Hip-hop artists Tupac and Eminem are among the most iconic music artists of the past two decades, and as Dr Akeem Sule and Dr Becky Inkster, co-founders of HIP-HOP-PSYCH, write, their lyrics can provide a valuable insight into the lives of some of the people most at risk of developing mental health issues.

The suffering and painful feelings revealed by Tupac and Eminem’s characters offer us a valuable insight to examine mental health themes related to psychosis and social adversity.

Tupac Shakur and Eminem are often touted as two of the greatest rappers of all time. While Tupac, who was shot dead in 1996, is African American and Eminem is Caucasian, their lyrics have similar narrative story telling styles that are filled with anguished suffering and anger conveyed in their hip-hop songs. The characters they portray in their lyrics are often surrounded by challenging environments – alcohol and drug addiction, parental abuse and gun crime, for example.

Two songs that describe important issues of adversity reflecting strong emotional turmoil in their lyrics are ‘Death around the corner’ from Tupac Shakur’s album, ‘Me Against The World’, and ‘Cleaning out my closet’ by Eminem from his album, ‘The Eminem Show’. In both songs, whether knowingly or unwittingly, the artists’ characters reveal many of the symptoms of mental illness – and also paint a picture that suggests why these problems have arisen.

In ‘Death around corner’, Tupac portrays a fictional character preoccupied with paranoia about a perceived threat to his own life and to his family. He feels the need to protect himself and his family from perceived targeted violence.

Straight away, the song opens with a skit, a dialogue between Tupac’s character, his partner, and their son. Tupac’s character is standing by the window with an AK47 firearm. His son is confused about his father’s strange behaviour and his wife is exasperated with her partner and feels he is consumed by his paranoia. She refers to Tupac’s character as “being crazy” and notes that he is neglecting his family (“you don’t work…you don’t do a…thing”). It is apparent that she does not share his concerns about their family’s safety and appears very irritated that he is preoccupied by his worries. What is particularly concerning is that the character – who is likely paranoid without justification – is carrying a potentially loaded gun at home whilst a vulnerable child and partner present and witnessing this behaviour.

The first verse makes reference to his need to stay ‘high’, probably through use of either a stimulant or cannabis, which are both risk factors for developing psychosis and paranoia.

The character describes his harsh urban environment as being where the “skinny” people “die” – in other words, where the weak are killed or exploited. The environment appears to be a place where vulnerable individuals can develop social defeat, which research has shown is a risk factor for psychosis.

Tupac’s character alludes to his daddy being “madder than a motherfucker”, which may indicate that the character has an increased risk of developing psychosis due to genetic factors, as we know people with a family history – particularly a parent or sibling – are at increased risk. He subsequently goes to bed “with my pistol in my sheets” due to feeling paranoid.

In the first verse, Tupac mentions his character’s use of “endo” (cannabis) and how it relieves his stress and paranoia. In the next verse, though, he mentions how smoking “…too much weed got me paranoid, stressed”. Is he contradicting himself here? Not necessarily: it depends on the type of cannabis that Tupac’s character has smoked which could explain both the increases in his paranoia and his relief from it – while some forms of cannabis are relatively benign, others, such as ‘skunk’, have been shown to increase the risk of psychosis.

Later, Tupac goes on to describe how his character was “raised in the city, shitty” at an early age, “drinking liquor out my momma’s titty” (a reference to his mother’s excessive alcohol use during early childhood whilst breast feeding), and possibly being exposed to second-hand cannabis smoke from an early age. All these risk factors highlight a chaotic household, which may have had an adverse effect on his developing brain – again leading to the development of psychosis in later life.

It’s clear from these lyrics that Tupac’s character has a family history of psychosis, that he abuses stimulants or cannabis, and that he lives in a harsh environment. All of these factors we know alter an individual’s brain chemistry and in particular how it responds to the key neurotransmitter dopamine, which research has shown leads people to fixate on or give too much emphasis to things in our environment or within our own thoughts, feelings or senses – and hence drive mental health issues such as paranoia and psychosis.

There is another way of looking at Tupac’s character, though: it’s possible that he is experiencing some form of Post Traumatic Stress Disorder (PTSD) following experiencing and witnessing life threatening situations from living in a violent hood “..I guess I seen too many murders…”. His behaviour certainly seems to match some of the common symptoms for PTSD: the frequent looking out of the window and paranoia could be seen as hypervigilance and hyperarousal which are prominent symptoms. His mention of seeing death around the corner could be referencing intensive flashbacks, ‘reliving’ of murders he has witnessed, and his use of “weed” might reflect the use of cannabis for ‘self-medication’.

Eminem’s song 'Cleaning out my closet' follows a similar trend of highlighting early adverse experiences. The song deals with Eminem’s angst against his mother.

In the first verse, Eminem highlights how he can’t keep his emotion in check and describes them as “the oceans exploding” attributing it to his parents relationship, their “tempers flaring”.

The chorus indicates that Eminem wishes to exorcise his emotional demons by voicing his angst in his lyrics. He uses the metaphor “but tonight I’m cleaning out my closet” to acknowledge that he would rather reveal his “skeletons” than allow them to eat away at him.

It appears he is trying to reach out to listeners as though they are psychotherapists. His character discloses his secrets in order to feel free from torment. Sigmund Freud described depression as anger turned inwards, often towards traumatic childhood experiences, hence we can see Eminem’s psychotherapy with the listeners as an opportunity to let go of the buried anger in an attempt to protect himself from depression.

The rest of the second verse involves Eminem making accusations against his detached, absent father, and Eminem promises to be different by being present for his daughter. It also reveals Eminem avoiding killing his ex-girlfriend and her partner (for the sake of his daughter), therefore he’s able to control his angry impulses.

The next verse explores his mother’s addiction to prescription pills, which echoes Eminem’s self-declared battle with addiction to prescription pills. This also highlights his increased risk of substance misuse partly due to his familial genetic predisposition.

Eminem’s character accuses his mother of Munchausen’s syndrome by proxy – where a mother fakes her child’s symptoms (or even worse, causes real symptoms) to make the child seem sick – describing himself as a “victim of Munchausen’s syndrome”. In this syndrome, it is believed that the intention of the caregiver is to gain attention and to receive commendation as the rescuer of the child for saving the child in their care from the illness. They do this to fulfill their need for attention by placing the sick role on to their child.

Eminem ends the song by accusing his mother of being jealous of his success and reveals his intention of not allowing her access to his daughter to protect her from becoming a victim of the abuse he experienced.

Interestingly, in a song released by Eminem later in 2013, entitled ‘Heights’, he regrets these harsh views toward his mother as previously written in ‘Cleaning out my closet’ and instead acknowledges his mother’s difficulty raising him as a single parent.

The suffering and painful feelings revealed by Tupac and Eminem’s characters offer us a valuable insight to examine mental health themes related to psychosis and social adversity. By utilising the interests of individuals who listen to hip-hop music – especially young people – we aim to enhance their understanding about mental health by delivering medical information in a context-enhanced manner. Perhaps this urban influenced approach will help empower and encourage individuals to examine what adversity is around the corner for them personally, and to explore what risk factors may still be locked away in their own closets.

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