Running head: MUSICAL, THEATRE, MENTAL HEALTH

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Taking Center Stage:
Exploring Mental Health Issues in Musical Theatre
Taylor Kodric
California University of Pennsylvania

Author Note
I would like to thank Dr. Yugo Ikach, Dean Kristen Majocha, Dr. Rebecca
Regeth, Dr. Craig Fox, and Dr. Mark Aune for their support, encouragement, and
direction throughout the course of this project, combining two of my passions of
psychology and musical theatre.
Correspondence concerning this project should be addressed to Taylor Kodric at
California University of Pennsylvania, California, PA 15419. Email may be sent to
kod5091@calu.edu .

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Abstract
The current project explores the influence of mental health in musical theatre. The
prevalence of mental health in musical theatre is crucial to the development of an
imperfect character that is relatable and circumstantial situations in which the audience
can see the character living and dealing with these different mental health issues. One of
the greatest accomplishments of musical theatre has been creating a platform to raise
awareness for mental health issues and disorders of any size or degree. Utilizing seven
different Broadway songs sung by female characters that each deal with a different
mental health issue or illness, each one is analyzed through lyrical content, performance,
characterization, musical significance and mental health inquiry. Each song choice and
character showcase a different mental health issue and how the character copes with the
challenges. The results showed limited research but contribute to a field that is beginning
to emerge as a staple in American society and culture. Musical theatre shows that mental
health issues and disorders are prominent in society and normalizes the stigma,
illustrating the concept that people struggle together. Different characters are portraying
different issues and conveying the message that everything will be okay.

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Taking Center Stage:
Exploring Mental Health Issues in Musical Theatre
In terms of previous exploration in mental health and musical theatre, research is
pretty limited in this combined area due to it being a new and emerging concept. The
turn of the twentieth century saw an increase toward mental health awareness in society,
however musical theatre is one of many outlets that has been featuring mental health as a
critical component since the twentieth century (Shevenock, 2018). Musicals utilizing a
mental health component in a main character is unique because the mental health
storyline is often used to raise the stakes or explain a character’s behavior. Other
musicals showcase how the mental health component affects the main character, and the
audience can see how the character’s perspective and how he or she behaves with a
mental health issue (Schiller, 2017). Musical theatre as a medium has been
phenomenally successful in addressing these themes and elements.
Characters who sing about their feelings are often displaying heightened emotion,
and songs play an important role in the fact that they can either move the plot or reveal a
character’s thoughts, obstacles, and triumphs, proving that musical theatre can easily
handle these significant topics (Schiller, 2017). What is unique and powerful to the
audience is that these characters are doing the extraordinary by fighting internal battles
onstage and exposed in front of everyone. The musical element of musical theatre
provides depth and dimension to emotions that may exist outside of people’s everyday
boundaries. These artists work out their own neuroses through their art. Mental health
and illness might be a stealthy enemy, but musical theatre has sparked a conversation that
is happening loud and onstage (Cindric, 2016).

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The stigma surrounding mental illness is a very controversial topic although it has
grown to be more accepted in modern society. Once a very taboo topic that could not be
discussed, mental illness has broken into the media and are becoming normalized in
society (cite this source). According to the National Institute of Mental Health, nearly
one in five adults in the United States lives with a mental illness. Mental illnesses
include many different conditions that vary in degree of severity, and the classifications
range from mild to moderate to severe. Mental illness is labeled into two categories: Any
Mental Illness (AMI) and Serious Mental Illness (SMI). AMI encompasses all
recognized mental illnesses, and SMI is a smaller, specific subset of AMI that
encompasses the more severe mental illnesses (World Health Organization, 2019).
Mental health was first explored on Broadway in 1941 through the facet of mental
illness with the musical “Lady in the Dark.” “Lady in the Dark” tells the story of Liza
Elliot, a successful businesswoman who is the founder and editor of Allure, a popular
fashion magazine. She begins having panic attacks and experiencing long bouts of
depression which leads her to consult Doctor Brooks to receive psychoanalysis. Through
psychoanalysis, she realizes that she is not as happy as she thinks in any aspect of her
life, particularly in her significant romantic relationship and in her profession. Liza
discovers her repressed memories and dreams from childhood in which her parents told
her how she was never to be as beautiful as her mother, and this led to relentless teasing
from other children. Upon realizing that these bad memories are the source of her
problems, Liza is able to become content with her life as imperfect (Wolf, 1997).
Trying to reduce the sigma surrounding mental illness has been a priority for
those who struggle with the diseases and mental health professionals who provide

