Music therapy and punk rock

Interview with Professor David Meagher of Sons of Southern Ulster

You work in general adult psychiatry and you are interested in music therapy interventions. Do you or your clinical colleagues use musical therapy in any form in your clinical practice?

How do you think such interventions are best aligned to more traditional models of care?

I think we all recognise the substantial capacity that music has to impact upon mood and general awareness of our milieu, and many of us use it therapeutically in our day to day lives.

On the ground, I think that the integration of recovery principles into everyday practice is central to 21st century psychiatry but I often feel that a lot of what is deemed ‘recovery’ is actually contaminated by the conservative values of professionals who are hopelessly middle class and safe.

Moreover, the all-consuming determination to standardise practices inevitably forces a ‘one size fits all’ philosophy onto what we do and this stifles the personalised and tailored care that I think many folk need.

This is a real battle for clinicians – trying to accommodate the individual need of patients with the seemingly relentless appetite of management for consistency. Similarly, our risk aversity causes us to hide behind ‘professionalism’ as an excuse for not engaging with many inconveniences.

Are there any particular initiatives in which you have been involved?

Along with our OT, I recently started an air guitar group on our inpatient ward.  It’s been really fascinating how what has unfolded is quite different from our prior notions – it’s surprising how well the sessions engage folk from across the age and diagnostic range.

Moreover, the determination of participants to facilitate each other’s enjoyment of the sessions has been really pleasing. On week four the session exited the therapy room as a human train of air guitarists to do a circle of the ward! There are times when you smile from the inside out, and that was certainly one for me. As a committed biological psychiatrist, it speaks to how better integrated we have all become in terms of combining all the different available therapeutic elements.

Although I am not sure of the actual scientific evidence, it’s my experience that psychiatrists who give time to a more complete biopsychosocial range of approaches are more likely to convince patients that trying medication-based solutions might be a good idea. It also raises the question – beyond the ear candy, how different are mindfulness and mindlessness?

As a training psychiatrist I worked for 18 months with Ivor Browne who is undoubtedly one of the most interesting Irish Psychiatrists of history. He ran a psychotherapeutic programme that included using LSD (and later Ketamine) along with body work and sound therapy to promote re-experiencing of suppressed traumas.

With my musical interest I got to control the sounds from an impressive library of samples (from the gentle pitter- patter of rain to the violent screams of a battlefield!) which in retrospect was not dissimilar to running a rave! This was in the late 1980s/early 1990s and understandably was viewed with scepticism by the mainstream of Irish psychiatry.

The programme was not continued after Ivor retired which was a pity as undoubtedly many patients who had exhausted the efforts of mainstream services made good progress, but equally the whole programme was pretty wild (and exciting!).

How did your interest in writing and playing music develop and evolve over the years?

Music has always been my ‘thing’. I was not blessed with talent at sports and the moment I encountered punk rock with all its inherent humour and naughtiness my interest in the big world out there took a big leap forwards. My subsequent journey has been played out to a background of music.

I am one of those who works best surrounded by noise rather than silence – for some people that the ultimate silence is found in extreme noise was something my father never really appreciated when I was growing up, as he couldn’t get the fact that the louder the music the more intense my studying! In terms of playing music, my generation were blessed to grow up in the punk era as the whole Do it Yourself philosophy (even if you are rubbish!) was a departure from the over technical dinosaur rock era that preceded it.

How did you maintain your interests alongside a medical career?

In the era before continuous assessment you could manage to have an active second life running in parallel with your medical studies and this allowed me to play in bands pretty much throughout my student years. Similarly, many of my fellow (The Panic Merchants) band members were medics. I somehow doubt that our graduate entry medical students at UL are hanging around rock venues strutting their stuff late at night and in many respects that is a pity.

Our medical school curricula have become overpopulated with must do’s to the exclusion of developing the person. I use our induction sessions to clinical attachments in psychiatry to challenge students as to how they can stay interested and amused throughout 4-5 decades of a medical career. If you aren’t careful medicine can become the gift that keeps on taking! 

