasted from July to November 1959, and resulted in many hours of recordings. Many of these were issued by Atlantic Records under the title "Sounds of the South", and some were later re-enacted in the Coen brothers’ film ‘Oh Brother, Where Art Thou’. 



Shirley Collins

Shirley then went on to have a successful performing and recording career in the 1960s and 1970s. She was influential in the folk music world, collaborating with key figures including Davy Graham and Ashely Hutchings of Steeleye Span and releasing several highly regarded albums, including Anthems in Eden, thought by many to be her finest work.


The loss of her singing voice, which appears to have been a form of psychogenic dysphonia, meant that Shirley could not perform or record from 1982 onwards. During this time, she raised her children and worked in several other jobs outside of the music industry. Further biographical information is available through excellent resources here and in an article in The Guardian from last year, which details the traumatic break-up of her marriage to Huthchings and the subsequent loss of her singing voice.


In recent years, a new generation of artists, including musicians Graham Coxon, Jeff Tweedy and Will Oldham, and the comedian Stewart Lee, helped to generate a revival of interest in her music. This has in turn led to the production of an upcoming documentary about her life, The Ballad of Shirley Collins. Last year, I was approached by the film’s director, Rob Curry, to interview Shirley as part of the film. As well as this, Shirley kindly agreed to a written interview, which I am including below.


In our interviews, I found that Shirley, now 80, has maintained her sharp intellect and fiery character. She continues to hold and express strong opinions about a range of subjects, including her distaste for a lot of contemporary music, particularly pale imitations of the folk tradition, and even jazz! In a happy ending to her remarkable story, Shirley has now regained use of her singing voice and has begun to perform and record again.

Shirley Collins

I believe Shirley’s story once again demonstrates how music is often closely entwined in our mental and emotional lives. I hope this piece will contribute to the ongoing revival of interest in her work. I think it can also shed some light on the serious impact and complexity of disorders of physical function that do not have an organic basis.

Many of Shirley’s songs are available to listen to here 

Can you tell us a little about your famous trip around the USA with Alan Lomax? What lessons did it teach, about music and about life?

It was in the autumn of 1959, and we recorded from both black and white singers and musicians in Virginia, Kentucky, Tennessee, Alabama, Mississippi, Arkansas and the Georgia Sea islands. They were field recordings of ordinary people – not professional singers, of course. I already knew that the white mountain singers sang mostly songs and ballads from the British Isles that had gone to America with the early settlers; what delighted me was how intact they were, as far as the words went, but with a difference in the melodies that were totally American.  The voices too, were different from British voices, a bit harsher, more strident, but I loved them.  I’d heard blues in England, mostly on recordings, but I wasn’t prepared for the age of some of the songs the black singers had – some that went back to before the American Civil War, and some that sounded incredibly African still.  Most of the people we met were friendly and welcoming, especially to a girl who’d come from so far away as England. This was at a time when tourism to the States hadn’t begun.  And it confirmed my belief in the quality of the music that ‘ordinary’ people can make.


Lessons about life?  How people (and their music and songs) endure under harsh conditions. How kind most people are and how talented many of them.


Readers would be interested to know about the loss of your singing voice- can you describe what happened? What do you think was the cause of losing your voice?

My then husband left me for another woman, an actress he’d met while we were both working at in ‘Lark Rise’ at the National Theatre. He chose to do it the day after a wedding anniversary – a day we’d spent together, and walked back down the lane to our cottage hand in hand. The next evening he came home and said he was leaving in the morning ‘consumed with love’.  The shock – and my grief – were considerable. Also the problem was that he and I were working in the band at the same show, and I was the singer. It was a promenade show, the audience standing, and night after night the actress came and stood in front of me as I was singing, often wearing my husband’s sweaters. It was unnecessarily cruel and provocative. I was having to sing through grief and anger, and sometimes tears, and I had no control over my voice. Some nights I could sing, sometimes my voice broke, and worst of all, sometimes when I opened my mouth, nothing would come out. It was a double humiliation both private and public. This situation went on for far too long, but I was reluctant to leave the show, as a) I thought I deserved to be there, and 2) I needed the money, I had two children to support.   I completely lost confidence in my ability to sing, and as a woman to be loved.


Has your perspective changed on this over the years?

As I look back, I wish I had responded with anger rather than grief.


You have mentioned your regret at the loss of years of your career. Has the experience of losing your voice brought anything valuable?

At least I learned that I was resilient, and won through in the end. And I found that many people had valued what I did. And I wrote a book, several shows and lectures, all helping to restore my self-confidence.


Did listening to music help you through harder times? Any artists or songs in particular?

On the whole I found listening to music painful.  I played a couple of Linda and Richard Thompson songs over and over, and I listened to Italian Renaissance and English Baroque music. It’s full of beauty and vitality.

Things seem to have turned a corner now and you are back singing and making music. What do you think has made the difference?

Partly the passage of time – partly realising that I had been good at what I did – and that I was an original voice. Also I was still championing English folk music and still believe I understand it better than most, and if it doesn’t sound too vain, that it needed me as much as I need it.


Can you select 2 or 3 lesser known songs from the folk tradition that you think all our readers should hear? Perhaps from both England and elsewhere.

I’d choose ‘Master Kilby’ by Nic Jones, ‘Gilderoy’ from me and my sister Dolly, and ‘Rainbow mid life’s Willows from Almeda Riddle of Arkansas. Three great songs.


Finally- why do you hate jazz so much?!

I find it too fidgety, tuneless and jazz musicians tend to wear silly hats!!!





27/11/2015 10:27:43

The Neuroscience of Music

Professor Lawrence ParsonsLawrence Parsons is Professor of Cognitive Neuroscience in the Department of Psychology at the University of Sheffield. He trained in cognitive and neural sciences at University of California San Diego and MIT, and was associate professor at the University of Texas Health Science Centre. From 2001 -2003, he was responsible for establishing a cognitive neuroscience program at the National Science Foundation in Virginia, USA. Lawrence was a trustee of the International Foundation for Music Research, on the Editorial Board of the Social Neuroscience, and a Fellow of the Royal Society of Arts. He has published papers in Science, Nature, Proceedings of the National Academy of Sciences (USA), Journal of Neuroscience, Proceedings of the Royal Society (UK), Scientific American, and Trends in Cognitive Science.
Professor Lawrence Parsons


Lawrence’s recent research interest has focused on reasoning, language, emotion and the improvisation of music and dancing. He organized the first public forum on music and brain (at the Royal Institution of Great Britain in London) and the first on the cognitive neuroscience of dance (at the Wellcome Institute, London). He also spoke as part of the excellent conference on creativity and mental health organised by the Royal Society of Medicine last year. He kindly took time out of his hectic schedule to answer some questions for this blog. His answers have provided a healthy dose of empirical evidence to the scope of this blog! 