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effective treatment. A playwright and actress who lives with bipolar disorder developed
a staged performance entitled “That’s Just Crazy Talk,” which targets stigmatizing
attitudes towards bipolar disorder. Prospective, longitudinal, and sequential mixed
methods were used to assess the impact of the performance on people with bipolar
disorder (n=80) and healthcare providers (n=84). Qualitative interviews were conducted
with 33 participants (14 people with bipolar disorders and 19 healthcare providers).
Quantitatively, healthcare providers showed significantly improved attitudes immediately
post-performance, but this change was not maintained over time, and people with bipolar
disorder showed little quantitative change. Qualitatively, both people with bipolar
disorder and bipolar disorder healthcare providers showed enduring and broadly positive
changes. A theatrical presentation designed to reduce stigma produced immediate impact
on healthcare providers quantitatively and significant qualitative impact on people with
bipolar disorder and healthcare providers (Michalak et al., 2014).
Music therapy has also been previously identified as a way to foster processes of
mental health recovery. Sometimes, characters and people alike use music to speak what
words cannot. Twenty-three people participated in interviews for a project that aimed to
address the gap between group singing and mental health recovery by exploring the
conditional and contextual factors involved in group singing which may promote
recovery for people with mental illness. The findings of this study were presented as a
grounded theory of group singing which describes how participants experienced
triggering encounters with music and used the supportive conditions of the group singing
context to regain a sense of health. A new term, musical recovery, was developed which

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depicts a process of regaining healthy relationships with music to promote mental health
recovery (Bibb & McFerran, 2018).
As musical theatre keeps growing and expanding, so does the desire to participate
in it. Participation in activities perceived to be meaningful is of importance in recovery
process among people with mental health issues and mental illness. A qualitative study
explored experiences in participation of music and theatre among people with long-term
mental illness. Data was collected through in-depth interviews with eleven participants
in a music and theatre workshops set in a Norwegian mental health hospital context. The
findings indicated that participation in music and theatre provided an opportunity to focus
on enjoyable mundane activities and demonstrate how the arts have the potential to bring
meaning and small positive moments into participants’ lives. Despite being small, these
moments appeared to add pleasure and meaning to the lives of those experiencing them,
and raised professionals’ awareness of how small moments carry meaning, power, and
how to facilitate arenas which can provide such moments for people with long-term
mental health issues or illness (Orjasater, Davidson, Hedlund, Bjerkeset, & Ness, 2018).
One of Broadway’s most successful and current-running musicals is “Dear Evan
Hansen,” which tells the story of a teenager named Evan Hansen. Evan struggles with
social anxiety, and his challenges are only heightened by modern society’s reliance on
social media. A close classmate named Connor dies, and a letter Evan wrote addressed to
him is found which causes Evan to spiral, questioning his sense of belonging and
connection to Connor. This show has garnered immense success and has prompted
families, schools, and community organizations to start talking about mental illness and
taking the topic seriously. Seeing the achievement of “Dear Evan Hansen,” other

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composers and producers have been moving forward with more original works focused
on mental health issues. Critics and artists have been realizing that audiences are ready to
see pieces of theatre that reflect the struggles they face in their own lives (Shevenock,
2018).
The current research project aims to look at mental health representation in
musical theatre from different eras of the American musical. The specific method of
research involves vocal performance of a highlighting song from a main character who is
struggling with a mental health issue or illness and is coupled with analysis through
lyrics, musical content, characterization, and mental health inquiry. The song excerpts
showcase the mental health issues of anxiety, posttraumatic stress disorder, the stages of
grief/grieving process, delusional disorder, self-esteem/self-image, trauma, and bipolar
disorder. Each song selection portrays a character struggling with some kind of issue and
projecting their struggles to the audience. The audience can relate to the characters,
identifying with the battle of mental health and normalizing the sigma of mental health,
illustrating the concept that we struggle together.
Breathe
“Breathe” is a popular song from one of Lin-Manuel Miranda’s famous musicals
In the Heights. “Breathe” tells the story of Nina, a Latina college freshman, who is
coming back to her neighborhood after her first year of college at Stanford. Always a
good girl and an overachiever, Nina is ashamed to come back and tell everyone who
looks to her as an inspiration that she has flunked out of college, losing her scholarship.
“Breathe” highlights the mental health issue of anxiety and how the pressure of
perfection and achievement puts immense strain on the mind and body.