In my case, after a few decades of intense career and family focus, in recent years I have rediscovered the joys of music. Central to that has been writing and performing as The Sons of Southern Ulster. Having produced mostly borrowed copycat music in our student years, Justin (Kelly-singer) and I were absolutely determined to make music that had an identity. Having the privilege over the past three decades of hearing patient’s first-hand accounts of their human journey has encouraged us to emphasise the narrative in our work and it’s been a real joy to find that people can relate to that.

Importantly, the SoSU project has allowed me to get a stronger sense of self. Truly courageous folk out there are not rejoicing in the unambiguous or populist notions of world peace or demanding an end to homelessness, but rather are engaged with more contentious areas of need. Life inevitably involves making choices and rationing – being unpopular but following a journey that is more complex takes guts and requires a strong sense of self.

The whole SoSU project has really helped me to know who I am – warts 'n' all – and to make choices about what I should do with my energies. Perhaps most importantly, it is a welcome escape from the overly transactional flow of day to day life and I think it has made me a nicer person to be around!

The band has received acclaim for its insights into small town and rural life. Is this something that especially interests you and the other group members?

We have stumbled back into a world that we had given up on.  As the interest has grown we have become increasingly confident about exposing ourselves as artists – much as you’d like to pretend that it doesn’t matter, in reality positive feedback is an energy that drives you on. We recently did features for RTE and Today FM which were a massive validation that we have an artistic meaning in the now.

When we started, we had this notion of being determinedly self-absorbed, but as the more universal aspect of the material has emerged we are enthused to delve deeper – who would ever have thought that songs about growing up in rural Ireland would connect so well? It’s really nice to have an audience that ‘get’ what we are doing and I think that really encourages us to keep doing our thing.   

Has being in a band been an added benefit to you, beyond solo performing, say?

Bono recently remarked that U2 saved his life, and that may indeed be so, but definitely the whole SoSU thing has been a major positive for me in recent years when I have felt a bit withered by things. My parents passing, along with the death of my closest academic colleague (Dr Maeve Leonard) and the realisation that I had not managed to dodge the family inheritance of coronary artery disease all served to make me rethink things. I think we all have childhood interests that get suffocated by the serious business of adult life and for me that was music.

It’s interesting that the friendship formed through shared musical endeavour never really disappears – I think that however much you might claim that you are unconcerned about the whole business of art and performance, in reality, there is a degree of shared exploration and narcissistic trust in band mates that endures beyond most things you do in life.

Re-engaging with my old band mates has been uplifting – I love working with folk who share a desire to find what is best within us while also having fun – this is something that the modern workplace has lost! I think that we laugh a lot less at work than we used to – partly due to how busy everybody seems, but also the excessive political correctness can suffocate things as we tiptoe around each other terrified that we might hurt somebody else’s feelings! If we are not careful we will find ourselves as stiff as folk back in Victorian times, reduced to overly formal and conservative social interactions.

What aspect of your involvement do you enjoy most- writing, recording, or performing?

I find all aspects fun. I guess for many recording can be a chore but I am a bit of a geek and find experimenting with equipment and different mixes on a par with that first trawl through a new research dataset! I have recently stumbled upon the combination of an Italia Modena with a Vox AC-15 as my primary guitar set up and just thinking about playing those pair brings a sparkle to my eye.

Writing has a therapeutic aspect that I benefit from – typically I will work on a piece of acoustic guitar mangling it into different shapes until I am happy that it has a flow and then move to electric. I often lose hours engrossed in this and find it really relaxing and de-stressing. I guess it’s a form of mindfulness. 

Last year Nicky Fennell made a film documentary about the origins of our album ‘Foundry Folk Songs’ which explores the driving factors behind making the album and how it relates to growing up in the wildness of rural Ireland in the 70s and 80s - Warts n all! It follows us on a tour that culminates in returning to our home town to play in the arts and cultural centre which is an old Methodist church. It was a very intense experience that included feeling quite derealised, but in a really good way! There are very few healthy ways to achieve that sense of Maslovian high and music is definitely one of them!

Who are your main music and literary influences?

I have particular love for Kavanagh, Dunleavy and Patrick McCabe. ‘Butcher Boy’ should be mandatory reading for all training psychiatrists. Again, I guess the playfulness of these writers catches me – it’s a terribly Irish thing that in order to be taken seriously you first need to establish your comedic credentials! More recently, I have been enjoying Donal Ryan (e.g. ‘The Spinning Heart’) who has a delightful narrative style that is underpinned by his background in social services.