Your work as a cognitive neuroscientist is an obvious starting point for your interest on the effect of music on the brain. What led to the development of this interest into a major part of your career?

I have been an active, wide-ranging music listener throughout my life; as a youth I played keyboard, stopping when I started university.  Later, when I was a professor, one of my colleagues asked if I would like to restart a research project that had stalled for various reasons.  This was early days, and the project was a neuroimaging study of piano performance: I jumped in with keen interest, realising upon its completion that a neuroscience of music performance could bring a variety of insights of general scientific, educational, and clinical interest.


Some of our readers may have read Daniel Levitin’s ‘This is Your Brain on Music’ or attended events such as the RSM conference on music and the brain last year or ‘’Shaping the Brain’ at Wellcome Trust this September. For the rest of us, could you select some key findings from research literature in this area that have relevance to mental health practitioners?  

Here is a selection of newly emerging, promising findings that could be of relevance to health practitioners:

- Learning to play a musical instrument appears to develop and maintain executive, multi-tasking, and attentional functions. Nadine Gaab and colleagues at Harvard Medical School published an excellent study on this issue.

- Listening to music may speed the recovery of health in patients in hospital and may elevate the threshold for pain. Robin Dunbar at Oxford and colleagues’ published a paper on this in Evolutionary Psychology (2012) (MacDonald, I., & East, V. P. (2012). Performance of music elevates pain threshold and positive affect: implications for the evolutionary function of music.) On Recovery, Teppo Sarkamo and colleagues University of Helsinki have papers on this in the journals Brain (2008) and Cognitive Neuroscience (2009).

- Learning and practicing dance, especially partnered dance, may enhance and maintain coordination, gait, balance, social relations, and quality of life, especially in middle aged and older adults, and those with movement disorders. Hackney (Emory University, Atlanta) and Earhart (Washington University, St Louis) have several studies on this.

- Learning to play a music instrument or to sing appears to improve the ability to detect prosodic emotion and other auditory speech information. Nina Kraus and colleagues at Northwestern University have a series of publications, as do Cesar Lima at UCL and Sao Luis Castro at University of Porto in the journal Emotion.

- Listening to, and performing, music may assist in the management of stress and arousal, and may enhance immune system function.  There’s a very helpful review on these issues by Mona Lisa Chanda and Dan Levitan in Trends in Cognitive Science 2013.

- Group drumming and group singing may enhance social affiliation and quality of life- Gunter Kreutz et al., in Behavioural Medicine (2004); Jonas Vaag, Arts and Health, 2013.

- Music can serve as a secure psychological space for autistic individuals, assisting with their social connectedness. Pam Heaton at Goldsmiths College Psychology Department has done very useful work on this issue.

Recent studies have emphasized the details how of music listening influences important parameters such as emotion regulation and reward.   These details will be helpful in elucidating possible applications in clinical settings. Valerie Salimpoor, Robert Zatorre and colleagues, have published very good studies on this, for example, in Nature Neuroscience 2011.


In your view, how can future research best further our understanding of mental health issues?

From increased emphasis on standardization, replication, and rigorous hypothesis-testing for clarifying the underlying mechanisms and potential effectiveness.  For example, delineating the role of music and dance experiences in treatment contexts of mental health.


What is your next project? What question(s) would you most like to answer in the remainder of your research career?

Two recent concerns of mine are (i) close investigations of the brain activity in each of a pair of co-performing musicians (singing together, or performing rhythmic percussion), and (ii) the close restrictive control of emotion in order to optimise available cognitive resources during concert/recital performances by musicians.  These issues are rich and unexplored, with various general implications for a variety of scientific and clinical issues.


How would you describe your own connection with music- fan, aficionado, obsessive, or other?! Can you select some pieces of music that have had a major impact on your own life and/or career?

As I mentioned, I am an avid listener to a wide range of music, always looking for new sounds.  I am not sure that any single musical piece has had a major impact on my life, but I can name (in random order) a few pieces, artists, or genre that I feel particularly close to. Here are a few:

Claude Debussy Sonata for Violin and Piano; Sonata for Flute, Viola, and HarpOliver Messiaen The Quartet for the End of Time






29/06/2015 17:17:35

Summer Update - Documentary Recommendations

Amy, 3 July 2015

It is an exciting time for fans of music documentaries. I recently featured ‘Be Here to Love Me’, ‘The Devil and Daniel Johnston’ and ‘Heaven Adores You’. While not directly related to mental health matters, 2012's ‘Searching for Sugarman’ and ‘Beware of Mr Baker’ are also interesting works about unusual characters. Ginger Baker, now 75 and only recently recovered from a serious physical illness, performed at The Jazz Café in Camden last week to a fervent reaction from an awestruck crowd, proving that 'difficult' personalities can sometimes make for astonishing creative output.





Kapadia's "Amy" premieres 3 July 2015.


Kurt Cobain - Montage of HeckEarlier this year, Brett Morgan's 'Montage of Heck', about the troubled life of musician Kurt Cobain, was met with a mixture of critical acclaim and criticism. On July 3rd, Asif Kapadia's film about Amy Winehouse, 'Amy', will be released to a legion of fans of the London singer, who tragically died of an overdose in 2011. Both performers were 27 at the time of their death, and have sadly been added to the '27 club', a list of musicians who have died at that age. After a college conference event on music and mental health in 2013, I spoke with a colleague intrigued by this phenomenon. He suggested to me that this age, associated with the onset of adult responsibilities and the end of late adolescence, perhaps resulted in the chaotic life of a musician being less easily managed, and represented a high risk period for vulnerable creative people. I recommend both films for those interested in these issues and look forward to feedback and discussion on this forum and our twitter account.


Beware of Mr Baker

For those of you who may bemoan the lack of female musicians featured in this blog to date, I am aware of this shortcoming! I will seek to make amends with my next interview piece, where I will speak to the director and producer of another upcoming documentary about the life of British folksinger, Shirley Collins. From the era of Billie Holliday to that of Amy Winehouse, there have been many brilliant female musicians who have struggled with mental health problems. I very much welcome suggestions for other female artists to feature.

I would like to wish all our readers an enjoyable summer break and thank you for your continued interest.




2012 Documentary "Beware of Mr Baker"
tells the story of Drummer and Hellraiser
Ginger Baker, who continues to play at a
professional level aged 75.


