Using Hip Hop In Therapy

Saulo Ortiz has an unusual approach to mental health therapy. The licensed clinical social worker and motivational speaker likes to connect with clients via hip-hop. At the beginning of his presentation as part of the Williamsburg Place Lecture Series, Ortiz gave his audience a quick quiz and then explained the four main elements of hip-hop: deejaying, or “turntabling”; rapping, also known as “MCing” or “rhyming”; graffiti painting, also known as “graf” or “writing”; and “breakdancing.” Ortiz emphasized that hip-hop is not just about rhyming words but consists of a whole culture that surrounds the music. 

Ortiz has used the music, the culture, and specific songs about mental health issues in working with his clients. Why hip-hop, a genre that has often been criticized over its explicit and offensive language? It’s because he grew up with this kind of music and so did most of his clients, explains Ortiz, so it can be a very genuine and effective medium to connect with clients.

The reason why hip-hop can function in this manner is because it is “a voice of the street, a way to vent frustrations about unfairness in society.” At its best, hip-hop can be “a poetic expression, creatively using language, similes, and metaphors to paint a picture.” As an example he showed the audience a video of Json’s song “Identity” featuring Jai.

The artists in the video explore identity tags such as “rejected,” “ugly,” and “failure.” At the beginning of the song, Json remarks that it’s “funny how your past can affect your present” and how one’s “future's being prepared by your adolescence.” In verse two, Json observes that he often wrestles with being himself, a problem all too very familiar with therapists. 

Interestingly, the song then reframes all the negative concepts: “rejected” becomes “accepted” and “ugly” turns into “beautiful. This song can be very therapeutic, argued Ortiz. It offers clients a chance to realize that they have the power to reframe and reshape negative or inaccurate thinking. 

Ortiz then explained how music in general can have a positive effect on mental health and even physical conditions. “Music can reduce chronic pain and depression. It can enhance literacy skills, spatial-temporal reasoning, mathematical abilities, and emotional intelligence,” Ortiz said. 

Ortiz presented the story of a 17 year-old boy, who had three home placements in 9 months. His mother had alcohol use disorder and could not take care of him. At first, he lived with a friend and then with an uncle who was misusing meth, and then he was with somebody else who was not a family member. “The only constancy he’s had in those nine months is me,” said Ortiz. “So, I told him, wherever you go, you’re not leaving me.” Ortiz gave him his mobile phone number. That way, he was able to use hip-hip therapy even remotely. “He texted me, saying ‘I got court tomorrow, hit me with a song real quick.’ and later ‘ Yo, they’re stressing me out over here and I don’t know what to do.’ So I hit him with another song.”

This use of hip-hop makes this dialogue possible. “Why not use that bridge” and meet them where they are, Ortiz asked his audience. “He has a playlist that we developed together. We have this dance that sort of developed from music.” 

Throughout the lecture, Ortiz offered examples of songs that deal with specific mental health problems. The rapper Biggie has a song called “Suicidal Thoughts”—its language may be offensive but the problem is real. In “I Hate Myself,” NF (stylized as ИF) describes his depression: “If this is it, then I feel hopeless. And I wish I could help but it's hard when I hate myself.” Joell Ortiz has a song called “Anxiety.” In the song “Therapy Session,” NF basically explains hip-hop therapy: “I write about life, I write about things that I'm actually dealing with….This is real for me, I need this, this is a therapy for me.” 

There are many other song topics about problems that may affect clients. There’s sexual assault, death of a parent, substance misuse, suicide, anxiety, depression, grief, trauma, and lack of education. All conditions and situations for which hip-hip songs could function as therapeutic icebreakers.

In conclusion, Ortiz summarized the goals of hip-hop therapy with these bullet points:

  • Meet them where they are
  • Find a way to connect with their story
  • Story may be too hard to share verbally
  • Provide a different focal point instead of the client
  • Get the music to say what the client wants to but cannot or won’t say
  • Identify someone else who feels like they do
  • Know that the counselor is willing to be uncomfortable like they are

Don’t just reject hip-hop outright, but learn to appreciate its potential for therapy.