In recent times I have taken a stronger personal stand on the industrialisation of academia and spend much less time doing me-too research and focus upon stuff that is genuinely new (let others do the replication work!). Hopefully that will see me reading some more. I am ashamed to admit that I only read Mark E Smith’s ‘Renegade’ last year and felt swizzed by the fact that I had almost overlooked such a classic!

In terms of musical influences, I grew up surrounded by uncles who were slightly older than me and who were into Dylan, Van the Man and the Horslips. Punk provided my own ‘personal’ scene that was railing against that. The Pistols were a gamechanger - it’s hilarious that they sold themselves as a band who couldn’t play as ‘Never Mind the B…’ is a stunning piece of work that still stands up sonically over 40 years later!

After that, of the later punk bands I really liked the Dead Kennedys, again I guess because the humour is so sharp but also East Bay Ray’s guitar is outstanding. Similarly, both the Gun Club and Screaming Blue Messiahs got a real hold of me, while all the Joy Division and Bunnymen post-punkstuff was totally compelling. I guess I am attracted by material that has psychological themes.

In a recent piece in the BJPsych, you wrote ‘psychiatry will always be the punk rock of medicine’, suggesting it is the discipline which most encourages thinking outside the box and challenging convention.

Others of course would argue that mainstream psychiatry very much represents the establishment, and that the duty of outsiders, or punk, should be to challenge its values and beliefs.

How would you respond in turn?

Strangely, the medical component of mental health has in my view been so downgraded that I sense that as medics we are almost the outsiders now! Certainly, as a scientist and a person of logic, I feel that modern life and medicine in its efforts to embrace the human experience has, perhaps, veered too far into the anecdotal emotional perception of individuals rather than actual fact. I find this frustrating but also a source of fun – If you cannot appreciate the inherent contradiction of being human then psychiatry is really not for you!

My sense is that science accounts for maybe 30% of the human experience and we need to try to fill in the rest – the question is with what and how! Interestingly, as we have become more aware of the limits of science and logic, we have also become so intolerant of uncertainty – the rise of the health and safety fascists really concerns me as they have seemingly bottomless capacity to stop humans doing their thing!

As a seasoned psychiatrist I have long since embraced the notion that our primary outcome is to help folk to realise their human potential. It seems to me that all these efforts to ‘protect’ people from life’s inherent variability have the net effect of reducing our capacity to function and enjoy life. Yes, it’s a grumpy old man perspective, but enjoy the honesty!

In keeping with this, how do you align your career in a ‘respectable’ profession with being a punk rocker?

Has your dual interest and career path led to scepticism from the music fraternity, and/or from the world of medicine and psychiatry?

If so, how to you respond to this?

I have never really struggled with being an outsider – if anything I have found the formalities of leadership roles more of a challenge! As a band, we have largely kept our personal lives out of the musical spotlight and I suspect that most folk who listen to the Sons have no sense of my psychiatry background.

I am not sure if that’s just a function of getting older, but I think that as a profession we are increasingly more engaged with the fact that we have lives outside of medicine that can complement and enrich what we do in clinical practice. I have a talk that I do to introduce the SoSU documentary (see above) that I call ‘Neurasthenia, medical grotesquery and the Sons of Southern Ulster’.

In essence I explore the options to us as medics when we look beyond the everyday grind and seek greater purpose from our professional efforts. There are many options – private practicus, health managericus (a particularly grotesque option!), athletics nervosa and tortured articus – the latter being my excuse for the whole SoSU thing!n reality, I think keeping yourself engaged, amused and titillated in medicine is essential to doing your best as a clinician, which is our ultimate responsibility.

Interestingly, in recent years I have started to diversify a lot more and some of my closer psychiatry comrades have goaded me by referring to it as ‘Langian drift’ which is an amusing put down! But in reality I suppose that while you discard the foolish absolutisms of early adulthood (and I trained in an era where we believed biological psychiatry would find solutions to most mental illness during our lifetimes!) it’s actually just good fun and at a certain point in your career you occupy a position that affords you the opportunity to veer outside the manual a little.