29/04/2015 10:13:32

The Songs of Elliott Smith

An interview with Nickolas Rossi, director of new documentary ‘Heaven Adores You’

Elliot Smith





Elliott Smith (1969-2003) was an American songwriter and musician. Having played in rock band Heatmiser for several years, Smith switched to a solo career. His first albums were ‘lo-fi’ works, which gained a cult following and critical acclaim. In 1997, several of his songs were featured on the soundtrack to 'Good Will Hunting', culminating in his performance at the Oscars ceremony in 1998. This led to him being exposed to a much wider audience and the pressures of fame, with which he greatly struggled.




“He gave us the words that we couldn’t find when we were sad.”

- Autumn de Wilde

Smith suffered from depression and substance misuse and he dealt with these subjects in his lyrics, often quite explicitly. In 2003, aged 34, he died in Los Angeles from two stab wounds to the chest. Many believe he committed suicide, although the autopsy evidence was inconclusive. At the time of his death, Smith was working on his sixth studio album, From a Basement on the Hill, which was posthumously released in 2004. (Read a Guardian Interview from not long before Smith’s death in 2003).


Smith was a gifted musician and composer and there is considerable variation in the style of his songs, from melancholic and intense to whimsical and playful. His detractors sometimes pointed to an overly-confessional approach to song writing, but the frankness of his lyrics resonated with listeners worldwide and his fan base has continued to grow in the years since his death. His life has been the subject of several biographies, including ‘Tormented Saint’, ‘Keep The Things You Forgot’ and ‘Can’t Make A Sound’ and the documentary 'Searching for Elliott Smith' (2009).


This year sees the release of a further documentary, ‘Heaven Adores You’ (2014), with UK screenings from next month. In anticipation of its release, I spoke to the film’s director, Nickolas Rossi. Nickolas is an experienced cinematographer who has worked on a variety of projects. His website is here. ‘Heaven Adores You’ is his directorial debut.

Heaven Adores You


JT: Can you tell us a little bit about how you came to know Elliott Smith, or about him?


NR: I didn't know Elliott personally. I met him once outside of a venue in London back in 1998 while he was on tour with his record, XO. I told him that I too had lived in Portland and that I admired his music. But that was the extent of it. We both lived in Portland at the same time, and probably had beers at the same bar, went to the same shows. I'd see him around Los Angeles before he died, as well. When it came time to explore this project, I relied on the people who actually knew him the best to help tell his story and his experience.


You have stated that his music has been very important to you- can you explain why? What about his songs are so distinctive or moving do you think?



I think a lot of people who discover Elliott’s music do so at a time that sort of makes the most sense for them. It’s likely that you come across his music when you need to have someone express some of those feelings for you, through lyrics and melody. As Autumn de Wilde says in the film, “He gave us the words that we couldn’t find when we were sad.”


I definitely had my Portland experience with the music of Elliott Smith. And when I left Portland, I carried that experience with me, but seldom really felt like it was a shared experience with anyone else. He has a way to make songs very personal for those who listen to them. I think he’s important because regardless whether or not you ever knew him or ever met him, he feels like an old friend.


You are primarily a cinematographer. What drew you to this project? Was it just the music or did it tie in in some way with your interest in visual art?


I enjoy the relationship I've had with music and with cinematography. Sometimes, it's just great to put some music on and put on headphones and go for a walk through the city, or get on a train and watch the scenery pass by while you listen to the poetry of the songs. So, I think it's both. I always felt that Elliott's music was cinematic and that there were images and situations to explore through his songs. As a cinematographer, I wanted to explore that in the places where he made that music. There's a feeling to putting those songs to images. The three cities he recorded his records in are all very different in their aesthetics. It was a really fun process to delve into those places with his music as the soundtrack and see what came out in the process of editing the film.


Some people feel that his work is overly confessional or personal. My view is that while his material dealing with darker mental states is undoubtedly powerful, some of his best output was more playful and musically inventive songs, such as ‘Junk Bond Trader’, ‘Lost and Found’ and songs like ‘Bled White’ and ‘Baby Britain’, which deal with serious subjects, but in perhaps a more hopeful way. This suggests to me that if he was able to overcome his difficulties with depression and drug use, his output in the long run may have been somewhat broader in scope, as well as him creating more of it. Others may counter of course, with arguments about suffering being required for great music. What are your thoughts on this?


One of the things that kept on coming up in interviews with his friends was how a lot of people thought his songs were autobiographical, and how that wasn't the case all the time. Elliott was a great storyteller and was very adept in observing situations and then writing about them and being able to tie them into universal themes. It's probably why his music is so relatable for a lot of people. I'm sure there's probably a lot of personal stuff in there, too, but I wouldn't be able to confirm that. 


When I first started listening to Elliott's music, I found a lot of it really heavy and dramatic, but I have had a few years to really absorb a lot of it, and I think you're right--there's a lot of hopeful and optimistic poetry in his music. I guess it really has to do with what time in your life you discover his music. It's all very honest and raw, but also very witty and well constructed. I hope that the film can start to sort of shift that "sad sack musician" mythology that people quickly tag on songwriters like Elliott Smith.

Nickolas Rossi


Can you tell us a little about the making of the film? What themes have you chosen to focus on most and why?


We wanted to tell the story of Elliott Smith, from the stories of his friends and from his own interviews. It was really an organic process, with a focus being primarily on what we thought mattered most- which was the music.


Nickolas Rossi


Have you been surprised at the scale of reaction?


I'm glad the film is being well received with the fans. It means a lot to us that they have been so supportive of the film, and I can only hope that it stays available for the newer generation of fans of Elliott's music that will crop up in the years to come.


Can you pick a few personal favourites from Elliott’s catalogue?


There's so many! I think at the end of the film we counted approximately 47 tracks of music. I think there's a lot there to start with as favourites. Sometimes, it's a different song depending on the day, the weather, or the kind of day you've had. I think that's what’s great about Elliott's music. There's something there for everyone and every occasion. But a few personal favourites by Elliott would be: Waltz #1, Everything Means Nothing To Me, No Confidence Man, Satellite.

16/02/2015 08:27:24

Stephen Brown interview‏

Stephen Brown

My prejudice is that psychiatrists ought to be rounded human beings, citizens of the world with what Denis Healy called  'hinterland', that we ought to be able to engage both sides of the brain and the bit at the front as well...

Stephen Brown is Professor of Developmental Neuropsychiatry in the Peninsula Medical School. He recently retired from clinical work but is still involved in research and teaching. He specialised in Epilepsy for nearly 30 years and is a past chair of the British Epilepsy Association and an Internal Ambassador for Epilepsy.

Stephen is also a trained classical musician, conductor and composer. He is the cello player with the Corineus String Quartet and also plays regularly with the orchestra of New Devon Opera, and for many other shows and choral societies in Devon and Cornwall. He belongs to Cornish Airs (a group of local composers) and is also Musical Director of Bodmin Musical Theatre Company. 