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Over 40 million adults worldwide suffer from anxiety, which is one of the most
common mental health issues that people struggle with. Anxiety can be manifested in the
form of general anxiety or can be very severe and be diagnosed with an accompanying
disorder. Symptoms of anxiety include excessive sweating, chest pains, heart
palpitations, shortness of breath, sleeping issues, and general panic, fear, and uneasiness.
Anxiety and anxiety disorders manifest from a combination of factors, such as
environmental stressors and genetics and often come about during heightened life events,
such as pursuing school or buying a home (American Psychiatric Association, 2013).
When performing this song, I focused on trying to convey the physical and
emotional dimensions of a character who is trying to summon all of her courage as she is
preparing to explain to everyone who believed in her and her abilities that she failed
them. This is a very nerve-wracking action that she is about to perform, and her emotions
are running at an all-time high, bursting with anxiousness. The character is having a hard
time controlling her physical reaction. She is trying to stay calm but is unable to, and at
times she is hyperventilating because she is breathing too much (Hendrix, 2016).
There are many significant lyrics in the song that speak to the overwhelming
theme of anxiety. “They’re not worried about me” and “They’re all counting on me to
succeed” show that Nina’s feeling the pressure to achieve very well, as it is not just a
reflection of her success but of her family, friends, and her culture. “The biggest
disappointment you know” and “I know that I’m letting you down” express Nina’s
feelings of failure and shame because she has not lived up to the expectations everyone
has set for her.

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The music plays a pivotal role in understanding and connecting with the issue of
anxiety. The beginning of the song is setting the folk-like community with guitar and
flute. The lyrics are sung as if they were being spoken, following the natural rhythmic
inflection of Nina’s speech patterns. The syllabic system of one note per syllable
represents the quick, small value of each note. The quickening tempo showcases her
anxiety through fast breathing, rapid heart rate, etc. The only contrasting point of this is
when Nina is singing the “Breathe” section, which is very drawn out and produces a
calming effect/coping tool to deal with her anxiety. Nina’s coping mechanism, the
“Breathe” section, is sung three times throughout the entire song. The high point in the
song is when Nina is singing with the most passion, and the music operates in stop time
with no accompaniment. This section is rhythmically driven and features faster
accompaniment as well with a higher range of vocals and volume. Lyrically, this section
is the most intense following her extreme anxiety (Hendrix, 2016).
I Never Knew His Name
“I Never Knew His Name” is a featured song from a lesser-known musical The
Civil War: An American Musical. “I Never Knew His Name” is sung from the point of
view of a nurse during the Civil War outbreak. The vast number of soldiers she sees
coming in with life-threatening injuries is so overwhelming to comprehend, and she
ponders the cost of what all the fighting is over as she witnesses Union and Confederate
soldiers traumatized by what they have endured and barely hanging onto life. “I Never
Knew His Name” presents the mental health issue of post-traumatic stress disorder
(PTSD) and how the trauma experienced by these individuals in high-pressure situations
can affect them for the rest of their lives. This song also alludes to the possible effect of

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what seeing the sheer volume of atrocities has brought the nurses who are exposed to
seeing these wounded soldiers day after day.
Approximately 8 million adults have PTSD during a given year, which is only a
small portion of the population who have gone through a trauma and are struggling with
the outcome. About six out of every ten men and five out of every ten women will
experience at least one trauma in their lives, ranging from sexual assault, child abuse, car
accidents, witnessing death, etc. PTSD is common for those who have served in the
military and affects these individuals throughout their lives as well. PTSD from military
affairs can include combat fighting, sexual assault, sexual harassment, etc. Some
common symptoms of PTSD include panic attacks and a stress reaction that can last for
long periods of time (American Psychiatric Association, 2013).
When performing this song, I focused on trying to portray the extent to which the
war has taken over the lives of people in this era and how the horrors of warfare have left
the soldiers beaten and battered and the caretakers helpless. The song is primarily meant
to serve as a medium for awareness of PTSD in military personnel. The nurse is tending
to countless soldiers who are pleading for help but trying to remain strong for their
causes. The character is overcome with emotion upon seeing these heroes on their
deathbeds as she sees them transform from boys to men. She realizes that regardless of
the uniform, each soldier who passes through and passes on is missing out on the same
life offerings, like family and happiness (Bey, 2019).
There are many significant lyrics in the song that contribute to the awareness of
PTSD and its message toward the intended audience of war veterans. “Pleading with his
eyes, suddenly so wise, trying not to cry” is painstakingly accounting for the soldier’s

