ArticlePDF AvailableLiterature Review

Psychedelics and music: neuroscience and therapeutic implications



From the beginning of therapeutic research with psychedelics, music listening has been consistently used as a method to guide or support therapeutic experiences during the acute effects of psychedelic drugs. Recent findings point to the potential of music to support meaning-making, emotionality, and mental imagery after the administration of psychedelics, and suggest that music plays an important role in facilitating positive clinical outcomes of psychedelic therapy. This review explores the history of, contemporary research on, and future directions regarding the use of music in psychedelic research and therapy, and argues for more detailed and rigorous investigation of the contribution of music to the treatment of psychiatric disorders within the novel framework of psychedelic therapy.
Full Terms & Conditions of access and use can be found at
International Review of Psychiatry
ISSN: 0954-0261 (Print) 1369-1627 (Online) Journal homepage:
Psychedelics and music: neuroscience and
therapeutic implications
Frederick S. Barrett, Katrin H. Preller & Mendel Kaelen
To cite this article: Frederick S. Barrett, Katrin H. Preller & Mendel Kaelen (2018): Psychedelics
and music: neuroscience and therapeutic implications, International Review of Psychiatry, DOI:
To link to this article:
Published online: 21 Sep 2018.
Submit your article to this journal
Article views: 33
View Crossmark data
Psychedelics and music: neuroscience and therapeutic implications
Frederick S. Barrett
, Katrin H. Preller
and Mendel Kaelen
Department of Psychiatry and Behavioral Sciences, Behavioral Pharmacology Research Unit, Johns Hopkins University School of
Medicine, Baltimore, MD, USA;
Neuropsychopharmacology and Brain Imaging, Department of Psychiatry Psychotherapy and
Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland;
Department of Psychiatry, Yale University School of
Medicine, New Haven, CT, USA;
Psychedelic Research Group, Department of Medicine, Imperial College London, London, UK;
Wavepaths Ltd, London, UK
From the beginning of therapeutic research with psychedelics, music listening has been consist-
ently used as a method to guide or support therapeutic experiences during the acute effects of
psychedelic drugs. Recent findings point to the potential of music to support meaning-making,
emotionality, and mental imagery after the administration of psychedelics, and suggest that
music plays an important role in facilitating positive clinical outcomes of psychedelic therapy.
This review explores the history of, contemporary research on, and future directions regarding
the use of music in psychedelic research and therapy, and argues for more detailed and rigor-
ous investigation of the contribution of music to the treatment of psychiatric disorders within
the novel framework of psychedelic therapy.
Received 11 February 2018
Accepted 30 May 2018
Psychedelic; hallucinogen;
LSD; psilocybin; music;
music therapy; music;
Classic psychedelic drugs
are being investigated for
the treatment of psychiatric disorders, such as
addiction (Bogenschutz et al., 2015; Johnson, Garcia-
Romeu, Cosimano, & Griffiths, 2014), end-of-life
distress (Griffiths et al., 2016; Grob et al., 2011; Ross
et al., 2016), and depression (Carhart-Harris et al.,
orio et al., 2015; Sanches et al., 2016).
Although mood and substance use disorders have a
long time-course and uncertain prognosis when
treated with currently available methods, psychedelic
therapies are showing great promise. Recent studies
demonstrate positive behavioural outcomes, including
clinically relevant reduction in self-report and clin-
ician-rated disorder severity (Bogenschutz et al., 2015;
Carhart-Harris et al., 2016a; Griffiths et al., 2016;
orio et al., 2015; Ross et al., 2016; Sanches et al.,
2016), physiological outcomes, including breath car-
bon monoxide and urine cotinine (Johnson et al.,
2014), and, in one case, modulation of potential
neurobiological correlates of mood disorders
(Carhart-Harris et al., 2017; Roseman, Nutt, &
Carhart-Harris, 2018). Given that only one or a small
number (i.e. 2) of psychedelic therapy sessions can
bring acute and sustained symptom improvements,
psychedelic therapies represent a strong departure
from the common medical model of chronic, daily
pharmacotherapy and/or counselling as treatment.