I interviewed him for this blog and he provided some intriguing insights into life as a musician and psychiatrist, thought-provoking views on the connection between music and other abilities, and a philosophical perspective on coughing at concerts.


JT: In my research for this blog I have encountered quite a number of psychiatrists who are also musicians or have a deep interest in music. Have you any thoughts on why this may be the case?

SB: It would be easy to construct an answer that included words like 'creativity', 'sensitivity', 'non-verbal communication' and so on but it would be quite evidence-free! Over the years I've encountered a small number of psychiatrists who were fine musicians, and a very large number who were not! I have however met many doctors from other specialities who were good players and I guess all the doctors together outnumber any other profession that also appears in the music world, with lawyers a close second. There is also a subgroup of those who went to music college, and then developed careers in another field for obvious economic reasons, such as accountancy or IT (one excellent musical colleague retrained as an Air Traffic Controller) but who still turn up on the freelance performing circuit.

So I rather think the idea that musical ability is specially represented in the field of psychiatry is sadly just a wish-fulfilling fantasy. But note I did say 'sadly'... because deep down I think it ought to be.

I think there are three major sets of skills that we need to consider. There are craft skills, to do with the technique of playing music, getting the fingering right, sustaining the downbow to the end of the note or phrase (that's for a 'cellist, the violin equivalent would be an upbow) counting difficult rhythms, playing in tune and so on. It's why some people practice scales, and the difficult acquisition of this skillset is probably the main reason people abandon lessons when they're beginners. Then there are receptive skills, which are those involved in listening to and appreciating music, and finally what I call expressive skills. These concern the ability to tell a story in performance, to communicate the message beyond the notes.

My prejudice is that psychiatrists ought to be rounded human beings, citizens of the world with what Denis Healy called 'hinterland', that we ought to be able to engage both sides of the brain and the bit at the front as well, and since the nature of our work often involves sensing the significance of communication that isn't just in the form of words, then we must have a subtle understanding of prosody, and a sensitivity to mood, inflexion and gesture. And I think it's arguable that these skills with meta-language are basically the same ones that allow both the appreciation and performance of music, the receptive and expressive skills.  Which perhaps begs the question, why do conservatoire trained musicians sometimes become accountants or software engineers, where arguably these characteristic aren't in such great demand? Part of the answer is that they don't all do that - one of the best professional musicians I had the pleasure of performing with a few years ago suddenly decided to retrain as a psychotherapist. I gave her a bit of a hard time when she told me, and offered the opinion that she'd do people far more good by continuing to perform professionally (I was going through a bit of an anti-psychodynamic phase at the time) but she did go on to have a highly successful second career. Another reason might relate to the reasons people choose to enter the music profession in the first place. There's a bit of a myth you sometimes hear that many musicians are on the autistic spectrum (well aren't we all, that's why it's called a spectrum) and I don't specially buy into such a generalisation, but occasionally I can't help noticing some have mild attentional issues that I guess are helped by the

activity of performing music.

And remember music is a craft as well as an art, so fine motor skills, left-right coordination and so on play a part, which may not be essential attributes for psychiatrists. So, basically, appreciation and understanding of music (which we might call receptive skills) could potentially be in the repertoire of psychiatrists even if performance at a high level may not be, whereas trained musicians need the physical skills as well as expressive ones.

People in the audience do not, as a rule, cough intentionally in concerts. They do not do it to annoy performers and they do not do it because they are stupid or ignorant.   Mostly in fact they try very hard to suppress their coughing until a break between pieces, and if it's persistent they will quite often leave the room.

How have you managed to balance a successful musical career alongside your work as a psychiatrist? We would be very interested to know about a day or week in the life of a doctor-musician.

Well the straightforward stuff has involved only accepting gigs that don't clash with the on-call, and using annual leave if given enough notice. Also, being married to a freelance professional 'cellist has been incredibly helpful as occasionally we've passed gigs on to each other. Freelance work is precarious because if you turn it down you may not get asked again by the same fixer! Years ago I was offered a particular very good and very popular annual choral society booking, but it clashed with an overseas conference where I had to present some research, so I passed it on to Sue. I've never got that one back! For a number of years I played with an opera company that had grants to do performances in a number of different venues in the south west, and the standard was really high. The band was always booked a few months in advance of the season, so I used to take annual leave to cover the time to get to & from the venues, which included taking some half days.

Because of my particular clinical and research interests I occasionally used be contacted by colleagues for advice even when I wasn't on-call. Fortunately this was never so urgent that it couldn't wait till the tea break in a rehearsal or the interval in a concert if I kept the mobile on vibrate only mode. I'm now in my anecdotage, so here's one: for my mobile ring tone I have the first movement of Mozart's K136, which I took from a CD. It's not a regular supplied ring tone that comes with any phone. Once when I forgot to switch it to vibrate only during an opera rehearsal one weekend (no I wasn't on call) someone did indeed ring me for some clinical advice. It happened just as the conductor stopped us to say something but instead everyone looked round to see where this unexpected Mozart string quartet was coming from, and all eyes fell on me as I pulled the phone out of my gig bag. The conductor looked at me and just said “Pretentious, toi?”. Which leads to another story. That particular K136 is a rather historic quartet recording and the 2nd violinist on it continued working on the freelance circuit in the west country until fully retiring recently. He was a real gentleman and I always enjoyed chatting to him on gigs. Once, in the Green Room, I played him my ring tone and told him that it was his recording that I used. He looked a bit puzzled and then asked, “So do I get a royalty every time someone calls you?”. Sadly no.


You play as part of a string quartet. The recent film A Late Quartet gave an interesting (if perhaps somewhat melodramatic) perspective on the dynamics of such a group. Can you tell us about your role and the dynamics of your particular group? How do the others feel about your being a psychiatrist, for example?

I heard about the film, but it has yet to get to the Wadebridge Regal down here in Cornwall, probably because it doesn't have lots of CGI, chase sequences or enough explosions. Or else I just missed it. Anyway... I've played in several quartets and small chamber groups over the years, and so has my wife, and of course every one is different. Quite often one dominant personality tends to take control of the rehearsals and decides on the interpretation, and this is usually, but surprisingly not always, the first violinist. One hears stories of some professional quartets where the leader can be quite a fearsome termagant or bully depending on gender, and I know of situations (fortunately not involving me) where members have been reduced to tears in a rehearsal. Thank goodness none of that happens with the Corineus String Quartet. At least not yet! We jointly agree the repertoire, usually after playing through various candidate pieces, and everyone has a say in interpretation. Of course we disagree sometimes so a discussion ensues but it's never acrimonious.