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strength depleting as the trauma overtakes him. “The true cost of honor is suddenly too
clear” illustrates that in the present condition, the realization that being a hero for our
country in the fight is not worth the suffering endured. “Whispering goodbye, thanking
God that I never knew his name” conveys the nurse’s relief in not knowing the names of
soldiers and getting emotionally attached to them, only to have their lives be cut short by
their warfare endeavors.
The music pays homage to the issue of PTSD and connects us lyrically and
rhythmically through the secondary source of a Civil War nurse. Throughout the song,
the accompaniment appears to be very intimate and folk-like with instruments such as the
flute, guitar, and the strings. With relatively simple accompaniment, the audience is
given more of a chance to focus on the lyrics and their connection to PTSD, but the
instrumental break in the middle of the piece builds up the powerful intensity that the
final verse possesses. “I Never Knew His Name” features noticeably short melodic
phrases that are smooth and sustained fully for emphasis packed with profound emotional
execution (Schiller, 2017).
On My Own
“On My Own” is one of the most memorable songs from one of the most popular
musicals of all time: Les Misérables. Based on the popular novel by Victor Hugo, the
success of Les Misérables has been worldwide and spawned several musical productions
as well as an award-winning movie. “On My Own” is sung from the point of view of
Eponine, a lowly thief during the French Revolution era. She is in love with Marius, a
lead revolutionary, but his feelings lie with another woman. She sings of her unrequited
love for him through experiencing visions of the two of them together in love. “On My

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Own” presents the mental health issue of delusional disorder and how when people
adamantly believe something, their minds can conjure up wild yet untrue fantasies.
Eponine is experiencing delusions/delusional states of her and Marius in love despite
knowing full well that he is in love with another woman.
Delusional disorder is generally classified as a rare mental illness in which a
patient is struck with delusions but previously had no known diagnosis of a psychological
symptom or disorder. According to German psychiatrist Emil Kraepelin, people who
possess delusional disorder remain “coherent, sensible, and reasonable.” People with
delusional disorder continue to socialize and function normally in terms of behavior, but
over time, these delusional ideas tend to overtake and disrupt lives. The DSM breaks
delusional disorder up into six different classifications: erotomanic, grandiose, jealous,
persecutory, somatic, and mixed when they combine more than one. Delusions often
accompany different forms of schizophrenia, and many times, people who suffer from
schizophrenia can experience these manic delusions more frequently (American
Psychiatric Association, 2013).
When performing this song, I channeled my focus into the portrayal of Eponine as
misunderstood based on these delusions. This song speaks very powerfully to the mental
issue of delusional disorder, specifically its specialization in erotomanic delusions which
are delusions that another person, often a prominent figure, is in love with the individual.
Eponine fantasizes that Marius, an important French revolutionary, is in love with her.
“On my own, pretending he’s beside me” and “Without him, I feel his arms around me”
illustrates simple accounts of her delusions and how Marius is with her and makes her
feel safe. “And I know it’s only in my mind that I’m talking to myself and not to him”

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shows the extent to which her delusions have affected her. She knows what the truth of
the situation is, but her mind pulls her back in with the delusion that they will be together.
“I love him but every day I’m learning” and “All my life I’ve only been pretending” are
explaining Eponine’s journey back to reality from her delusions. She has refocused on
what is truly occurring and is coming to terms with it (Ørjasæter et al., 2018).
The musical execution throughout the song bridges the missing gaps and connects
the audience to the mental health issue of delusional disorder through the brilliance of the
music. The strings throughout the song create the illusion or impression of rain. The
soft, controlled moments reflect gentle rainfall, and the intense, commanding moments
are indicative of torrential downpours, which are all reflective of Eponine’s mental and
emotional state as she is experiencing these delusions. The first half of the song is
engaged in happier times, when Eponine’s delusions overtake her and provide a sense of
comfort and safety. This is replicated in the instrumentation as well with soft and
controlled strings and slow, legato phrasing. The second half of the song is when
Eponine finds herself faced with reality. Marius is not in love with her, and the world is
not her safe haven. In this section, the strings pick up strength and volume, extending her
vocal range and focusing on her suspensions. The final motif of the song brings Eponine
to understand that she is “on her own” despite her love for him, imitative in the
resumption of the soft string plucks, which are emulative of gentle rainfall (Shevenock,
2018).
Wishing You Were Somehow Here Again
“Wishing You Were Somehow Here Again” is a featured song from the longestrunning Broadway musical of all time: Phantom of the Opera. Inspired by historical

