Long before the emo generation, parents questioned the influence of music on impressionable youth.

This topic caught my attention recently as an adolescent shared with me the importance of music in her recovery. She described how listening to “emo” music provided her with a sense of belonging to a larger community, something missing in her life otherwise. Her parents expressed concern as to whether allowing her to continue listening to her increasingly “dark” music was the right thing to do. They wondered if listening to this music might have contributed to her recent peak in depressive symptoms.

Adolescents listen to music anywhere fromHeavy metal teens music two to eight hours each day. It plays an important role in adolescent socialization and identity formation and has affect regulation potential. Yet their relationship with music is complicated.

Music’s impact on teens

Music is an important form of communication. It provides words for adolescents who might otherwise struggle to communicate increasingly complex emotions and experiences. Rapid growth in cognitive-emotional capacity, technology driven over-exposure and expanding awareness result in adolescents whose resources are rapidly overwhelmed by adult-world difficulties. Adolescents grieving the loss of protection by an idealized parental superhero and rapidly confronting adult-world hypocrisies often turn to music that validates this perception of the world. Some adolescents embrace an ideological stance where music offers a safer venue for rebelling against authority figures or the establishment.

Music supports identity formation and group affiliation. For adolescents seeking a stable identity, music provides a quick means of establishing a group affiliation. Common interests are a binding and healthy aspect of most friendships.

Music provides common humanity. Adolescents struggling with emotional difficulties or psychiatric illness often select music that matches their internal state. A depressed teen listening to music with themes of isolation and despair might at first sound like a really bad idea. However, if this activity provides a sense of belonging, something to reduce their terrible sense of isolation, the music may provide tremendous comfort. Common humanity is offered in a three-minute soundtrack, and suffering is lessened.

Demonstrate interest

However, parents and professionals should demonstrate interest in the soundtrack of our youth. Music has significant influence on mood and thus behavior. Studies have documented music’s influence on adolescent self-injury, suicidality, substance use, promiscuity and violence. As one example, a recent study revealed the average adolescent is exposed to more than 80 references to substance use each day while listening to music. References depict the social use of illicit substances with a positive social outcome.

Talk with your teen about their music. There is research to support that simply asking a young person about their experience of their music is likely to correlate with their behavioral response. A relationship with a young person in which there is curiosity, openness and a lack of judgment provides a space in which one can ask questions that promote reflection and joint exploration around the choices and influences in their life. There are no guarantees, but an open dialogue at least increases the likelihood that the adolescent will consider how and when they listen to their various playlists.

Parents may find some of the current music so offensive that they are tempted to react by trying to shut off an adolescent’s access. Reactivity and coercive efforts are likely to illicit greater rebellion, reduce communication and in this era of internet radio and inexpensive media players, a parent’s control over exposure to musical influence is limited. Taking a more thoughtful and collaborative approach is much more likely to offer a young person the opportunity to develop the internal guide needed to navigate our media-saturated culture.


Gonzalez de Rivas, M. R., et al. “Impact of music, music lyrics, and music videos on children and youth.” Pediatrics 124.5 (2009): 1488-1494.


binge drinking collegeHave you heard a college student say this before?

“I don’t drink every day so I’m not an alcoholic.”

When most people picture someone with a drinking problem, they probably imagine someone who drinks every day and can’t function without alcohol. But even those who aren’t dependent on alcohol yet routinely drink to excess, i.e., binge drinkers, are in danger of experiencing long-term consequences.

The National Institute on Alcohol Abuse and Alcoholism is very clear about the high costs of college drinking: Alcohol poisoning, assault, unsafe sex, sexual abuse, injury, academic problems and death are some of the agonizing consequences of binge drinking.

So what is considered binge drinking?

Many people may feel that having a drink to take the edge off is a good way to start socializing. And though it’s true alcohol decreases inhibitions, those who drink to excess often find themselves consuming more drinks than they had intended. For women, that means consuming four or more drinks over the course of a couple of hours and for men it’s five drinks. (Keep in mind that this number may be lower depending on a person’s body mass and that blood-alcohol levels continue to increase after the last drink is consumed, which increases the chances of alcohol poisoning.)