As I write this we've just started rehearsing the Schubert String Quintet with guest cellist Patrick Gale, who is also an award-winning novelist as well as an excellent musician, so we are fitting in the rehearsals and performances around his busy international book-signing schedule. I took the liberty of asking them all about this question, and it did elicit a certain amount of hilarity, especially since we had just had a robust discussion about how closely we should slavishly follow the ‘urtext’ Schubert edition. For example, informed scholarship tends to think the bar before the exposition repeat in the first movement should be a first time bar and therefore omitted if you don't do the repeat, as is the case in some recordings that we've listened to (and between us we've listened to a lot as due diligence in preparation). The reason is that it makes more musical sense that way. It wasn't published in Schubert's lifetime so the urtext is based on manuscript that could easily have mistakenly omitted the first time bar mark. Schubert was a notoriously fast writer after all, and would have had a chance to correct proofs before publication, but that never happened so we have to make musical sense of it ourselves. As you can probably guess I'm on the side of making musical sense rather than slavishly following a possibly flawed manuscript for the sake of it. After a couple of weeks' thought we are nearly in agreement, but eventually we'll do what the leader Ian decides and I'll be happy with that. Meanwhile I'm tempted to draw a comparison with the way the phase 'evidence-based medicine' can be abused by some, so that just invoking it even when it's incorrectly applied adds a spurious strength to an argument. So it is with the urtext, which is a skeleton on which we must put flesh, clothes, life movement and motivation. Meanwhile we suggested to Patrick that these sort of tensions might find their way into a scene in a novel, so wait and see! It occurs to me that although I express myself quite strongly when I do have an opinion, most of the time I listen and occasionally say something intended to sum up and move on, which I suppose has some parallels with psychodynamic group work except that there's no interpretation. Heaven knows what would happen if I even tried thinking that way.


As for what the others feel about me being a psychiatrist.... it's only really come up once. One day between the afternoon run through and the evening concert everyone, as usual, retired to a pub for a meal. I was late getting to the pub as I was meeting a friend off the bus who was coming to the concert, so when I got there the others had already ordered. Debs the violinist handed me the menu and suggested that as a psychiatrist I should be able to guess what meal each of the others had ordered. Ian was easy - the biggest portions obviously. Can't remember how I did with the rest. And that's it really. I guess they think it slightly amusing and like to tease me about it. Having a novelist in the group though... that's much more intriguing. Actually we're all good friends and enjoy just about everything we do together.


Do you have a preference between live performance and recording? From the psychological perspective of the performer, what are the key differences between the two in your view?

When in the zone, a good live performance is an unbeatable, peak experience, whether as listener or performer. Sometimes when not in the zone though I find it a bit excruciating. We recently did a well-attended quartet concert on a Sunday afternoon with Schubert's Rosamunde and Shostakovich's 8th. Being the time of year, the sun was low in the sky and extremely bright. During the concert the sunlight moved across the window at the back, starting off by not focussing on any of us, but as the concert went on at least two of us in turn were dazzled by an incredibly bright beam of light in the eyes. We discovered that if you see this in the corner of your visual field while you're looking at music on a stand there's an irresistible urge to glance up. No really, it's irresistible. And if you glance up you're basically blinded for a second or three. This wasn't helpful to the leader in a difficult bit of the Schubert last movement, and it struck me in the eye at the most difficult part of the Shostakovich. But the point is, although we both felt something must have gone really badly wrong, the feedback from the audience was superb and several people made a point of coming up to us afterwards and saying how moving and beautiful it was. Also, we recorded it for our own feedback purposes, and sound-wise you wouldn't notice anything had happened. However, definitely slipped out of the zone for a bit and it was uncomfortable.

Corineus String Quartet

I've been involved with a couple of commercial recordings in the past and we plan to do some more with the quartet in the future. Of course in this situation the tension is off and if you have a good sound engineer you can get a good quality tone and dynamic changes and stitch together something with all the right notes in the right order. But as I said, the tension is off; we have to beware of the product being less emotionally satisfying if we don't also continually remind ourselves that we're telling a story and have the audience in mind.


Who and what are your favourite composers and pieces to play? What is it about these composers and pieces that you find compelling? Can you give us a recommendation of a classical piece with healing qualities?

It's a great indulgence to be allowed to give an opinion that doesn't depend on a literature search or meta-analysis of top level evidence and where I can just say what I think. Obviously that not all music is mood enhancing, or meant to be. Great music, like all great art I expect, tells us a story,

sometimes with an explicit narrative, but often more abstractly so if we wish we can project a personal narrative into it. There is typically some contrast, possibly some conflict, and hopefully resolution. When I listen to recorded music, as opposed to being in the audience at a concert or performing it, I rarely if ever do so just to cheer myself up, More likely I want to calm down or enhance my concentration on another task, or, quite frequently, I want to familiarise myself with a piece I might be playing. Incidentally many professional musicians that I know find background music really distracting and somewhat unpleasant presumably because their training and general sensitivity makes them unable to avoid analysing and focusing on it and distracts them from other tasks. In fact it's been suggested to me that this is a key difference between amateurs and professionals, though I think that's an exaggeration. Nevertheless your question about 'healing' music got me thinking about which composers, and which pieces, are basically happy. This is purely subjective of course, but to me there's a sort of first division group of composers whose music is psychologically well-adjusted and whose output has a positive, uncomplicated feel to it. The ones that come to mind straight away are Handel, Haydn and Dvorak, with a sort of second division that includes Vivaldi, Corelli, Rossini, Mendelssohn and Saint-Saens. Beethoven typically has a sense of optimism that often shines through the tribulation, whereas Mozart has a lot of flashes of joy, especially in the earlier works, but he can also display an underlying melancholy if you but look for it. And Shostakovich can laugh and cry at the same time, but he's a very special case.


That's not the same list as my 'favourite' composers, or pieces. That list varies from week to week! This week I am mainly enjoying Mozart, and also the Australian composer Peter Sculthorpe (recommend you look him up if not familiar to you!), and I've recently finished listening to the complete works of Thomas Tallis and a complete cycle of Beethoven piano sonatas. Next week it'll be some other composers, I'm sure. Mozart piano concertos are always good in the car and remind me of driving in Tuscany. In fact no long journey is complete without numbers 18 & 19 (number 20 on the other hand is a bit too melancholy for that, but has its place in the home, and number 21 too distractingly beautiful to have on while negotiating a difficult junction).

My wife Sue and I occasionally discuss what we'd like played at our funerals, and that sometimes changes a bit. I think we'd both like the Cavatina from Beethoven Op. 130, but last week she prodded me and said “Andante from Mozart 29, don't forget that!” and then I listened to it and thought yes I'd like that too.

