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As a child psychiatrist, my patients aren’t always eager to talk to me. While adults seeking treatment often come in with an agenda, ready to start work, my adolescent patients are rarely as easy to engage. I am always looking for a bridge that will provide me with an entrance into a teen’s world. What question will help me know who you are and what is important to you?
I didn’t expect that the fourth season of the Netflix show Stranger Things would hand me a hook that is both accessible and deeply meaningful.
Here’s the windup (spoiler alert): Season 4’s stories repeatedly reflect on the trauma and PTSD of several characters. A teenage girl, Max, is being stalked by Vecna, the latest monster in the parallel universe near her home, known as the Upside Down. Vecna targets those who have been traumatized, activates vivid terrifying flashbacks with debilitating headaches, and then murders them. Max knows she is the next intended victim, and her friends work furiously to see if there is any way to protect her.
Her friends learn that if Max listens to her favorite song while trapped in a trance that embeds her in the Upside Down, a path home will emerge. Earphones placed on her head, they blast her favorite song, “Running Up That Hill” by Kate Bush. The song opens a window that breaks the spell, guiding her out of the hellscape and toward her friends. She races toward freedom and pushes through the outlet to safety. It was an incredible scene; by the end, I was on my feet cheering.
So, here are my new questions: What song brings you safely home? What music do you turn to when you are upset? How did you discover this song? Where were you in your life when you connected with it? Which lyrics speak to you? The questions aren’t intimidating, but they are also intimate. Whatever the answers, I will know you better after you share this with me.
Sometimes the answer is immediate and other times, it takes some time to reflect and decide how to respond. In all the cases, the answers have been riveting. In the office, teens take me through their playlists, explaining how they connect with each piece and whom it connects them with. Trust is earned, not given; a younger patient may not be ready to dive into direct discussions of emotionally loaded topics, but they may feel comfortable sharing their songs with me.
You don’t have to be a therapist to find this question meaningful. What song would your parents choose? Your partner? Your children? Your siblings and close friends? I’ve been asking. A 90-year-old physician remembers when his beloved older brother was deployed on D-Day +1. He chose “Coming in on a Wing and a Prayer” about a World War II plane that has lost its motor, but is making it back to base in its wounded state. A 23-year-old woman remembers the song she sang at her elementary school graduation: Listening to it makes her grin, as she remembers the innocence and energy of that day. (“Good Riddance—Time of Your Life” by Green Day). For a 15-year-old, Jon Batiste’s “I Need You” is the song that carries them out of their seat and onto their feet; the dancing literally shakes off their frustration. And then there is the young man who mentions how he would watch Curb Your Enthusiasm to distract himself during a time of great stress. His song is the show’s unmistakable jaunty theme song. (“Frolic” by Luciano Michelini) Each choice is connected to a story, and it is via story that we often learn the most about one another.
These are difficult times we live in right now. At the height of the pandemic, we were separated from family, friends, and teachers, with many feeling a profound sense of isolation. COVID continues to cause increased stress, and in its wake, a mental health pandemic. There is tremendous psychological need, but without enough providers to meet the moment.
A song doesn’t get rid of the hurt, the worry, and the pain, but it is a balm. Sharing music that speaks to you creates a bond—it pushes through isolation and creates connection. It may be especially helpful after a time when we were required to be far away from one another. Feeling less alone and understood carries tremendous power.
I’m creating a playlist now of all the song choices that people share with me. Added in, of course, is my choice: “Closer to Fine” by Indigo Girls, a song that sustained me during medical school and psychiatric residency. While I struggled years ago during long hours of training and anxiety-provoking moments of uncertainty, the song spoke to me: “There's more than one answer to these questions, pointing me in a crooked line.” Music can act as a North Star, helping point us in the right direction, as we find our way.
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