Important factors in the development of binge drinking include:

  • Learned patterns regarding drinking
  • Genetic factors
  • Attachment to family or significant caregivers
  • Core beliefs about oneself and
  • The age at which someone starts drinking

So how do these factors play into the college experience?

College is an exciting and eye-opening time filled with new challenges, relationships and environments. It is a time of testing independence and discovery. For most, this is exactly what they have been anticipating.

In times of exponential change like this, many of the underlying beliefs that people hold about drinking and how it relates to them socially can be intensified. Brain development continues to mature well into the 20s, which means the brain can be prone to increased risk taking; so learning stress-management skills during the college years is vital.

Drinking to fit in

Four out of five college students drink alcohol and half of them binge drink. “Drinking to fit in” is one of the top reasons for drinking in college. Young adults being treated for alcohol-related issues endorse social anxiety, social fears (like not fitting in) and difficulty creating new relationships as reasons for their drinking.

For those who drink, it seems that alcohol becomes a social equalizer of sorts. If those entering college have the perception that drinking helps them fit in and those who are already in college uphold similar beliefs, then it can be difficult to challenge this association.

This perception, coupled with increased feelings of loneliness and isolation, puts young adults at a greater risk for developing excessive drinking habits like binge drinking. Those who are likely to turn to alcohol due to stress are likely to develop excessive drinking habits that can lead to dependency on the substance. Dependency on alcohol ultimately leads to drinking alone, which is the paradox of “drinking to fit in.”

Decreasing risk

Young adults who are able to evaluate their actions and motives for coping are better able to channel stress into manageable outlets. This usually stems from the ability to recognize and utilize significant people in their life who are reliable, which creates increased feelings of safety and decreased loneliness.

Such young adults tend to feel safer in exploring their new environment without turning to alcohol. Finding sober activities, creating a structured homework environment, touching base with important social support and utilizing and evaluating coping skills are all ways to decrease binge drinking behavior.

The bottom of the glass

In the end, severe consequences are not just a result of daily drinking: Those who engage in less frequent drinking but who drink greater amounts are also in danger. If you or someone you know is binge drinking, discuss the risks. Explore how they might seek help or handle stress without turning to alcohol.

If you or someone you know is unable to limit their drinking, dependency on alcohol may be developing. Remember that after your last drink, your blood-alcohol level continues to rise and symptoms of alcohol poisoning may develop. Most people feel responsible for alcohol-related tragedies when they may have missed the signs and did not seek help.

Whether you plan on drinking at college or not, please learn more about the risks associated with drinking and have emergency numbers ready to call. It may not be the popular thing to do, but it’s the right thing to do.



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narcissistic personality disorderAmbition’s dark side regularly captures our attention. The relentless quest for status, fame and power is not only off putting but also damaging to the extent that the quest comes at a cost — getting to the top by climbing over the backs of others, potentially injuring them in the process.

Narcissistic personality disorder

Psychiatry, in its inclusive spirit, has a diagnosis for the dark side of ambition: narcissistic personality disorder. Here are some of the pertinent diagnostic criteria: grandiose sense of self-importance; preoccupation with fantasies of unlimited success, power and brilliance; belief of being special and unique; requiring excessive admiration; entitlement; interpersonal exploitation; envy; and arrogant attitudes. Dark indeed.

But the fruits of ambition also capture our attention. President Kennedy’s challenge to put a man on the moon in a decade launched an extraordinarily ambitious project with spectacular success and spinoffs with substantial social benefits.

But ambitions need not be so grand to be fruitful. For many of us, identity is forged by our life projects that embody our ambitions, be they great or more modest. And ambitious projects need not be as tangible as putting a man on the moon. Raising and caring for a family is ambitious and perhaps the ambition most crucial to our collective well-being. We might say that ambition accounts for much of our cultural progress and achievement. Without ambition, we stagnate as individuals, institutions and societies.

Ambition: virtue and vice

Perhaps we should think of ambition as a double-edged sword — potentially a virtue and a vice. Ambition goes awry when it is driven more by the status of the self than the value of the project. But we should not think of healthy ambition as selfless.