As for pieces that might be healing, well, I'll take that at face value and start with Handel's Concerto Grosso Op 6 no 7. If I listen to that from beginning to end I definitely feel that all is good with the world, and everything's going to be OK. It is like walking through an English garden in full bloom on a beautiful day in late spring or early summer. Of course the performance is important. Some groups take parts of it far too quickly in order to show off how good they are at fast finger passages, so the audience thinks how clever the performers are, but I think that seriously misses the point. As in most other music, the performer’s task here is to be a bridge between the composer and audience, not to be needy and attention-seeking. The same movement when played a little slower with careful phrasing is a beautiful gracious acoustic miracle.

Also in the category of healing or uplifting pieces would be several extracts from Haydn's Creation, most notably the first part closing number The Heavens Are Telling which I find relentlessly and infectiously happy and uplifting. The New Created World chorus earlier in the piece is also just about in this category. I've played the cello in at least three performances of this over the years (plus one where I was singing in the choir) and look forward to doing it again as I'm sure one of the local choral societies will get round to it.

If we're just talking about performing I'd also bring in Brahms, especially the clarinet quintet and the string sextet in B flat. Also I'm really enjoying the Schubert string quintet that we're rehearsing at the moment.


I interviewed the pianist James Rhodes last year. He has been quite outspoken about stuffiness or snobbery in the classical music world. Have you encountered this in any way? Would you like to counter the view?


I'm pleased to say that in everyday situations I've found most professional musicians to be remarkably unstuffy and indeed keen to break down any barriers of perceived elitism. At our quartet concerts we always have a chat with the audience about each piece before we play it, and in orchestral gigs I don't think anyone minds at all if, for example, there's applause between movements, in fact I would take it as positive feedback!

There is however a tranche of professional musical behaviour that is frankly precious, truly pretentious and absolutely open to the criticism of being elitist, and I disapprove of it immensely. It is exemplified by some recent stories in the press about what happens when someone in the audience coughs during a performance. Now just let me mention first of all that there are many fine musicians who don't work in the conventional 'classical' genre. They might do jazz, folk or nightclub work, and it would be ludicrous if they got worked up about audience coughing! It's only some rarefied folk who really ought to get over themselves who seem to have a problem. One of the reasons I feel strongly about this stems from my professional work with people with disabilities. In a previous job I used to arrange concerts that were often attended by people with learning disability and/or cerebral palsy and it was quite normal for there to be 'noises off'. This still happens of course and I'm pleased that people come to our concerts and enjoy them. As musicians we can learn how to play through it not be put off. I have always found audiences to be inclusive and accepting of this. And as far as coughing is concerned… well I was astonished recently to hear an eminent pianist whom I used to know quite well many years ago holding forth on the radio about how terrible people who cough in concerts are, and really being quite dismissive and pejorative about the people who buy tickets to listen to them and are therefore their source of income. I think it was a discussion about some German research that also seemed to miss the point. So here's my opinion:

1. People in the audience do not, as a rule, cough intentionally in concerts. They do not do it to annoy performers and they do not do it because they are stupid or ignorant. Mostly in fact they try very hard to suppress their coughing until a break between pieces, and if it's persistent they will quite often leave the room. Generally speaking the audience is on the side of the performers, even if the performers sometimes behave as if they are not on the side of the audience.

2. The reason that people cough is because something has set off the cough reflex, a normal and typically involuntary biological process.

3. But here's a thought – if you are concentrating really hard on something you may swallow less often. Saliva may accumulate in the mouth and dribble back, get accidentally inhaled and set off a cough. So someone listening intently to music in a concert may actually be more likely to cough.

This can go for performers too. It's happened to me a couple of times in a concert over the years, intense concentration leading to a barely suppressed coughing fit. I didn't do it deliberately and the other musicians didn't stop and ask me to leave. They didn't even accuse me afterwards of attention-seeking behaviour!


Do you listen to much music outside of the classical genre? Have your tastes changed over the years and if so how? Can you give us a non-classical favourite?

I guess my knowledge of popular music and my enjoyment of it froze sometime in my 20s, which means I'm a child of the 60s & 70s and have fond memories of sixth form discos and university parties and the background music to those events. Like most musicians these days, I sometimes get involved in the wedding music playing circuit and this can mean producing arrangements of contemporary songs, so I get some exposure to the modern stuff. What strikes me about present-day popular music is that the songs often have one idea that just gets repeated and there's no development or middle section or modulation. I'm sure this is just a current trend and won't last, but frankly I find a lot of it quite boring. It crossed my mind that it might be related to whichever recreational drugs are popular at the time; amphetamine-related drugs do tend to make people stare at the wall for prolonged periods of time and the music kind of goes with that sort of mindset. Whereas in the 60s & 70s, LSD and related drugs were matched with psychedelic music (late Beatles, Jimi Hendrix, Blind Faith, etc).

Right now in the CD rack in the car apart from the Mozart I have a Beach Boys collection and some French Cafe music. I live in Cornwall. On a sunny day driving along with the sea in sight Californian surfing music is a perfect match, whereas driving back late at night some Serge Gainsbourg or Brigitte Bardot goes down a treat.

Finally, years ago Jacques Loussier made an LP called Pulsion which consisted of his original compositions and was therefore completely different to his Bach or Satie interpretations. It was absolutely brilliant. I had a copy and have lost it. I wish it could be reissued on CD.



13/01/2015 10:03:38

The Devil and Daniel Johnston

Daniel Johnston - Minds in Music blog

 Musicians with mental health problems are not immune to some potentially troubling implications of such a construct, for example that ‘madness’ is required for great artistic work.


The connection between mental illness and creativity is an interesting and contentious subject. I have explored different aspects in this blog to date. One consideration that has not been mentioned is the possible exploitation of those with a mental illness to generate notoriety or sensationalise their artistic work.

An excellent overview of the life of the poet Robert Lowell and the role of mental illness in his work points to a romanticising of mental illness by poets and critics in the US in the 1950s and 1960s, exemplified by this quote from Peter Davidson’s  ‘Madness in the New Poetry’:

"Madness .. can be construed—and is by some poets—as the regular and inescapable concomitant of the reach beyond reality; and sanity is construed as the dullness of those who refrain from reaching."

While the idea may be alluring, there are implicit dangers in such a simplification. Musicians with mental health problems are not immune to some potentially troubling implications of such a construct, for example that ‘madness’ is required for great artistic work. My last piece dealt with some of these, focusing on the troubled life of Townes Van Zandt, who was the subject of Margaret Brown’s compelling documentary ‘Be Here to Love Me’.