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events and the success of movies and stage adaptations, Phantom of the Opera has turned
into a worldwide phenomenon that has left a monumental impact on the world of musical
theatre with its memorable characters and award-winning music by Andrew Lloyd
Webber. “Wishing You Were Somehow Here Again” is sung by the lead female
protagonist Christine Daae who is the muse for the Paris Opera House phantom. She
sings a lament dedicated to her father, the pain that she has endured because of his death
and the sadness she feels as he is no longer with her. “Wishing You Were Somehow
Here Again” presents the mental health issue of grief, the stages of the process that
people experience, and the progression of these emotions. Christine is going through the
grief process due to her father’s death and is experiencing the accompanying emotions
with it.
Grief is a multifaceted response to loss, particularly to the loss of someone that
has died, to which there was a profound emotional bond, but people can grieve a variety
of losses in their lives. Grief is a natural response to death, and everyone’s grief
experience is different and individualized. The Kubler-Ross model, developed by
Elisabeth Kubler-Ross and commonly known as the five stages of grief, identifies five
distinct stages on how people process the grief they are feeling: denial, anger, bargaining,
depression, and acceptance. This theory emphasizes the stage each as essential parts of
the framework that helps people to learn to live despite their losses (American Psychiatric
Association, 2013; World Health Organization, 2019)
When performing this song, I worked toward conveying each stage that Christine
passes through purposefully and deliberately, highlighting the different emotions she is
feeling. This song is monumental in highlighting the stages of grief and each stage’s

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specialization in feelings and actions. Particularly in this song, Christine experiences
denial, anger, and acceptance as she comes to terms with her father’s death. “Sometimes
it seemed if I just dreamed, somehow you would be here” and “Wishing I could hear your
voice again” are indicative of the denial stage where she still believes that her father is
present with her. “Too many years fighting back tears, why can’t the past just die?”
represents the anger stage when she is ashamed for letting the grief consume her life and
her desire to move on from the past and what she cannot change. “Try to forgive, teach
me to live. Give me the strength to try” and “Help me say goodbye” are emulative of
Christine experiencing the acceptance stay where she is trying to let go of her grief and
move on with her life (Bey, 2019).
The brilliance of the music in “Wishing You Were Somehow Here Again” uses
the stages of grief in conjunction with the music to propel the themes of grief and
acceptance even further. As Christine is passing through each stage, the music is
reflective of this and adjusts accordingly to each one. Christine’s denial stage music is
melancholy and angelic with the prominent role of the gentle violin that emphasizes the
legato line, coupled with the yearning and sincerity in her tone. This musical idea
continues through until Christine reaches the anger stage where the music picks up in
volume and intensity along with the instrumentation of the strings, signaling Christine’s
descent into fury and aguish. Toward the end of the song, Christine enters the last stage
of grief which is acceptance, and this is the climatic point where the power of the
orchestra and her vocal strength and control are in sync and produce a passionate display
of grief that subsides into acceptance of the situation. This musical section is so

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controlled in the instrumental execution, vocal control, and dynamic shift as the intensity
slowly decreases back to the origin of the music in the beginning of the song.
“Wishing You Were Somehow Here Again” predominantly features two sections
throughout the song and are split by major key and minor key. The minor key highlights
the melancholy, slower section in G minor. This key emphasizes the depression
Christine is feeling in the denial and isolation stages as she is along in a cemetery,
grieving over her father’s headstone. The transition between sections is indicated by total
stoppage. The major key draws attention to Christine’s reminiscence and the faster
section in G major. As the song builds up strength, the intensity grows in volume and
pitch. At the focal point of volume and register, Christine’s anger dissipates into
acceptance of her father’s death, and she returns to a soft, low register. It is important
that each key is connected to and effectively highlights each stage of grief that she is
passing through (Palidofsky, 2010).
She Used to Be Mine
“She Used to Be Mine” is one of the title songs from one of the newer Broadway
musicals gaining success: Waitress. The music and lyrics of Waitress was written by
widespread pop singer-songwriter Sara Bareilles and is based on the 2007 movie of the
same name that achieved commercial success when it was released. “She Used to Be
Mine” is sung by the lead female protagonist Jenna who is a waitress and expert pie baker
and is experiencing unhappiness in her marriage with her husband. She unexpectedly
becomes pregnant and begins an affair with her gynecologist. Looking for a way to get
out of her unsatisfying lifestyle, she plans to enter a pie-baking contest and use the
winnings to create a new life for herself and her baby, away from the chaos her current

