"You never think that this inanimate object is going to have such a mental connection with you and get you through your darkest hours," Peterson shared in PG's Conversations in the Key of Life podcast ("Episode 3: Guitar as Therapy," June 2016).
"I can't tell you how many times—especially dealing with the post-traumatic-stress aspect of things, when the triggers come around—that I've just picked up the Mira, laid on my back, and plunked around on it. Nothing in particular … just me and the guitar. When you feel like your body can't move on to do anything else, it seems like the music—that connection—drives you just for that brief moment while you're contemplating that next string bend. You forget everything else."
But beyond the scores of untold private battles like Peterson's, where music becomes both shield and weapon against encroaching darkness, there are many other instances where guitar has played a more oblique role in therapy, whether through 6-string stars playing benefits for rehab centers, selling their instruments and donating the proceeds, or, in Eric Clapton's case, both. Anecdotes and superstars aside, the guitar has found a more institutional place in the healing process through the relatively new field of music therapy.
Roots and Branches
To get an overview and history of music therapy and understand the guitar's place in it, we chatted with health professionals who administer this treatment on a daily basis. One such person is Dr. Robert Krout, professor and director of music therapy in the Meadows School of the Arts at Southern Methodist University in Dallas, Texas. Krout also teaches guitar online and has taught at the National Guitar Workshop, as well as guitar workshops around the world.
"Music therapy as a profession started in 1950," explains Krout. "You use music-based experiences in the relationship with the therapist to help achieve desired health outcomes, whether they be physical goals, social rehabilitation, helping with developmental issues, and so on."
Krout notes that people are usually referred to a music therapist by a psychiatrist, nurse, social worker, or health insurance company. The therapist then conducts a comprehensive assessment to see if the referred individual might benefit from music therapy. "The patient doesn't necessarily have to be able to play or sing," says Krout, "but the therapist would assess whether music might be beneficial for them based on their needs, and also based on how they respond to music either actively or passively."
Potential music-therapy beneficiaries run the gamut from parents anticipating an addition to their family to individuals who've recently lost a loved one—and all sorts of related situations in between: Krout works with expectant mothers and couples in Lamaze training, using music to help with the timing of contractions. He also works with patients who are nearing the end of their lives or are in hospice care. Music therapy can also help bereaved siblings, spouses, children, grandchildren, and other survivors with grief healing. Meanwhile, music can often stimulate forgotten memories or buried emotions in patients with Alzheimer's or cognitive impairments. Music therapy can also be a great way to communicate with children on the autism spectrum, especially those who are nonverbal.
"I work with people with eating disorders, and often they have a series of verbal defenses that shield them from how they're feeling. When we do music-based experiences, many of those defenses fall away and they have an emotional reaction to the music—even when they try not to." —Dr. Robert Krout
The work that Dr. Krout and others are doing with music therapy is often effective where other forms of therapy have come up short—for instance, with clients who lack the verbal skills to benefit from talk-based therapy. Further, it can often make inroads with patients who have highly developed verbal skills that have, for one reason or another, proved an impediment to treatment.
"I work with people with eating disorders, and often they have a series of verbal defenses that shield them from how they're feeling," says Krout. "When we do music-based experiences, many of those defenses fall away and they have an emotional reaction to the music—even when they try not to. We can sometimes use that emotional reaction to take the discussion deeper into some of the issues they're facing."
Music therapy has been found to be very helpful in treating post-traumatic stress disorder (PTSD), particularly that suffered by troops returning from combat. Thanks to George Hauer—whose organization Operation: Music Aid supplies thousands of musical instruments to recovering military and armed forces personnel—we chatted with music therapist Bobbi Blake about her experience working with veterans at a VA medical center in Connecticut. She began by explaining that music therapy had its beginnings in the U.S. Department of Veterans Affairs system after World War II.
"They found when they played music for the veterans it was very helpful in calming them down and soothing them," Blake says. "They started to investigate it more, and that began the music-therapy research in the '50s. There has been extensive research ever since. Now, they're doing neurological work on how music affects the brain. In working with veterans with PTSD, I'm trying to use music to help engage their coping skills and self-expression."