Aura of mystique

In the modern hype-driven music world, another danger is use of an individual’s mental illness to create an aura of mystique. Daniel Johnston, another Texan songwriter, is also the subject of a fascinating documentary, ‘The Devil and Daniel Johnston’ (2005). The film provides an insight into his life and development as a creative individual. Far from romanticising his illness however, the director does not shy away from the more troubling effects of illness on the artist’s life, including an incident where he caused a small plane in which he was travelling to crash-land due to behaviour arising from a psychotic episode.

There are also several moving accounts of those close to him about the effects his illness had on his life. The film was directed by Jeff Feuerzeig and won the Documentary Directing Award at the 2005 Sundance Film Festival. It is highly recommended viewing for those interested in music and mental health.


The music industry

Johnston has certainly suffered from a severe psychotic illness throughout his adult life, characterised by episodes of both manic and psychotic symptoms. A somewhat disturbing feature to Johnston’s life was the apparent lack of understanding or outright disregard demonstrated by facets of the music industry towards Johnston’s mental illness.

While he was very unwell in a psychiatric hospital in the early 1990s, there was a race among record companies to sign him on the back of an endorsement by Kurt Cobain. Others do not appear to grasp just how vulnerable he may be in the stressful environment of a live performance.

Counter to these concerns, others from the music world have been very supportive and understanding. Johnston’s success at continuing his creative career despite his mental health problems may also serve as a source of inspiration and encouragement to those experiencing similar difficulties.


Acquired taste

Johnston’s music is certainly an acquired taste. He has a very unusual approach to writing and singing and his live performances can be erratic and unpredictable. Some find his often child-like lyrics to be simplistic and his music unsophisticated. However, others point to similar apparent limitations in some of Neil Young’s work, which do not necessarily lessen its emotional impact. Other still cite a quirky inventiveness similar to the offbeat work of 90s indie groups such as Neutral Milk Hotel and the Elephant 6 Collective

There is no doubt that other artists have taken a great interest in his work and cover versions of his songs may provide a gateway to his music for those put off by his own idiosyncratic delivery. Many of these are collected on the 2004 album ‘The Late Great Daniel Johnston: Discovered Covered’ (note - Daniel Johnston is still very much alive (and touring); like Townes Van Zandt he appears to have used ‘Late Great’ in an album title as a moment of black humour).

Daniel Johnston is also an artist, with a focus on often absurdist cartoon-like imagery, and his work has been shown in galleries in London and New York.




01/10/2014 13:58:41

Townes Van Zandt

Townes Van Zandt  (1944-1997)

There is a sense when learning about his life that there was an element of ‘self-medicating’ ... and that had he received some form of intervention, he may well have been capable of continuing as a creative force to a much later age.

Townes Van Zandt (1944-1997) was a Texan songwriter. His intense, poetic songs and unconventional delivery distinguished him from other forms of ‘country’ music and a deep emotional intelligence is evident in his work. Although he did not achieve great commercial success in his lifetime, he was regarded by many of his peers as the greatest songwriter of all (friend and fellow songwriter Steve Earle famously declared he would inform Bob Dylan of this while standing on Dylan’s coffee table wearing cowboy boots). His reputation has grown further since his death and his influence is cited by a diverse range of artists, from Lyle Lovett to Sonic Youth. His songs have been covered by Bob Dylan, Neil Young and his friend Willie Nelson, who turned
‘Pancho and Lefty’, Van Zandt’s unconventional and abstract tale of two outlaws, into a major country hit in the 1980s. 

Throughout his life, Van Zandt struggled with substance abuse. From early adulthood, he was drinking heavily and he used intravenous heroin extensively throughout his adult life. His death aged 52, following an operation on his hip, was contributed to by his very poor underlying physical condition. Van Zandt was always adamant that drinking and using drugs was simply part of his ‘life on the road’ and took a very philosophical view of the likelihood of an early death. This was in keeping with his purist vision of song writing as an art form which required deep and utter commitment, even to the detriment of his health, finances and relationships with friends and family. 

A closer look at Van Zandt’s biography however strongly suggests that he also suffered from a severe comorbid depressive illness. His description of the ‘blues’ as a sense of deep despair beyond sadness has the hallmarks of a severe depressive state, and several of his songs, such as ‘Flyin’ Shoes’ and ‘Nothin’ also reflect this. For long periods, his creativity was severely blunted and towards the end of his life he was often unable to play or remember his songs. Although Van Zandt had a privileged and largely unremarkable upbringing, those close to him frequently identified memory loss from a crude form of Electroconvulsive Therapy(ECT), given to him on a questionable basis when in his late teens, as a major traumatic event in his life. (Those interested in ECT should see information on modern use of ECT in accordance with guidelines here). 

There is a sense when learning about his life that there was an element of ‘self-medicating’ in Van Zandt’s drug and alcohol misuse and that had he received some form of intervention, he may well have been capable of continuing as a creative force to a much later age. It is of note that contemporaries such as Dylan and Kris Kristofferson struggled with similar difficulties yet managed to produce quality material until much later in life. This is also true of Leonard Cohen, who overcame severe depression and experienced a renaissance in his later career. The difficulties encountered by those with a ‘dual diagnosis’ of substance misuse and mental illness has been identified by key figures working in this area and is in my view an important consideration when considering the difficulties encountered by creative individuals in maintaining their mental health.  

In 2005, American filmmaker Margaret Brown directed the excellent ‘Be Here to Love Me’, a biographical film about Van Zandt’s life, named after one of his songs. The classic 1970s film ‘Heartworn Highways’ about ‘outlaw’ Texan songwriters also contains some memorable scenes which give an insight into his work and lifestyle.

A biography of Van Zandt,
‘To Live is to Fly’, is also available. An erratic studio performer, Van Zandt was often at his best in a live setting, at least earlier in his career. This is evidenced by his peerless live album ‘Live at The Old Quarter’(released in 1977 from a recording of a 1973 performance).  


26/08/2014 11:27:55

Darkness in the music of The Smiths: Dr Benjamin McNeillis

No-one would argue that the lyrics of Morrissey and the music of The Smiths is a fertile ground for exploration of forms of mental distress and disarray. Dr Ben McNeillis is a core trainee in psychiatry at the South London and Maudsley Foundation Trust. His love of The Smiths combined with his day-job led him to the idea of a talk at the Institute of Psychiatry Summer School this summer. His stimulating presentation was very well received by attendees and I took the opportunity to develop it into a piece for Minds in Music.


JT: You mentioned in your talk that you feel a lot of pop music is quite narcissistic in nature. What in particular made you choose the music of The Smiths to explore the concept of narcissism and narcissistic personality disorder?