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life provides her. “She Used to Be Mine” is performed after Jenna’s abusive husband
runs off with all of her savings and presents the mental health issue of identity and the
crisis of truly figuring out and distinguishing who someone is. Jenna is experiencing an
identity struggle as she does not recognize the woman she has turned into and is trying to
remember who she once was.
Struggling with identity is something that can take place at any point in life,
particularly at stages with transitions or high levels of stress which can take place in
teenage years, adulthood, or the elderly years. Developing a sense of self or a distinct
identity is an essential part of every individual becoming mature and satisfying specific
stages of development. Experiencing an identity crisis is through a period of uncertainty
and confusion in which a person’s sense of identity becomes insecure, typically due to a
change in their expected aims or role in society. Erik Erikson addresses identity crisis in
his theory of psychosocial development. Successful resolution of an identity crisis is
attributed to stable identity and self-image throughout adulthood, but failure to resolve an
identity crisis can lead to unstable identity patterns and poor self-image (American
Psychiatric Association, 2013).
When performing this song, I worked toward my portrayal of Jenna as someone
who is experiencing the peak of an identity crisis. All of the misfortunes that she has
endured in her life has left her feeling unsatisfied, knowing that this is not truly the
person she set out to become. The meaningful lyricism coupled with the array of
intensity show Jenna admitting her shortcomings in life and striving to move forward as
the person she genuinely wants to be. “It’s not simple to say, most days I don’t recognize
me” illustrates how far Jenna has strayed from her identity to the point of being unable to

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distinguish herself. “It’s not easy to know I’m not anything like I used to be” conveys
her poor self-image and belief that her insecurities and other’s perceptions leave her
amounting to nothing. “She is messy but she’s kind. She is lonely most of the time.
She’s all of this mixed up and baked in a beautiful pie, she is gone but she used to be
mine” is Jenna describing the girl she once was and who is she trying to reclaim, her true
identity (Schiller, 2017).
The music utilized in this piece propels the issue of struggling with identity to the
forefront, and the issue’s importance is heightened in this way. It is interested that Jenna
addresses the song in third person, which can take the blame off of her or hide her shame
in who she has become. Much of the singing is very speechlike. Most of the
accompaniment consists of chords, and the use of these chords is varied throughout the
songs to display different significance and meaning to the section it is addressing. In the
beginning of the song with the first verse and chorus, the chords are soft and sustained for
the whole measure, allowing the lyrics to be featured and highlighting Jenna’s
vulnerability and disappointment with the development of her identity. Transitioning to
the second verse and bridge, the chords are now singular and punctuated for heavy
emphasis at Jenna’s anger over the situation and desire to rewrite the past. The intensity
of the passage increases as she imagines a new version of herself, a girl who is reckless,
tough, and fight for the things she wants. The volume of the vocal line and the pitch both
increase. The original chord structure reappears at the end of the song, coupled with the
original soft tone and affirmations as Jenna is working toward reclaiming her identity.
The song undeniably highlights the lyrics, while the chords are pseudo recitatives,
serving as the bare minimum. The singing follows the natural inflection of the speech in

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the low register with a very syllabic tone to allow the audience to focus on the words.
She takes great care to overenunciate the words with meaning. The chorus is higher and
held out longer to signify its importance, and the accompaniment is absolutely
subservient to the words.
As Long as He Needs Me
“As Long as He Needs Me” is a powerful ballad from the famous Broadway
musical Oliver!. Inspired by Charles Dickens’ classic book Oliver Twist, Oliver! tells
the story of a poor orphan named Oliver who is searching for a home and family while
simultaneously navigating the London underworld of theft and violence. Oliver is
welcomed by a group of pick-pocketers but gets more than he bargained for when he is
accused of a crime he did not commit. He is rescued by a kind and wealthy gentleman
but must work to clear his name. The main female protagonist Nancy is desperate to help
Oliver but is controlled through the trauma that her abuser, Bill Sikes, has put her through
since joining the gang. Nancy sings “As Long as He Needs Me” as a romantic
expression of her love for her criminal boyfriend Bill despite his mistreatment of her and
the pain he has inflicted on her. “As Long as He Needs Me” presents the mental health
issue of trauma, how people mistake negative emotions for positive ones, and how they
convince themselves to stay through the horrific ordeal. Nancy is going through trauma
because despite the suffering she is enduring from being with her abusive partner, she
convinces herself that he truly loves her and needs her in his life.
Trauma is psychological damage to the mind that occurs as a result of a
distressing event, which can be the result of a singular stressful event or recurring events
of being overwhelmed over long periods of time. Trauma is often the result of an

