Tamsin Embleton is a psychotherapist, specialized in working with musicians and music industry professionals. She runs a group called Music Industry Therapists Collective, comprised entirely of therapists, psychologists and physicians, that used to work in this business. Embleton just release a book called “Touring and Mental Health: The Music Industry Manual,” a resource for anyone associated with the live music industry. It’s a clinical guide written by performing arts medicine professionals . It tackles a wide range of psychological, physical, and social issues that can occur on the road, including how mental health and mental illness develop, different forms of anxiety like fear of flying or performance anxiety, stress, trauma, depression, addiction, sleep science, injury prevention, and more. Physical issues like gut, hearing, vocal, and sexual health, nutrition, meditation, breath worth, exercising on the road, chapters on how to deal with the media, group dynamics, mindset – it seems like no tour-related physical and psychological issue was left out. Each chapter is underpinned by recollections taken from over 80 interviews with artists and touring professionals.
Embleton used to work in live herself in multiple roles, including festival and venue booker, artist, events, and tour manager. During her ten years in the game, she recalls being taken aback by the intensity of touring, and being very aware of how the job was affecting her own mental health as well as the mental health of professionals working around her. Having gone through therapy herself to address childhood trauma, she had a language for what she was seeing: people being withdrawn backstage; anxiety, including stage fright; anger and conflict, overindulgence.
That was more than ten years ago. Embleton decided to retrain and become a therapist. She was surprised to find hardly any information on touring and mental health out there, and decided to make it her main field of research. A few studies, including one focusing on crew, came out as she was studying. “We really needed that, because the focus is often on artists. The study revealed high rates of suicidality, depression, and addiction. I discovered during compiling the book that performers and crew may also be more prone to heart-related issues due to elevated levels of the stress-hormone cortisol, and the generally unhealthy lifestyle. Touring’s all encompassing, it’s not a nine-to-five, you don’t get to go home to your family and home comforts to recover. It’s a rollercoaster, with intense highs followed by lows, or just regular periods, while one’s body is trying to regulate through all of it. When the body is faced with a prolonged period of chronic stress physiological changes start to occur, as my colleague Dr Arun-Castro says, ‘it retunes to new norms’.”
The tricky part: a lot of what makes this line of work stressful is also what makes it exciting. Many professionals won’t even notice that they’re operating in an elevated stress state. “Touring is fast paced, you’re problem solving all the time, while creating events pretty much out of thin air. In that sense, it felt exhilarating to me. And that felt really good as it matched my internal elevated stress state. But there were other aspects that would compound things and weren’t helpful, like the competition, for example. I’m not that money orientated, and I’m not very competitive, and, as a promoter, you offer your pitch against all your other promoters, sometimes you are working in silos and end up pitching against other promoters in-house. I’m a team player, so there were some aspects that were a naturally good fit, and others that weren’t,” Embleton said.
Other aspects of this business that make it an emotional rollercoaster ride are the large amounts of money that can be lost on shows, and the loss of esteem that comes with it. “I found the crushing disappointment and shame of that very difficult,” Embleton said, adding that just like the recorded industry has postulated the mantra that “you’re only as good as your last hit,” the live biz is full of people believing “you’re only as good as your last show” – a value judgement that will affect people differently, depending on how much their identities are tied to their work and the people they’re working with. Embleton explained that people, who were struggling with their mental health often had areas where they were highly functioning, which made it easy to overlook the areas where they were really struggling. “So long as you’re doing your job well, and aren’t a nightmare to deal with, problems may be overlooked” she said.
When it came to gathering all her findings in one book, Embleton decided take the modern-day threefold approach, which looks at mental health “from a bio-psychosocial framework,” meaning that it takes into account “biological issues, psychological issues, social issues, and how they interact.” Through her many industry friends and contacts, her book pitch found its way into the inbox of one Michael Rapino, who wrote to Embleton, asking her what she’d need to write it. Live Nation has since purchased 3,000 copies to be placed inside venue and festival dressing rooms.
“Touring and Mental Health” took four years to complete. It features contributions from Jeordie Shenton, who collates a variety of different research, the aforementioned Dr. Arun-Castro, who writes about general health, Sital Panesar, who writes about sexual health, plus pioneers, who’ve been doing research in the field for a long time, like Dr. Susan Raeburn, Professor Paula Thomson, Professor Dianna Kenny, Dr. Louis Cox, and many more. Some 80 people were interviewed for Touring And Mental Health, including tour and production managers like Dale “Opie” Skjerseth, Jake Berry, Pollstar Impact International Honoree Suzi Green, Tina Farris, as well as artists, including Nile Rodgers, Philip Selway, Justin Hawkins, Katie Melua, and others. “We wanted to bring it to life through these real-life anecdotes, and for it not to be too stiff and academic. The interviews really helped,” Embleton explained.
It’s hard to pick a general theme in a subject so varied and individual as mental health. One aspect the book really brings home is this: when the body experiences stress, we perceive it as a threat. “On the road,” Embleton continued, “there are multiple stresses. What we’re trying to do in the book is promote what we would call psychological safety, which will help reduce the impact of stress, and foster better communication between people. There’s various aspects to that: understanding how people relate to each other, ie group dynamics, the pressures on relationships back home, because of the psychological as well as physical separation from loved ones, and much more.