Like patients with eating disorders, PTSD patients often have a hard time expressing the multitude of profound, overwhelming feelings bubbling just beneath the surface. They can become socially isolated or be fearful of being around other people, crowds, and trying new things.
"Bringing them together to play music is a wonderful way to have them be with other people in a safe place and learn a skill that's going to help them with anxiety, mood swings, and relaxation," she adds.
Music therapy can play an important role in treating those with substance addictions. Paul Pellinger, one of the founders of Recovery Unplugged (a Florida-based rehab center), uses music to engage clients in different ways. For example, the center organizes live performances by famous musicians, who share stories and songs related to their own issues with drug addiction and alcoholism.
The program incorporates music as early as the pre-assessment process. Before being accepted, a prospective client is asked about his or her favorite genre of music. "If they say, 'classic rock,' I'll ask if there is a particular song that describes their life," says Pellinger. "When I pick them up [to bring them to the center], I have that song playing in the van. Right away, rapport is established and they feel heard versus being yelled at. When they get to our facility, we don't have to deal with a two-week adjustment to the new environment."
Like people with PTSD or eating disorders, many addicts have trouble accessing their emotions. But music can often be a gateway through those mental walls. "Identifying what you think or feel is an obstacle for most people in general, and it's especially difficult for addicts—but I guarantee you somebody has written a song about it," Pellinger says. "We often let song lyrics be the catalyst to verbalize what's going on. We're using music not only to engage the clients, but also to make recovery more of a payoff than using drugs. If you look at [a scan of] the brain after somebody takes a hit of crack cocaine, it lights up similar to how it does after hearing a simple chord change."
Guitar in Therapy
Dr. Robert Krout from Southern Methodist University (center) poses with a class that includes special-needs students at the Hope Town School on Elbow Cay island in the Bahamas.
When music therapy began in 1950, it traditionally employed piano as the accompanying instrument. But at the same time, electric and acoustic guitars were becoming mainstream instruments. Guitar gained more popularity and began to be used, in part, because it was portable. As a teacher of guitar, Krout has a unique view on the instrument's special place in music therapy.
"Clients of different ages and needs are very attracted to the guitar—the look of it and sound of it," he says. "I've worked with emotionally disturbed teenagers who normally would not have any reason to relate to me, but if I walk in with a Fender Stratocaster they relate to that. So the guitar can be used as the go-between. I do a lot of songwriting for music therapy, and the acoustic guitar is a musical instrument I can hold while sitting across from the client. They relate to the guitar, which creates a therapeutic space, and then we can safely do other things with singing, lyric discussion, or songwriting. With autism, it might be the way the guitar smells. A person with a psychiatric syndrome might have played guitar when they were younger, before the disease took over, and they connect to that."
To maximize effectiveness, Krout adapts his choices of instrument and songs to the background of the patient. For example, if a patient is a baby boomer, he may rely on the guitar-based music of the '60s. Meanwhile, if radio hits from the 1950s were the soundtrack of his nursing-home patients' youth, Krout might use Buddy Holly songs as an emotional connection.
The guitar also figures prominently in Blake's work with the Connecticut VA health system. Perhaps the country's best-known nonprofit working with veterans via the 6-string is Guitars for Vets, which provides a free guitar and lessons to veterans through local chapters set up all over the country from its base in Milwaukee, Wisconsin. In contrast, Blake's Six Strings for Soldiers program is much smaller and locally focused, with more of an emphasis on the music-therapy side than on the guitar-centric aspects.
"With an instructor, the primary concern is about instrumental skills, like teaching someone how to play chords, rhythms, or notes," she says. "I'm more concerned about how playing guitar is helping them with their coping skills and stress."
Blake says one of the most rewarding parts of working with Six Strings for Soldiers is that patients use what they've learned when they return home. If they start to get anxious, they pick up the guitar and it calms them. She also finds that even small improvements in learning the instrument quickly reward patients with increased self-esteem.