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overwhelming amount of stress that exceeds one’s ability to cope or integrate the
emotions involved with that experience. Trauma differs between individuals, and people
react to traumatic events differently. After a traumatic experience, a person may be
triggered through re-experiencing the trauma. Other symptoms of trauma include panic
attacks, insomnia, flashbacks, nightmares, emotional detachment, and mental exhaustion
(American Psychiatric Association, 2013).
When performing this song, I worked toward portraying the extent to which
Nancy has undergone this traumatic experience, highlighting the different emotions that
she is undergoing. Nancy has a range of emotional execution to perform, and it is crucial
to her delivery and expression to portray the diverse sentiments of her trauma. “In spite
of what you see, I’m sure that he needs me” is indicative of Nancy’s adamancy that she is
a necessity in Bill’s life. “He doesn’t say the things he should, He acts the way he thinks
he should. But all the same I’ll play the game his way,” shows that Nancy has essentially
been brainwashed to convince herself that verbal and physical abuse along are a normal
part of a relationship full of love. “If you are lonely then you will know, when someone
needs you, you love them so” illustrates the effect the trauma has had on Nancy’s selfesteem, demonstrating that her worth is based on someone’s love and approval of her;
otherwise, she’ll be lonely (R, 2013).
The music of “As Long as He Needs Me” is simple and reflective, truly putting
the character’s emotions at the forefront of the song. This ballad does well to double as a
monologue, and many portrayals begin the song “talk-singing.” The same simple
musical theme of “As long as he needs me” is echoed throughout the song, and it is kept
low to show Nancy’s alto register, her heartiness and growl. The “talk-singing”

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transitions into a fuller orchestral performance, but the vocal line and quality is designed
to be subdued to play more to the emotions than the music. The structure of the music
and vocals feature both an interior monologue and a plea to the audience to recognize her
dilemma and instead of disapproving, understand her intentions. At the end of the
phrasing in each verse, the flatted note sounds which is different from the rest, alerting
the audience that not all is well. Nancy sings the whole verse, then alerts the audience
with that note. The intensity grows and Nancy displays her tenacity even more in her low
register, belting the masochistic sadness of the song. The final verse of the song brings
back the familiar musical structure, recognition of Nancy’s brokenness and her
commitment to her abuser. The big triumphant ending symbolizes Nancy’s decision to
stay with him to the point of death because she believes her existence is based on his
need (R, 2013).
Didn’t I See This Movie?
“Didn’t I See This Movie?” is a fast-paced feature from one of Broadway’s most
famous musicals that addresses mental illness: Next to Normal. Next to Normal is a
contemporary family drama about a woman’s struggle with bipolar disorder and the
effects of this disorder on her family. The main female character, Diana, seems to have
an ideal life, but the façade soon shatters. Diana has bipolar disorder, is plagued with
anxieties, mood swings, and delusions that trace back to a family tragedy from years
earlier, and all of these symptoms are growing worse with times. Throughout the course
of the musical, Diana goes through a series of doctors and treatments in response to and
sometimes triggering the ups and downs of her illness. “Didn’t I See This Movie?” is
Diana’s reaction to receiving electroconvulsive therapy as treatment for her bipolar