A central principle in psychedelic therapy is that
the quality of subjective experiences during acute
drug effects predict (Roseman et al., 2018) and medi-
ate (Griffiths et al., 2016; Ross et al., 2016) clinical
outcomes. Music listening during acute drug effects
has been a consistent feature of both research and
therapeutic administration of psychedelics, as a
method to guide or support experiences (Eisner &
Cohen, 1958). Although music delivery during psy-
chedelic therapy is not standardized, and methods
used to select music for psychedelic therapy are
largely untested, there may be some consistency in
the features of music that are used to support
therapeutic experiences (Barrett, Robbins, Smooke,
Brown, & Griffiths, 2017b). Recent findings point to
the potential of psychedelics to support meaning-
making (Preller et al., 2017), emotion (Carbonaro,
Johnson, Hurwitz, & Griffiths, 2018; Kaelen et al.,
2015; Kaelen et al., 2017), and mental imagery (Kaelen
et al., 2016) during music listening, and suggest that
music plays an important role in facilitating positive
clinical outcomes of psychedelic therapy (Kaelen et al.,
CONTACT Frederick S. Barrett, PhD Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of
Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA
All authors contributed equally to this work.
ß2018 Institute of Psychiatry and Johns Hopkins University
2018). In this review, we will explore the history of,
contemporary research on, and future directions
regarding the use of music in psychedelic research
and therapy, and argue for more detailed and rigor-
ous investigation of the contribution of music to the
treatment of psychiatric disorders within the novel
framework of psychedelic therapy.
The history of music and
psychedelic therapies
Music is ubiquitous in society and throughout known
history. The earliest known musical instrument, a
sophisticated bone flute, dates back at least 35 000
years (Conard, Malina, & M
unzel, 2009), but recorded
music history begins much more recently (Burkholder,
Grout, & Palisca, 2010). The earliest records in
music history document the use of music in religious
worship, such as plainchant (including Gregorian
Chant), and later in maintaining local and cultural
histories, as in the medieval troubadours and
trouveres (Burkholder et al., 2010). Theories of the
origins of music suggest that music evolved to sup-
port emotional communication (Juslin & Vastfjall,
2008; Snowdon, Zimmermann, & Altenm
uller, 2015),
and may even have developed before more formal
spoken language (Brandt, Slevc, & Gebrian, 2012;
Panksepp, 2009). Theories that associate the co-evo-
lution of language and music gain traction when we
consider that the preponderance of brain regions
that track syntactic components (Koelsch, 2011) and
time-varying structures (Janata et al., 2002)inmusic
are also brain regions critical for language processing
(Levitin & Menon, 2003;Patel,2008;Sch
et al., 2010).
Alternative evolutionary theories focus on social
functions of music or view music as a product of sex-
ual selection (Hauser & McDermott, 2003). Although
a consensus on biological origins of music is yet to be
found, an increasing number of empirical studies
illustrate a diverse significance of music in human
development and culture. Research with infants indi-
cates biological predispositions for melody-perception
(Trehub, 2001), which likely serves an important
social function (Mehr, Song, & Spelke, 2016), and
cross-cultural studies show a universal singing of
lullabies by mothers (Trehub & Trainor, 1998). Cross-
cultural studies have also provided evidence that
emotional content can be universally perceived as being
associated with acoustic properties of music (Fritz
et al., 2009; Laukka, Eerola, Thingujam, Yamasaki, &
Beller, 2013). Emotional responses to music occur
reliably in young children (Dalla Bella, Peretz,
Rousseau, & Gosselin, 2001;Mote,2011) and occur
continuously in daily life (Juslin, Liljestrom, Vastfjall,
Barradas, & Silva, 2008). Across the globe, music is
an important element of diverse aspects of life, rang-
ing from work, entertainment, and social settings to
medicine and spirituality (Hargreaves & North, 1999;
Merriam, 1964;Nettl,1956).