BMcN: I didn’t come at this very scientifically, for instance as a neutral observer saying, “right, here we have narcissistic personality disorder, let’s take a sample of 100 bands and find the lyrics which most closely matches the criteria”. I think that it was a lot more personal. I first heard The Smiths when I was 19, thought they were brilliant and listened to them (and recreated them) a lot throughout University – my yearbook entry (written by friends) suggested that in Morrissey, I found the strength required to get through medical school, which I suppose was at best a tongue-in-cheek comment. I suppose we all encounter narcissistic conflicts to varying extents and deal with them in different ways. So I suppose I was very familiar with the sort of character represented by The Smiths, maybe I even identified to an extent.  I was always aware, though, that they were a sort of “musical Marmite”, and many people took a strong dislike to their music.

Then I started my Core Training in psychiatry, and on a number of occasions I would find myself thinking “this reminds me of The Smiths”. In my psychotherapy job, when we looked at papers on narcissistic personality disorder, I felt really familiar with what was being described, through my familiarity/identification with The Smiths’ lyrics. Interestingly, I found that these papers gave a helpful framework with which to approach the music, and began to go beyond the idealisation/denigration split (“They’re geniuses”/”what miserable crap”) and became more aware of the conflicts going on, the real suffering – and began to acknowledge the more obnoxious side of the lyrics which I had previously minimised.

'... I think relating to music and lyrics can keep things at a safe distance for adolescents – well, actually that’s probably true for everyone...'

What are your favourite songs by The Smiths? What are the other themes in The Smiths’ work that you think are relevant to those with mental health problems and those working in mental health?

These are very difficult questions! I would say that possibly my favourite song is “Rubber Ring”, on “Louder Than Bombs” – I love the theme. Morrissey seems to address the listener directly for what they are – a listener – and asks what role does the music play in the listener’s journey through life, imploring them not to forget “the songs that saved your life”. In answer to the question “Do you love me like you used to?” – no, but that doesn’t mean I don’t still love the music – it’s a different appreciation now.

My other favourite song is “What She Said”, from my favourite album “Meat is Murder”. The whole band is just amazing on this song – the drums in particular are really driving and frantic, the guitars screeching manically whilst the bass runs around underneath – and then Morrissey delivers one of my favourite couplets:

“What she said, on heavy books she’d sit and prophesise,

It took a tattooed boy from Birkenhead, to really really open her eyes.”

But maybe I love this song so much because it comes immediately after the final couplet of:

I want the one I can’t have”:

 “And if you ever need self-validation,

Just meet me in the alley by the railway station...”

In response to the second question, I would say that the prominent themes in the music which are relevant to mental health are suicidality, abuse, sexuality, violence, and politics. Some would argue that all of these could be in some way approached with a framework of narcissism, but there are different approaches as well. For instance, I had thought that “The Headmaster Ritual” gives a clear suggestion that the character portrayed by the lyrics has been abused:


“He grabs and devours,

He takes you in the showers...” 

But actually the students in the workshop felt that “Reel around the fountain”, the first song on the debut album, is about an abusive encounter, which I felt was quite perceptive. I suppose that therefore we could approach the music and try to understand the potential effects of sexual abuse during someone’s development, but it is worth noting that people can react in many different ways to such an experience.

Sexuality is always going to be a big talking point. My own take on it is that the lyrics clearly talk about homosexual encounters and uneasy interactions of a sexual nature with females, but I really admire the way Morrissey avoided being pigeonholed, and I think this is very important – we all have our own individual sexuality. I think that being “gay” is different to having some homosexual urges/aspects/thoughts/actions, and many psychoanalysts would say that we all have some unconscious homosexual drives. The Smiths give us the opportunity to look at the sexuality of the individual.


You mentioned that you are not as interested in Morrissey’s solo work – is this mainly due to the musical differences (eg no Johnny Marr), or did you perceive a shift in song writing style not to your taste?  Fans would argue that the subject matter and lyrics have continued to be every bit as intriguing!

I think I have always been very strongly affected by the sound of the music – my mother used to play piano a lot when she was pregnant – and I was a musician (guitar mainly) long before I started to sing. So you’ve absolutely struck on the reason – I heard some of it and it didn’t grip me, before I really processed the lyrics. I love Johnny Marr’s guitar work in The Smiths and that is probably a large part of it, but I think the rhythm section of The Smiths was also outstanding, and it is always possible that the sound of Morrissey’s singing was more engaging in his 20s! However I haven’t really given Morrissey’s solo music much of a listen so I can’t really give a good comparison. I gave a similar talk in 2013 entitled “Psychotic Phenomena in the Music of David Bowie” and it emerged that I only really listened to the music from his 20s (and early 30s) so it could be to do with my age.


Do you feel your interest in the music of The Smiths was intensified by your work in psychiatry? Has music in general helped you in your work in any way, for example in terms of a shared interest with a patient?

I wouldn’t say that it intensified it – it was in my early University years that I really listened to them a lot and learned the songs and lyrics. I would say however that my work in psychiatry has really helped me to relate to the lyrics in a different way. As I say above, I have moved past the idealisation phase to an appreciation of the narcissistic conflicts portrayed therein – maybe a move from “sympathy” to a more accurate empathy.

The examples that came to mind of music being a shared interest with a patient come from my time working in an Adolescent Unit.  During a long inpatient admission, this person learned guitar as he began to come out of his shell, and I remember playing Iron Maiden’s “The Trooper” together with him. There was a Smiths fan on the ward too. I think relating to music and lyrics can keep things at a safe distance for adolescents – well, actually that’s probably true for everyone, maybe it was just that Adolescents are spending more time listening to music!

I would also say that my interest in rap and reggae music helped when moving from Oxford to South East London, in particular my CT1 year in Lambeth Hospital. It gave me a small but helpful degree of familiarity with cultures very different to my own.


Please give us a recommendation of a lesser known song by The Smiths which tackles a difficult or challenging subject.

Handsome Devil” on the album “Hatful of Hollow”. It’s quite disturbing. I used to find the shocking chorus couplet quite amusing:

“Let me get my hands,

On your mammary glands...”


But then actually you listen more closely to the verse and it seems that in this song he is identified with a rapist – and gives a very clear example of “lack of victim empathy” in the first verse:

“All the streets are crammed with things 
Eager to be held 
I know what hands are for 
And I'd like to help myself 
You ask me the time 
But I sense something more 
And I would like to give you
What I think you're asking for 
You handsome devil“

I suppose that coming across this song, in the context of other songs in which the singer is identified with a victim, makes it difficult to know how to react – is this song just the victim trying to portray or make sense of the abuser’s point of view – or could the singer have the potential or desire to carry out such a crime?  This makes for uncomfortable listening, especially given Morrissey's use of humour in the chorus.



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Minds in Music

  Dr John Tully  


Dr John Tully is a forensic psychiatrist and researcher at the Institute of Psychiatry, Psychology and Neuroscience, London. He is also a musician and is interested in the role of the arts in mental health.