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disorder. She references the popular expose addressing mental health institutionalization
“One Flew Over the Cuckoo’s Nest” and famous celebrities who coped with depression
like Sylvia Plath and Frances Farmer. “Didn’t I See This Movie?” addresses the mental
illness of bipolar disorder, the dangerous treatment options, and the dehumanization of
clients as simply crazed lunatics rather than people who are struggling.
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that
causes unusual shifts in mood, energy, activity levels, and the ability to carry out daily
tasks. There are four basic types of bipolar disorder, and all of them involve clear
changes in mood, energy, and activity levels. These moods range from periods of elated
and energized behavior (known as manic episodes) to incredibly sad or hopeless periods
(known as depressive episodes). Less severe periods are known as hypomanic episodes.
The four basic types of bipolar disorder are bipolar I disorder, bipolar II disorder,
cyclothymic disorder, and other specified and unspecified bipolar and related disorders.
Each vary in range of symptoms and episodes, and there are different treatment and
therapy options available. Many people take different types of medications, such as
mood stabilizers, and participate in psychotherapy. Other treatment options are
electroconvulsive therapy, sleep medications, or supplements (American Psychiatric
Association, 2013; World Health Organization, 2019).
When performing the song, I worked toward exploring the protest that Diana has
for ECT treatment for her struggles with bipolar disorder. Underneath all of the rage and
anger, Diana could very well be experiencing fear of the unknown. “That hospital was
heavy, but this cuckoo’s nest is worse” is reflective of Diana’s understanding of being
labelled as crazy and losing her role as just a normal woman. “Didn’t I see this movie,

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and didn’t I cry?” is indicative of Diana’s fear and trauma associated with possible
dangerous treatment of her bipolar disorder. “What makes you think I’d lose my mind
for you? I’m no sociopath. I’m no Sylvia Plath.” Illustrates Diana’s frustration of not
being viewed accurately by the medical personnel, that just because she struggles with
mental illness does not mean she is insane. “I know where this is going, and I know what
you’re about, ‘cause I have seen this movie and I walked out.” Reveals Diana’s
knowledge of this procedure and her outright refusal to participate in the dangerous
therapy treatment (Hadaegh & Shirazi, 2019).
The music of “Didn’t I See This Movie?” is fast-paced and energized,
representative of the emotional depth of someone with bipolar disorder and what they
would experience. The accompaniment is structured with a regularized pattern and a
drive that is almost monotonous. The music hypes the audience up with a fast tempo of
eighth notes and frenetic syncopation. The first part of the verse features simple
accompaniment to draw attention to the words Diana is singing. The second half of the
first verse transitions with intensity and more powerful instrumentation as Diana is
reminiscing over the movie “One Flew Over the Cuckoo’s Nest” and how her treatment
process is turning into the plot of that movie. Throughout the song, the melody is
syncopated, but she sings on the off-beats and does not land on the strong beats, alluding
to how she feels living with bipolar disorder. The guitar, bass, and percussion become
more prominent and explodes with power as she reaches her peak, vocally and lyrically
crying about the move. The doctor then rhythmically speaks the electroconvulsive
therapy procedure, and Diana erupts in fury vocally defending her sanity along with the
supplementary aggressive accompaniment, particularly percussion and cymbals. She is

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asserting her label as not being psychotic or like any others who have publicly struggled
with mental illness. The song then takes a transition back into its original rhythmic
content, and Diana is outright refusing the ECT treatment, walking out of the
conversation. The ending features an unsatisfying deceptive cadence because although
the song is in B major, it ends in E major. The entire song captivates the viewer with its
fiery passion, blunt delivery, and powerful vocal range complemented with powerful
lyrical and instrumental significance (Hadaegh & Shirazi, 2019).
Discussion
The research of the connection between mental health and musical theatre reveals
that there is essentially no research. This area of interest has extremely limited research
due to it being a new and emerging concept. Mental health expression being utilized in a
musical theatre format has been successful thus far and continues to be as playwrights,
lyricists, and composers continue to bring mental health issues to the forefront of a
beloved character’s personality. Utilizing mental health concepts will continue to
challenge society on their views of acceptance while simultaneously educating,
promoting tolerance and acceptance, and normalizing the stigma.
Further research can absolutely be conducted in this area. Specific mental health
disorders or different types of mental illnesses can be analyzed in a musical theatre
setting instead of just a general mental health issue. It would be worthwhile to explore
this topic and how if affects children by studying children’s musicals and conducting
behavior analyses. Conducting research on social issues such as racism such as racism
and LGBTQ rights and their influence on musical theatre would be a logical next step.
So many of these types of musicals exist that explore these issues and also have an effect

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on audiences that can be observed and analyzed. Mental health exploration in musical
theatre can also be evaluated to create different training programs for professional actors
and educational seminars for audiences such as talk-backs with the performers. The
current project explored mental health issues from the female perspective, but it would be
remarkably interesting to also explore mental health representation in musical theatre
from the male perspective as well.

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