I increasingly recognise that a big part of my career has been research into cognitive disorders but equally the main legacy derives from my efforts to promote  undergraduate and postgraduate structures that create a community of clinicians that will endure way beyond my passing.

Many music fans acknowledge that while punk was heavily influential, much of it is almost unlistenable. What is your view on this?

I suppose that depends on what you find aurally appealing – I like my noise to be jerky and abrasive. I cannot stand bland elevator music and, frankly, classical and traditional music have little or no purchase upon my nucleus accumbens! I think the best punk music has an edge that you can be energised and amused by.

For me, much of the later punk (e.g. the Oi movement) lost its sense of humour but thankfully post punk recaptured that along with a new depth (e.g. Joy Division and the Smiths). More recently, I have been really enjoying Idles – their debut album ‘Brutalism’ is a genuinely important document of now that speaks to identity (especially male identity) in the modern era more profoundly than any other work I know of out there. I think for many folk (myself included) music needs to catch your attention and the power of its meaning often follows.

What is the legacy of punk in your view, and who are the contemporary artists who best represent its spirit? Does punk need to have a political message, or is attitude enough?

I think punk was a movement of permission and possibility. This is the cultural legacy. Amongst contemporary artists I think Idles are a good example of how that attitude can be powerful. In amongst all that depth of noise are some really astute observations about modern life and how we can maintain values and identity in a toxic and confusing world of fake news, stifling political correctness and Godlessness. 

Also, I am impressed by John Lydon’s continued ability to challenge lazy thinking – legacy? I think he’s still up there with the best of conventional voices. Personally, I think any political or philosophical message comes as secondary to an attitude of respecting human spirit and our capacity to embrace life.

Can you give us a selection of tracks that have been formative in your life and career to date?

Ooogh, this is a big ask and provokes the civil war within me, but here goes:

Sex Pistols: Never Mind the Bollocks: I was always surrounded by music growing up, especially on my mother’s side where her brothers were all into the music of the early seventies. My grandfather was a bookmaker in Co. Tyrone and always took the newspapers and my uncles sneaked in the popular music press into the weekly order so that I was exposed to the NME and Sounds and such like before many of my peers.

However, it wasn’t until I heard the Sex Pistols for the first time that I encountered that WOW factor. They were so utterly naughty and in all honesty I think the biggest swindle was fooling the world that they were musically rubbish when a listen back to Bollocks now over 40 years on quickly clarifies that the production and music was of a high standard. As psychiatrists we must never settle for “a cheap holiday in other people’s misery!”

The Fall: Live at the Witch Trials: This was my first Fall album and I remember thinking that they were less musical than the other bands of this time (I was only starting to appreciate the glory of anti-music!). However, there really is something about the Fall that’s hard to pin down – they really do reach the parts that other bands don’t. Sometimes they can try your patience but always you return.

From a creative perspective, an evening listening back over the Fall’s catalogue never fails to inspire new ideas. Early Fall is much easier to penetrate in terms of meaning and this album has lots of psych-posturing with ‘Psychic Dancehall’, ‘Psychomafia’, ‘Bingo Master’s Breakout’ etc that certainly appealed to this young Psychiatrist in the making! The repetition and vortex effect of the lyrics means that even if you don’t have the foggiest what a song is about, it still brings you to a meaningful place – weird but most definitely wonderful!

The Dead Kennedys: Fresh Fruit for Rotting Vegetables: Just when you thought punk couldn’t get any naughtier the DKs arrived on the scene. Beneath the abrasive exterior lies a depth of musicianship that rewards again and again. Is there a better guitar riff than Holiday in Cambodia? Definitely not for my ears!

This is probably the album that most bound my teenage pool of friends together – listening to this and wearing DK’s badges in Co. Cavan gave us a taste of being deeply subversive! And that’s a pretty addictive feeling. In recent years I have met Jello Biafra (singer) but find him a little too preachy these days – the DKs had a special ability to capture that perfect mix of humour with the political message.

Screaming Blue Messiahs: Good and Gone: When I first heard Bill Carter’s guitar playing on this six-track EP I realised that I had found the guitar style that most interested me – dirty, rhythmic and  slightly evil, for me his playing embodied selling your soul at the Crossroads for six string genius! I was lucky enough to see the Messiahs at the Mean Fiddler in 1984 – it was a truly crazy evening with a relentlessly energetic mosh pit.