For the present discussion, the medicinal and spir-
itual usage of music is particularly relevant. Although
the use of music may be diverse, traditionally cultures
often place a special emphasis on musics capacity to
facilitate altered states of consciousness, and historic-
ally music-making has been a respected role reserved
for priests or medicine-men (Nettl, 1956).
Contemporary research on music listening has begun
to address musics capacity to engender or support
altered states, including emotionally intense peak
experiences (Gabrielsson, 2011), absorption (Sandstrom &
Russo, 2013), groove and flow states (Cs
1990; Janata, Tomic, & Haberman, 2012), trance (Hove
et al., 2016;Rouget,1985), and states of religious
ecstasy (Penman & Becker, 2009).
Similar to the use of music, archeology suggests
ancient roots for the use of psychedelics. Cave art
depicting mushrooms in Algeria (Lajoux, 1964;
Samorini, 1992) and Spain (Akers, Ruiz, Piper, &
Ruck, 2011) are dated to be 70009000 years old;
40005600 year old specimens of psychedelic plants
and seeds are found across North, Central, and South
America (Bruhn, De Smet, El-Seedi, & Beck, 2002; El-
Seedi, De Smet, Beck, Possnert, & Bruhn, 2005;
Torres, 1998), and 20003000 year old mushroom-
shaped stones were uncovered in Guatemala (de
Borhegyi, 1963; Guerra-Doce, 2015). Many traditional
societies preserved their use of psychedelics until
today in a medicinal and spiritual context (Schultes,
Hofmann, & R
atsch, 2001), and modern research has
demonstrated psychedelics can reliably facilitate spirit-
ual-type experiences (Bogenschutz & Johnson, 2016;
Carhart-Harris et al., 2017; Garcia-Romeu, Griffiths, &
Johnson, 2015; Griffiths, Richards, McCann, & Jesse,
2006; Griffiths et al., 2011,2016; Roseman et al., 2018;
Ross et al., 2016).
Traditional medicinal and spiritual practice with
psychedelics was most likely combined with music
(Nettl, 1956). Icaros, or ritual songs, are a universal
component of traditional ayahuasca ceremonies, and
are considered to be necessary to facilitate both phys-
ical and spiritual healing (Dobkin de Rios, 1984).
Music is also a central component within mushroom
ceremonies of the Mazatec Indians (Estrada, 1981),
the peyote ceremonies of Native Americans
(Maroukis, 2005), and the ibogaine rituals of Bwiti in
west-central Africa (Fernandez, 1982; Schultes et al.,
2001). In Europes antiquity, music was also specu-
lated to play a critical role in the Rites of Eleusis,
which involved imbibing a psychedelic mixture
(Wasson, Hofmann, & Ruck, 1978).
The synthesis of LSD (Hofmann, 1983) spurred a
large wave of psychiatric and neuroscience research
with psychedelics in the 1950s and 1960s. The thera-
peutic potential of psychedelics was heavily explored
(Busch & Johnson, 1950), and music was early on iden-
tified as a factor that can potentiate and influence drug
experiences significantly (Eagle, 1972; Eisner & Cohen,
1958; Gaston & Eagle, 1970). Soon, music was recog-
nized as an important element of the setting to support
the therapeutic process (Chandler & Hartman, 1960;
Eisner, 1997; Eisner & Cohen, 1958; Hoffer, 1965;
Holzinger, 1964). Emphasis was given to view music as
a therapeutic aid (Hoffer, 1965), and that, due to musics
profoundinfluence (Bonny & Pahnke, 1972), great
care and responsibility must be practiced in selecting
the music for patients individual therapeutic needs
(Bonny & Pahnke, 1972; Hoffer, 1965).