I was inspired to write this piece by the thinking of a contemporary philosopher whom I greatly admire, Christine Korsgaard. She articulates the ideal integration of the self with ambitious projects. Befitting her profession, she gives the example of wanting to write a book (on Kant’s ethics) that would be good enough as to be required reading in all ethics classes. She acknowledges that this desire could be perceived as “raw vanity” (the dark side). But she sees the desire differently; in her own words, excerpted from her book, Self-Constitution: Agency, Identity and Integrity:

“I think that such a book would be a good thing and my ambition is not conceivable without that thought. It is an ambition to do something good …. I think someone should write a book on Kant’s ethics good enough that it will be required reading. I think that this is something for which there is a public reason.

This doesn’t, however, mean that my ambition is just a disinterested response to that public reason …. I don’t just want it to be the case that someone writes the book. I want to be the someone who writes that book.” (pp. 210-211, emphasis in original).

Self-ConstitutionKorsgaard goes on to acknowledge that the personal component to ambition is often essential to carrying out the arduous work of one’s projects. She is keenly aware that this personal ambition might lead one to subvert others’ efforts to carry out the same project, for example, undermining a colleague’s attempt to write the book. She wisely asserts, “This is not an expression of ambition, but rather a very familiar perversion of it.”

More broadly, I think this “perversion” includes ambitious self-enhancement devoid of investment in worthy projects for their own sake. The desire to be “Number One” is ubiquitous in our culture. We must ask: For what purpose? Toward what end? Sheer shelf-aggrandizement will not do. With such misguided directions of ambition, we move from what we psychologists call “healthy narcissism” (as Korsgaard brilliantly exemplifies) to “pathological narcissism.” And who wants that?


APA (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5. Washington, D.C. American Psychiatric Association.

Korsgaard, C.M. (2009). Self-Constitution: Agency, Identity, and Integrity. New York: Oxford University Press.


Haven’t We All Needed a Crisis Hotline at Some Point?

by Anonymous March 19, 2015

My name is not Anonymous, but it will suffice for this blog post because I must be, well, anonymous. Volunteering to help others in a crisis I’m one of hundreds of suicide/crisis hotline volunteers around the United States, and who we are is not important relative to our callers. Their crises are what we focus […]

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Navigating Mood and Food during National Nutrition Month

by Kim George, RD March 16, 2015

I am a nutrition geek. The science behind how our body and brain work is so amazing to me. The foods we eat help our brain work efficiently, and I love being able to teach others the link between food and mood. National Nutrition Month March is National Nutrition Month, and while my colleague, Tessa, […]

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Woman’s Obituary Highlights Child Abuse

by Michele Arnold January 25, 2015

I read the obituary of Marianne Theresa Johnson-Reddick with interest. She tortured people by her cruelty. This abusive mother did not get a free pass to the afterlife. Two of her eight children let the world know how they were all “abrasively exposed to her evil and violent life” in her obituary. “Mom” ran a […]

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Grocery Store-based Screening Better than Lucy’s Mental Health Advice

by Nancy Trowbridge January 22, 2015

On the shelf of my cubicle sits a Hallmark-brand Peanuts tree ornament with Charlie Brown seeking Lucy’s 5-cent psychiatric help. It reminds me of watching every holiday Peanuts TV special while growing up and the mental health setting where I work today. Hallmark moments create a warm feeling, don’t they? A kind of Hallmark moment […]

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Is Depression a Brain Disorder? Yes and No

by Jon G. Allen, PhD December 12, 2014

Thirty years ago, I submitted a manuscript for publication and received the following response from the editor: “There is nothing new here, but some ideas warrant repeating.” The manuscript was published. I have already written about the problems in reframing psychiatric disorders as brain disorders, but I was inspired to write yet another post about […]

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Of course I’m envious!

by Herman Adler, MA October 17, 2014

A few years ago I wrote a blog post about the trait of stubbornness and its application to personality disorders. This time, I’m here to delve into the complicated and misjudged trait of envy. According to the DSM-V, the trait “often envious of others” is among the traits of narcissistic personality disorder. Two perfectly reasonable […]

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Tackling the Problem of Domestic Violence

by Dallas Adams, LCSW October 10, 2014

Why write about domestic abuse and violence in a mental health blog? Especially since these two behaviors are not caused by mental illness? I write about domestic violence and abuse here because domestic violence and abuse can result in physical injury, psychological trauma and, in severe cases, even death. The devastating consequences of domestic violence […]

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