"Within four weeks it's possible to teach somebody how to play some I-IV-V chord songs," says Blake. "And to accomplish that is very exciting! Guitar is, of course, very complicated to play well—as any instrument is—but for a beginner it's very accessible. It can be particularly effective with isolation issues. It's empowering for socially isolated and fearful PTSD patients when they walk around with a guitar, because it's like walking a dog. People say, 'That's a nice dog' or 'What kind of dog is that?' Similarly, they say, 'You play guitar?' The patient may then say, 'Well, I'm learning,' and it encourages a conversation."
When they leave our facility, we don't just give them a certificate and coin and tell them not to drink, and to go to meetings." —Paul Pellinger
Meanwhile, Pellinger from Recovery Unplugged—which has centers in Austin, Texas, and Fort Lauderdale—has yet another perspective. As the center's name implies, acoustic guitar figures prominently in its treatments. Three or four guitarists work full-time with the program. One of the musicians on staff is Richie Supa, a songwriter who has worked with Gladys Knight & the Pips, Bon Jovi, and Aerosmith—and who performs acoustic sets of songs about addiction and recovery for Recovery Unplugged patients.
But Recovery Unplugged clients don't just consume music, they can also make it. The centers offer musical workshops where Supa and other staff members help interested patients learn to create songs or take their guitar playing to the next level. Recovery Unplugged even found a way for clients to take their musical experiences home after completing treatment by providing a recording studio where patients can create soundtracks of their stay. The soundtracks can be any combination of prerecorded songs they've chosen, performances they've witnessed, or tunes they've performed or written.
"When they leave our facility, we don't just give them a certificate and coin and tell them not to drink, and to go to meetings," Pellinger says. "We give them earbuds and an MP3 player. Music is used as a catalyst for recovery, whether to help them be grateful, call their sponsor, or remember the consequences of using. For instance, Richie Supa wrote a song called 'I Got This.' That's one of the things addicts say when someone asks for their car keys because they are in no shape to drive—'Go away, I got this.' The song was on the soundtrack of a client who graduated from our treatment center. He was on his way to use drugs instead of going to a meeting. He was thinking, 'I got this,' when the song reminded him he didn't have 'this' and should go to a meeting."
Of course, Recovery Unplugged isn't the only music-therapy center that celebrates the unique attributes of flattops. SMU's Krout finds that acoustic guitar can work especially well with certain patients because of the physical vibrations they feel through the back of the instrument.
"With an electric guitar, the sounds are coming out of a speaker across the room," he explains. "Sitting across from a person with an acoustic guitar, it is the vibrations that actually connect us in that moment and create the shared therapeutic space."
Despite that advantage, Krout often uses electric guitars as well. "I worked with Fender for a number of years to bring the electric guitar into music therapy," he says. "We were trying to introduce music therapists to more contemporary sounds by using electric guitar."
Even so, not everyone relates to guitar—acoustic or electric. Krout says the instrument's popularity has fallen off a bit with younger patients in recent years, as it has become less the currency of popular music—especially in the inner city, where rap and hip-hop are often the music of choice.
"With teens, often I will work from an iPad using GarageBand. I use loops with hip-hop, electro, and techno types of sounds," Krout explains. "But many times they want to be doing something active, and even if they hadn't [previously] thought about being a guitarist, if I've got a guitar and they see me playing along with a GarageBand track, it might be attractive to them. I'm working with a young man now from India who is into Bollywood movies and soundtracks. We're working on guitar with very simple chords in the context of a huge Bollywood arrangement. It may just be guitar chords, but it feels like Bollywood to him."
Get Involved
For guitarists wanting to explore career alternatives that involve music and guitar, music therapy is a path worth considering. Therapists must meet educational and clinical training requirements set up by the American Music Therapy Association (AMTA). Graduates must take and pass a comprehensive exam administered by the Certification Board for Music Therapists in order to become certified music therapists (MT-BC), which qualifies them to work as a member of treatment teams in schools, hospitals, or nursing homes.