Halfway through I retreated to the bar where I got into drinking with Paul Fox of The Ruts fame and come the end of the night there was a posse of us planning to go back to his place but I declined. For years not going back to Foxy’s was in my top ten regrets of life! I met Segs and Ruffy (remaining members of The Ruts) at a punk literary conference in 2015 and recounted my tale of regret to them at which point they burst into laughter revealing that his wife would have almost certainly chased the lot of us! I had carried the weight of that regret for many years!  

The Gun Club: The Fire of Love: I spent the Summer of 1983 in San Francisco living with friends who worked in local radio and who had access to the heart of the music scene. I encountered a shed load of mind-expanding music but the most enduring was this absolute gem of an album by the Gun Club.

I think there’s a bit of the swamp blues monster in all of us and these guys found their mojo with this creole-infused collection of bad bad songs! ‘She’s like heroin to me’, ‘Jack on Fire’’ and ‘Ghost on the highway’ just hypnotize you into another place that has a dark dark soul. Play late into the night and very loud!

Billy Bragg: Workers Playtime: This album has stalked me across time, popping up in the oddest of places and on the most unexpected turntables. There’s a freedom about these songs that soothes the very core of your soul. Speaking as a psychiatrist who has heard the many stories that characterise the human journey, the narratives have a romanticism and hope that is truly uplifting.

I’ve had the considerable pleasure of meeting Mr Bragg a few times and he’s a top bloke – and, even better, a Hammers fan to boot! I think the resonance with our efforts in SoSU is pretty obvious, and the final track of the album ‘Sons of Southern Ulster’ was written with Billy’s fabulous ‘Between the Wars’ in mind and even played on a Burns steer which was his preferred axe of that era.

Sparklehorse: VivaDixieSubmarinePlot: In all honesty, all four Sparklehorse albums are magnificent but Hammering…and Cow put this on another level. The silky textures, bold guitar sonics and earthly lyrics are truly pleasing. I saw Mark Linkous and his band in Galway in 2009 and had the pleasure of chatting with him afterwards. The man exuded melancholy and kindness.

The best thing I could think of to say was to thank him for such beautiful songs and tell him that Sparklehorse are my preferred last thing before bed music when I am in wine-enhanced out of bodyness mode on a Saturday night (Yes, I am thinking Eyepennies here!). One of life’s real pleasures is recommending Sparklehorse to the uninitiated.

Lift To Experience: Texas Jerusalem Crossroads: Wow, what a gem! I love albums that are like a novel rather than a collection of individual pieces and this is a double album of celestial greatness! Incredible singularity – it’s like a psychotic manifesto recounted to the backdrop of truly angelic guitar playing.

After a 16 year hiatus Josh T Pearson and the boys returned for the Edinburgh festival last year and I was there amongst a sea of believers – even better, it was all it was billed to be and some more. Total cowboy shoegaze with a hall full of folk who absorbed every last note. It’s a mad and very deep tapestry but try it – I do, often late at night when other folk are in slumber!

From an Irish perspective, I was part of that post-U2 one thousand bands of Dublin era. Looking back two bands stand out – A House for their musicality and the Virgin Prunes for their truly International outrageousness. I recently got to meet with Gavin and Guggi and was reminded how  they say don’t ever meet your heroes – I think there’s a presumption that they may disappoint but I wonder if actually it is because it is you rather than them who will fall short - I was truly star struck and almost speechless!

In terms of more recent bands I guess if I was making recommendations I really enjoy the narrative aspect of bands like Richmond Fontaine (check out ‘You can’t go back….’), Arab Strap (and subsequent Moffat activities), Sleaford Mods (everything!) and John Murry (‘The Graceless Age’). God is an Astronaut are an Irish band that really push that astral awareness thing and I have been lucky to cross paths with them while at medical meetings in all sorts of interesting places like Athens and San Francisco.

I could go on but…

Foundry Folk Songs is available on Spotify etc., or hard copies from Avalanche Records.
Paddy K’s Mescaline Diaries is due out in early Autumn.
For upcoming gigs see  the SOSU Bandcamp page or follow us on Twitter.