Peak experiences are important to facilitate because research has shown that peak experiences during psychedelic-assisted therapy correlate with positive therapy outcomes for a range of psychiatric conditions (Garcia-Romeu et al., 2014; Griffiths et al., 2008; Roseman et al., 2018; Ross et al., 2016). One study found that music-evoked emotions of ‘wonder’ and ‘transcendence’ are enhanced under LSD compared to placebo (Kaelen et al., 2015). Further, a clinical trial using psilocybin and music to treat depression showed that, from a diverse range of subjective experiences clients reported, the music experience selectively correlated with peak experiences (i.e., feelings of union, bliss, and spirituality) (Kaelen et al., 2018).
Importance of Music in Psychedelic-Assisted Therapy
The combination in psychedelic-assisted therapy of health professionals offering their support and empathetic abiding presence in a carefully curated treatment room allows music to be the container for the client experience.
Acknowledging music as the container of experience is critical because it honours the amount of influence music holds. We recognize that there is a long history of combining music with psychedelics to help facilitate particular experiences, visions, emotionality, and insight.
Figure 6.1 Mazatec dancers from Huautla de Jimenez (Paunde, 2010).
Figure 6.1 Mazatec dancers from Huautla de Jimenez (Paunde, 2010).
In the 1950s and 1960s, recorded music was introduced as part of the therapeutic framework and has remained a staple in contemporary research on psychedelic-assisted therapy, particularly with respect to setting.
Did You Know?
What research is available that supports the use of music during psychedelic-assisted therapy?
Presently there is limited research on the implications of music in psychedelic-assisted therapy. However, research has shown that psychedelic medicines significantly modulate music-evoked emotion, music-evoked mental imagery, and perceived personal meaningfulness of music (Kaelen et al., 2015). It is common for those undergoing psychedelic-assisted therapy to state that the music significantly altered their experience (Belser et al., 2017; Swift et al., 2017; Watts et al., 2017). The musical considerations outlined in Modules 5 and 6 have been primarily informed by and adapted from the work of Mendel Kaelen (Grob & Grigsby, 2021) and a presentation by Alicia Danforth (Danforth, 2021).
Motivations for Incorporating Music
Mendel Kaelen, a neuroscientist and leading researcher within the field of music and psychedelic-assisted therapy, provides the following summary of motivations using music in psychedelic-assisted therapy (Grob & Grigsby, 2021):
Please ensure that you read through all items before proceeding by selecting each title.
Studies indicate that music-evoked emotion is significantly enhanced under the influence of psychedelics (Kaelen et al., 2015; Kaelen et al., 2018), and that music plays a significant role in facilitating personally and therapeutically meaningful emotionality within sessions (Kaelen et al., 2018). It is common in psychedelic-assisted therapy for clients to frequently experience emotional releases, and these releases are typically described as an important contribution to their positive therapy outcomes (Belser et al., 2017; Gasser, 2014; Kaelen et al., 2018; Watts et al., 2017). Additionally, population studies relate emotional ‘break-through’ experiences under the influence of psychedelic medicines with improvements in well-being (Roseman et al., 2019).
Research has outlined how the combination of psychedelic medicines and music can modulate neural circuitry specialized in mental imagery and personal memory (Kaelen et al., 2016). Psychedelics and music are also correlated with enhanced vividness of mental imagery and autobiographical memories (Kaelen et al., 2016).
Reassurance can support the client to drop psychological defences and engage pro-actively and openly with their unfolding experience. In a recent study, music was helpful in facilitating calm and safety and a source of “support” and “reassurance (Kaelen et al., 2018). The reassuring effects of music outlined in this study were particularly appreciated in situations where apprehensions were present, such as prior to the onset of the medication effects, and also when reduced arousal and more “mental space” was desired (such as after emotionally intense periods). The use of music to reduce anxiety and provide comfort has wide empirical support and utility in a range of other clinical contexts (Finch & Moscovitch, 2016; Mondanaro et al., 2017; Pavlov et al., 2017).
References
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Danforth, A. (2021, February 19). Experience as Medicine [Presentation]. Wavepaths.
Finch, K., & Moscovitch, D. A. (2016). Imagery-Based Interventions for Music Performance Anxiety: An Integrative Review. Med Probl Perform Art, 31(4), 222-231.
Garcia-Romeu, A., Griffiths, R. R., & Johnson, M. W. (2014). Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction. Curr Drug Abuse Rev, 7(3), 157-164.
Gasser, P., Holstein, D., Michel, Y., Doblin, R., Yazar-Klosinski, B., Passie, T., and Brenneisen, R. (2014). Safety and Efficacy of Lysergic Acid Diethylamide-Assisted Psychotherapy for Anxiety Associated With Life-Threatening Diseases. The Journal of Nervous and Mental Disease, 202(7), 513–20. doi:10.1097/NMD.0000000000000113.
Griffiths, R., Richards, W., Johnson, M., McCann, U., & Jesse, R. (2008). Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. Journal of psychopharmacology (Oxford, England), 22(6), 621-632.
Grob, C. S., & Grigsby, J. (2021). Handbook of Medical Hallucinogens. Guilford Publications.
Kaelen, M., Barrett, F. S., Roseman, L., Lorenz, R., Family, N., Bolstridge, M., . . . Carhart-Harris, R. L. (2015). LSD enhances the emotional response to music. Psychopharmacology (Berl), 232(19), 3607-3614.
Kaelen, M., Giribaldi, B., Raine, J., Evans, L., Timmerman, C., Rodriguez, N., . . . Carhart-Harris, R. (2018). The hidden therapist: evidence for a central role of music in psychedelic therapy. Psychopharmacology (Berl), 235(2), 505-519.
Kaelen, M., Roseman, L., Kahan, J., Santos-Ribeiro, A., Orban, C., Lorenz, R., . . . Carhart-Harris, R. (2016). LSD modulates music-induced imagery via changes in parahippocampal connectivity. Eur Neuropsychopharmacol, 26(7), 1099-1109.
Mondanaro, J. F., Homel, P., Lonner, B., Shepp, J., Lichtensztein, M., & Loewy, J. V. (2017). Music Therapy Increases Comfort and Reduces Pain in Patients Recovering From Spine Surgery. Am J Orthop (Belle Mead NJ), 46(1), E13-E22.
Paunde, E. (2010). Bailable de sones mazatecos de Huautla de Jimenez [Photograph]. WikiMedia Commons. Public Domain. https://en.wikipedia.org/wiki/File:Huautla_de_Jimenez.jpg
Pavlov, A., Kameg, K., Cline, T. W., Chiapetta, L., Stark, S., & Mitchell, A. M. (2017). Music Therapy as a Nonpharmacological Intervention for Anxiety in Patients with a Thought Disorder. Issues Ment Health Nurs, 38(3), 285-288.
Roseman, L., Haijen, E., Idialu-Ikato, K., Kaelen, M., Watts, R., & Carhart-Harris, R. (2019). Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory. J Psychopharmacol, 33(9), 1076-1087.
Roseman, L., Nutt, D. J., & Carhart-Harris, R. L. (2018). Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression. Frontiers in pharmacology, 8, 974.
Swift, T. C., Belser, A. B., Agin-Liebes, G., Devenot, N., Terrana, S., Friedman, H. L., . . . Ross, S. (2017). Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress. Journal of Humanistic Psychology, 57(5), 488–519.
Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R. (2017). Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression. Journal of Humanistic Psychology, 57(5), 520–564.