"You don't have to be a doctor or go to medical school, though you will learn about some medical conditions in a music-therapy program," says Blake, who achieved certification in the aforementioned manner. "It's music training combined with psychology." She adds that, just as medical doctors often specialize in certain areas, music therapists can, too. "I work at a VA hospital with veterans. Other therapists work with the elderly, kids with autism, pain management, people who are developmentally disabled, and so on. Depending on what you choose as a specialty, you may need advanced training to be able to work with that population."
According to the AMTA, music therapists must have a bachelor's degree or higher in music therapy from one of AMTA's 72 approved colleges and universities. They must also complete 1,200 hours of clinical training. Some states also require a license for board-certified music therapists.
Premier Guitar readers know the big and small ways in which playing guitar and listening to music can be therapeutic. The admirable work of music-therapy practitioners like Krout, Blake, and Pellinger is but a small sample of how the instrument we love is helping countless others.
[Updated 11/12/21]
Alan Harrison, E6 Boatswains Mate 1st Class, is a 21-year US Navy veteran who's taking part in the Guitars for Vets program at the Veterans Administration Medical Center in Milwaukee, Wisconsin.
It's easy to slap a "Support Our Troops" magnet on the back of a vehicle to show solidarity in times of deployment, but where is that support when these men and women come home physically and emotionally broken? Where do they turn when society is not informed or empathetic enough to understand their state of mind, or when they are shamed into silence by the stigma of "mental illness"?
These are crucial questions too often left both unasked and unanswered. However, two guitarists with their hearts in the right place are doing their best to make a difference. Guitar instructor Patrick Nettesheim and guitar-playing Vietnam War veteran Dan Van Buskirk decided to take matters into their own hands by creating Guitars for Vets (G4V), a unique form of music therapy they're taking to VA medical centers.
Founded in 2008, Guitars for Vets is a nonprofit that provides six free, one-on-one guitar lessons and a new acoustic guitar to veterans in recovery. Its mission is simple: Turn the guitar into a source of healing, communication, and self-expression. Veterans enrolled in the program receive their own new Oscar Schmidt acoustic guitar at their sixth lesson, and thereafter they can continue learning through group lessons. G4V began in Milwaukee, Wisconsin, but has chapters in several other states—as well as one in Afghanistan—and it's receiving requests from VA centers across the country. Six strings at a time, it's working miracles.
To Hell and Back Again
Van Buskirk and Nettesheim met in 2007, when Van Buskirk became Nettesheim's guitar student. It was a fortuitous step on the long road to recovery for a lifetime pacifist who joined the military to uphold family duty.
Although the Peace Corps was his first calling, Van Buskirk joined the Marine Corps and became a reconnaissance scout and sniper during a time when, he says, "We were a bunch of young men confused by John Wayne movies, masculinity, and serving your country. I was assigned to Albrook, the hottest, best team battalion. We were on patrol schedules in Laos, and it was so dangerous that all the guys left letters and valuables for their loved ones because no one expected to return alive. Because Albrook was so good, the whole team would go on patrol. Except they wouldn't let me go—I was too inexperienced. One day, the North Vietnamese set up an ambush for Albrook. They shot down the helicopter with a rocket and all the guys died."
During Van Buskirk's 1968-1969 tour, he did 40 patrols in Laos and Cambodia, lost his best friend there, and witnessed unspeakable horrors that remain with him today. Upon return, he was hospitalized for a year and told he had "shell shock," as it was called then. "They didn't know how to treat it," he says. "I was in a deep, deep depression. You feel like you are in a black tunnel that has no light on the other side. I just wanted some light, but I couldn't see it."
Van Buskirk struggled to maintain a normal life. He married, became a father, worked, and went back to school to earn degrees in sociology and anthropology. Though he attempted to become an adjusted civilian, Vietnam never left him. "I mostly had a sense that 'I just don't get it,"' he says. "It plagued me. Some people live joyously, but for veterans with PTSD, we're in survival mode." Van Buskirk still experiences flashbacks and nightmares.