Embleton really wanted her book to recognize the strain touring puts on families. “You’d hear stories about the impact on children, and it’s quite sad. I hadn’t really thought about until I fist met somebody on tour, showing me pictures of their newborn child, who they hadn’t seen for months, with tears in their eyes. The separation and reunion of families, and the impact of that, as an attachment therapists I found that very interesting to consider,” she explained.
“Touring and Mental Health” is structured in six sections. One, for instance, focuses on relationships, and is subdivided into chapters on why bands fail, romantic relationships, group dynamics, anger and conflict management and resolution, as well as one’s own role in a conflict. All of it is designed to help people understand the ‘why?’. Why do I feel stressed out? What is underneath my anger? Embleton interviewed her “all-time hero,” Charles Thompson from Pixies, who acknowledged, that had the band known more about anger and conflict, they might have never split up the way they did.
There are ways of addressing all of the above, but it requires the willingness of all involved in touring to rethink a formula that has seemingly worked well for decades. Judging by the numbers, this industry never had a problem. But the lockdowns offered a chance to take a deep breath – something many professionals had never allowed themselves to do in this fast-paced biz – and realize: there’s more to life than turning around a great show night after night after night. However, changing one’s own ways can be incredibly hard. What could help are high-profile artists taking the lead. Chris Gratton, who’s worked as tour director and production manager for Justin Bieber, Maluma, Kanye West, and more, recounts in the book, how Hailey Bieber instigated “family hour” on tours. This means that the entire touring party tools down for an hour to call loved ones, go outside, get some fresh air, and, especially, daylight, speak to a therapist, etc.
Embleton agreed that this industry, and society at large, has made progress in lifting stigmas around mental health, and in understanding that it was not only okay, but necessary to talk about our inner worlds as much as we like to talk about what’s going out in our external, shared reality. One sign of progress was, that “we’re not using as many euphemisms now. It’s not called exhaustion. We have a lot of artists to thank for that, who are being brave enough to speak about what’s actually happening for them. They’re changing social norms around talking about mental health. There is a flip side to that,” she added, noting that some artists were being encouraged to disclose mental health difficulties as part of their album campaigns to become more relatable, or even vulnerable, as means to connect with their audience. “When they’re in early recovery, that’s not always a helpful thing. It’s good to keep some things private is a rule of thumb,” she explained.
Taking things slower as an industry would also help. There are several factors that work against this simple realization, however. Promoting is seen by many as an elite task, especially working on major tours. There’s pride in sacrificing one’s entire being to the job, there’s stigma attached to “taking it easy.” For some time now, live has been the main source of income for artists. The lockdowns cut off a lot of people’s money supply, which is why they were determined to make the most of their return to the road. Worldwide price explosions across all parts of live’s supply chain only exacerbated the problem. “There was a lot of anxiety about lost momentum, lost sales. So, people are going quite intensely, and cramming quite a lot in. It’s tricky to book buses and trucks and things like that, so there’s a compression effect, which will hopefully even out,” Embleton said, adding, “it’s expensive to take it slower. We either need sponsors, or find ways to do it differently, or divide the profits differently – something that allows a healthier pace.”
A big part of the solution seems for people to make more use of what may be the most powerful word in the world: no. It takes courage to say, “no, I’m not doing this,” whether that’s an artist succumbing to pressures from management; parents, who leave their families behind for months on end during tours; crew putting up with abusive/aggressive behavior from colleagues; taking on too much work for fear of economic hardship.
Another chapter in Embleton’s book lays out many things venue operators can do in the short term to create a healthy environment for artist and crew – from signposts reminding everyone of the correct lifting techniques to sound proofed chill-out rooms to find rest to exercise rooms; it touches on performance anxiety and managing the post-show high; and it talks about changing the culture around alcohol consumption, and consulting a nutritionist so that people are getting a balanced diet.
Positive examples are coming from the UK, where she observes “a big trend towards mental health first aiders on the road.” It would go a long way, if pre-tour mental and physical health consultations to assess each artist’s capacity became the norm. There’s also the duty of artists towards their crew. As CAA’s Emma Banks explains in the book, some artists just want to go hell for leather, oblivious to the impact on crew, who are the first ones in and last ones out. And because crew often feel like they’re replaceable, they may go to great lengths to prove they’re not, which can range from working with an injury to not disclosing pregnancies.
“You might want to have somebody in each department that has a rudimentary understanding and training of spotting early warning signs that might facilitate some conversations,” Embleton said. HR is usually absent on the road, but it might be the right place for people to talk about their struggles – things they won’t disclose in front of their colleagues, because they don’t want to seem weak. Embleton said, “there’s cultural issues, too, it’s complex, but just talking about it is a good place to start. And talking things through before they reach crisis point would be ideal. People with clout can say, ‘this is how I want to tour, this is what I’m gonna do’, and it will have a knock on effect.”
You can find Tamsin Embleton @tamsinembleton, and The Music Industry Collective @weareMITC on most socials. You can order “Touring and Mental Health: The Music Industry Manual” here.