Music in Psychedelic Psychotherapy
By Alberto Cantizani López
“‘I’m going to take you on a ride here, but I promise I won’t abandon you. It’s just going to be tough, and you know, you’re going through the grinder here, but you won’t be left in pieces.’ That seemed to be what the music was saying to me.”
Participants in psychedelic trials often remark the central role that music played during their experiences with psilocybin. Dr Mendel Kaelen, a neuroscientist whose research focuses on the therapeutic effects of music and psychedelics, has referred to music as “the hidden therapist”. During his presentation at ICPR2020, Dr Kaelen discussed the psychedelic properties of music and why researchers should pay attention to more factors other than the drug. Here are some of the lessons that we learned from him.
Music & Psychedelics: And old healing alliance
Humans have historically resorted to music and psychedelics as tools to alter normal consciousness in ritual and healing practices. It could be argued that whole music genres, from shamanic drumming to electronic dance music, have been developed with the purpose of triggering and intensifying trance states. Already in the sixties, music was a major element in the setting of psychedelic therapy, and often, the only external stimulation that the patient would get during the whole session. Early LSD therapists like Helen Bonny would look closely at what kind of music worked best at immersing patients into the psychedelic state in order to facilitate the therapeutic process.
As his research team at the Imperial College London designed a protocol for a psilocybin trial, neuroscientist Mendel Kaelen noticed that most of the available playlists from the 60s featured predominantly Western classical music. This genre did not appear to him as the most appealing musical language for today’s trial participants and, thus, he decided to curate a new selection based on the insights of pioneering psychedelic therapists. In the process, Dr Kaelen came to realize the importance of setting variables during the psychedelic experience and developed an unique line of research exploring the role of music in the therapeutic process. “We should not only look at the drug,” he emphasized during his talk at ICPR2020, “we should look at how music and psychedelics interact with each other to better understand how this therapy works and how we can actually leverage and enhance therapy outcomes.” With this in mind, he founded Wavepaths, a startup that, based on cutting-edge neuroscientific research, is aiming to develop tools to optimise the therapeutic benefits of music and psychedelics.
Guiding Patients with Music
Music provides direction to the psychedelic journeyer, and when properly employed, it can offer a sense of structure to the patient’s experience. “Whenever psychedelic therapists refer to psychedelic therapy as non-directive I strongly disagree,” adds Dr Kaelen challenging one of the supposed key features of the drug-assisted model, “the fact that we provide a medicine that enhances suggestibility and mental flexibility and then play very evocative music on top of that makes it a very directive form of therapy.” Under a state in which the usual linguistic channels may be disrupted, music becomes a useful language to catalyze meaningful and healing experiences. According to Helen Bonny: “It is the wordless meaning of music which provides its power of direction and emotional structure.” This is, however, a double-edged sword. While carefully selected music can be utilized to further therapeutic goals, playlists that do not resonate personally may make the patients distance themselves from the experience and jeopardize their feelings of trust and safety.
Patients in clinical trials often talk about a feeling of being carried on a journey in which the music is experienced as the vehicle that carries the listener across different mental spaces. Music also enhances the intensity of emotions and helps patients surrender to the experience. Patients under psilocybin may offer resistance and experience difficulties to completely let go. Some researchers have reported that in such cases, changes in music have proved useful at breaking through these defense mechanisms and triggering deeply emotional catharsis.
Although the important role of music in psychedelic therapy has been established, there is still much to learn about how to optimize and tailor the musical experience to the individual patients and the particular therapeutic process they are going through. So far, clinical research has used standard preselected music playlists across participants and not so much experimentation with music has taken place given the risks of inducing negative experiences. One of Dr Kaelen’s goals with Wavepaths is to match music selection to the idiosyncrasies of every individual patient. He brings an illustrative analogy to make this point: “If I have been listening to classical music my entire life and suddenly I have a psychedelic session with primarily electronic ambient music, it is almost the same as if I, a Dutch-speaker, went through talk therapy with someone who speaks Chinese.”
Furthermore, music selection can also be matched with the very pharmacokinetics of the psychedelic substance. Already in the 70s, therapists distinguished between a number of phases in the psychedelic session with different therapeutic functions. While in the early stages before and during onset, calm music helps to create a climate of reassurance and safety, it is during the peak phase that the therapist should play evocative music that supports the engagement with intense emotions.
Experience as Medicine
Increasingly, researchers are realizing the value of the experiential aspects of psychedelic therapy. The role of music shows how the more personally meaningful the experience, the stronger the symptom reduction. This emphasis on inducing a transformational experience through the synergistic effects of drugs, music and context makes psychedelic therapy a unique treatment paradigm in mental health. Within Wavepaths projects, Dr Kaelen is partnering with experience-designers and musicians in order to explore the potential of this experiential approach to therapy, and for example, looking at how to facilitate psychedelic experiences without administering psychedelic drugs.
If you want to learn more about how to best use music during psychedelic sessions, Dr Kaelen will facilitate an online workshop focused on practical skills about how to tailor music selection to the needs of the patient and the therapeutic process.