In 2005, after losing two jobs, Van Buskirk was placed on full chronic disability. As part of his search for ways to deal with depression, he bought a guitar. He had tried playing years before, but lacked focus due to PTSD. Cream City Music, in Brookfield, Wisconsin, recommended Nettesheim as an instructor. The lessons became educational for both men: Van Buskirk learned to play, while Nettesheim learned about Vietnam and the struggles returning veterans faced. They realized they were on to something.
Guitars for Vets debuted in the Milwaukee VA spinal rehab unit, where Van Buskirk and Nettesheim performed for paralyzed veterans whose lives are spent in wheelchairs and on their backs. "Dan played 'Knockin' on Heaven's Door' and we saw guys who had been staring at the ceiling for 40 years just light up," says Nettesheim. "The smiles, the happiness—they would hold the guitars while I strummed them. I knew it was magic. These men with broken bodies, broken spirits, and no way out of their situations as prisoners of their own bodies—I saw the light in their eyes." During their next lesson, Van Buskirk and Nettesheim put a plan in action and created Guitars for Vets.
Asked to explain the source of that rekindled light—why the guitar is a source of comfort— Nettesheim says, "How you hold it against your midsection—it's a metaphoric shield. When you look at trauma as part of the human condition, in moments of sadness and weeping, you rock back and forth and hold a pillow or a teddy bear to your midsection. It's an innate trait. The guitar is a good surrogate for that. It allows you to speak without words. The cool thing with the guitar, and many instruments, is the universal language: Others get what you're feeling by what you play. It helps us communicate emotions that may be too difficult to verbalize. That's why music touches so many people deeply."
Faces of the Faceless
A group of vets from the St. Louis, Missouri, chapter of G4V gathers to socialize and support each other through song.
Photo by Glen Harris
Miami resident John Miranda understands using music in place of words. He spent a good portion of his adult years entrenched in the rock-musician lifestyle on the West Coast. In 1973, he joined the service and became a parachuter during the final stages of the Vietnam War. "Conflict and war are no picnic," he says. "Nor was the way we were treated when we came home. When I got out of the military, I began drinking heavily, jumped onboard with a band, and played my life away."
Miranda is now in his mid 50s, and not long ago he found the courage and the means to clean up his life. He went to the Miami VA for help in 2009 and met music therapist Elizabeth Stockton, whom he credits for not giving up on him during the hospital's three-month program. Through music and sobriety, he is learning to unlock emotions he believed didn't exist. "I know the power of music and what a program like this can do," says Miranda, who became the first instructor for the Miami chapter of Guitars for Vets. "There's life to music. It's very spiritual."
Guitars for Vets is staffed entirely by volunteers. Instructors must train through a strict VA program, and they're submitted to rigorous FBI background checks that require fingerprinting and official badges for admission to facilities. In addition to government protocol, G4V has three requirements. "Instructors must show gratitude toward veterans for what they have given," says Nettesheim. "They must be empathetic and sincerely able to feel these veterans' stories, and they must be nonjudgmental and throw all political thoughts out the door."
Marc DeRuiter instructs the Grand Rapids, Michigan, chapter of Guitars for Vets. A Navy veteran from 1972–1975 who was stationed in both the Philippines and Vietnam, he discovered the organization in 2009 through a web search. Based on his experience performing for patients in Alzheimer's Disease units for seven years, he understands the therapeutic effects of music. He has been a musician since his teens, and he has a repertoire of country, bluegrass, rock, and oldies tunes. He has performed with the same musicians for 30 years, and he began teaching guitar at his church 10 years ago. After discovering G4V online, DeRuiter says he emailed Nettesheim because he thought he'd be "a good fit." He explains, "Our philosophies are right in line with each other. I'm sold on the therapeutic value of music—you spend an hour a day doing it, and your body treats it like a workout. It relieves your stress. You practice until you get it right, and that provides a sense of accomplishment."
Marc DeRuiter (right), a Navy vet who served in Vietnam from 1972 to 1975, instructs Richard Pierson in a Guitars for Vets class at the Grand Rapids, Michigan, VA center.
Photo by Marc DeRuiter
For that reason, DeRuiter makes a point of teaching actual songs to his students right away, helping them through "He's Got the Whole World in His Hands" and "The Ballad of Tom Dooley." "If you've got a song, you've got something," he says. "Some of these veterans have never played guitar before, and they love it. They practice on their own and get together to practice too."
Nettesheim says that camaraderie is a crucial element of Guitars for Vets. "When you talk to veterans—especially combat veterans—they'll tell you that they miss the teamwork and close friendships they formed while in the service. When their tour is over, they often move on and never see each other again. They fight to protect each other's lives, and there is a great sense of loss when those relationships are gone. They go from the battlefield to being thrust back into civilian life. Concentrating on playing and practicing in groups helps them to stop thinking about their grief. Working together brings them feelings of family and belonging."
Dan Van Buskirk (right), a Marines reconaissance scout during the Vietnam War, took up guitar in 2005 after years of PTSD had ravaged his personal and professional lives. In 2008, he and his instructor, Patrick Nettesheim (left), formed Guitars for Vets.
Photo by Tim Evans
Alan Harrison, another Vietnam vet involved with G4V, learned about the organization through the Milwaukee VA hospital. He had played guitar as a teenager but gave it up when he joined the Navy, where he spent 21 years. He also suffers from severe PTSD. During his time in the service, he says, "I saw a man dismembered, sucked into the intake of a jet, and that wasn't the worst thing I saw."
When Harrison returned to civilian life, he couldn't erase his memories.
PTSD and depression had set in. Two years ago, he signed on for lessons with Guitars for Vets and now he's a volunteer for the program. "When I pick up the guitar, it takes me to a simpler time when I didn't have these memories," he says. "The guitar eases the pain. Without this program, I would still be in serious therapy. It helps me cope." (Visit myspace.com/guitarsforvets to hear "Dusty Old Road," a song Harrison and Meaghan Owens wrote about his experiences as a veteran.)
Of course, Harrison, Van Buskirk, DeRuiter, and Miranda are just a few of the countless veterans of past and present armed conflicts who suffer from the debilitating effects of PTSD. Van Buskirk expresses great concern for those who have served multiple tours in Iraq and Afghanistan. "I see a lot of men and women slip through the cracks when they come home. I see them get fired because employers aren't held accountable for dealing with soldiers with anxiety issues. I see things that sadden me," he says. "But a smiling face, a compassionate heart, a listening ear, and the vibrations of a guitar can help. I can't sit back and not be part of the solution. Medication is a useful band-aid but in no way helps the soldier get their soul back. If a soldier takes meds as the end-all be-all, they will miss out on getting their whole person back. If we take the lead with this program, maybe others will find it easier to help veterans—and maybe the VA will become more progressive and not just say, 'Increase your meds.'"
How to Help
Guitars for Vets has distributed over 600 guitar packs to date, but these instruments are purchased, not donated—and G4V incurs significant shipping costs to send guitars to its chapters. Each guitar pack consists of an instrument, a bag, and a tuner, and it is paid for by G4V, with the Oscar Schmidt acoustics being purchased at dealer cost. To date, no manufacturer has been willing to donate any instruments, so the organization relies on monetary donations from supporters. For the price of an evening out—dinner, movie, and drinks—you can help pay for one of these packs. Stay home one night and change a veteran's life.
Before receiving their free guitar at their sixth lesson, veterans enrolled in G4V learn to play on donated practice guitars. If you have an acoustic guitar gathering dust in your closet, send it in. Even if the instrument is no longer playable, artists associated with the program can turn it into an art piece that will then be sold to raise funds for G4V. Even if you don't have an old guitar to donate, you can help raise awareness of the program and provide useful funds by purchasing Guitars for Vets merchandise on the organization's website. There are other ways to get involved, too. G4V needs instructors and coordinators to set up new chapters and help with existing groups. Visit their website guitarsforvets.org or G4V's Facebook page for more details on the program and ways you can make a difference.
[Updated 11/10/21]