Studies reported profound alterations in a patients
perception of and response to music, and suggested
this underlies the usefulness of music as an adjunct to
psychedelic therapy. For example, Hoffer
(1965) noted:
Very often, sounds which normally have no
particular aesthetic appeal, were heard in a most
unusual manner. Subjects who were indifferent to
music, were enthralled by it. [ ] This property of
the experience is very useful in bringing out the
psychedelic reaction. Carefully selected music can be
very powerful in altering the subjects mood and
associations. (p. 204)
Studies investigating the effect of psychedelics on
auditory processing reported altered sensitivity and
tolerance to sound after the intake of LSD (Silverman,
1971), and have shown that, after the administration
of psilocybin, participants listening to music described
an intensive, exhilarating sound experience (Weber,
1967). One participant reported that she was for the
first time able to fully surrender to the music, while
at the same time she could not capture the structure
of the piece (Weber, 1967).
Subsequent early research on the therapeutic effects
of psychedelics included music listening as a consist-
ent feature during acute drug effects (Grof, 1980;
Grof, Goodman, Richards, & Kurland, 1973; Kurland,
1985; Kurland, Unger, Shaffer, & Savage, 1967;
Pahnke, Kurland, Goodman, & Richards, 1969;
Richards, 1979; Richards, Rhead, DiLeo, Yensen, &
Kurland, 1977). Guidelines for the use of music in
clinical settings were developed (Bonny & Pahnke,
1972), and clinical opinion suggested the use of spe-
cific musical pieces (Eisner, 1997), or styles of music
(Bonny & Pahnke, 1972) to support specific phases of
psychedelic experience (e.g. onset of effects,peak
intensity of drug action, and return to normal con-
sciousness) (Bonny & Pahnke, 1972). Consequently,
modern guidelines for safe use of psychedelics in
research recommend the use of music listening as a
critical element of the therapeutic setting (Johnson,
Richards, & Griffiths, 2008). The use of music to sup-
port specific experiences during psychedelic therapy
has been typically framed and characterized in terms
of supporting specific emotional experiences, such as
peak or mystical experiences
or emotional catharsis
(Bonny & Pahnke, 1972).
Contemporary research on the
neuropsychobiology of music and
Music listening has been shown to engage a wide
range of domain-general brain areas, including those
associated with reward, emotion, and memory proc-
essing (Barrett & Janata, 2016; Blood & Zatorre, 2001;
Salimpoor, Benovoy, Larcher, Dagher, & Zatorre,
2011; Salimpoor et al., 2013). Brain regions recruited
during music listening overlap at least partially with
brain regions where activity and connectivity are
altered after the administration of psychedelics
(Carhart-Harris et al., 2012a; Carhart-Harris et al.,
2016b; Preller et al., 2017). Psychedelic drugs have
notable effects on auditory perception (Hoffer, 1965;
Silverman, 1971; Timmermann et al., 2017; Umbricht
et al., 2003; Weber, 1967). This follows from the
neurobiology of both psychedelic drugs (serotonin
2A, or 5-HT
, receptor agonists) and the neurobiol-
ogy of auditory processing. Brainstem serotonergic
neurons have been implicated in selective neuronal
responses to auditory stimuli (Hall, Rebec, & Hurley,
2010; Hurley & Pollak, 1999), and 5-HT
has specifically been shown to alter neuronal
responses to auditory stimuli from the cochlear
nucleus (Tang & Trussell, 2015), through the pre-cor-
tical primary auditory sensory pathway (Hurley, 2006;
Hurley & Sullivan, 2012), through to the primary
auditory cortex (Riga, Bortolozzi, Campa, Artigas, &
Celada, 2016) and auditory cortical neurons (Luo, Hu,
Liu, Guo, & Wang, 2016).
Investigating the neurobiological mechanisms
underlying psychedelic-induced alterations in auditory
processing, modern neuroimaging studies reported a
reduced N1 sensory EEG-ERP, suggesting reduced
processing of intensity of auditory stimuli under
psilocybin (Umbricht et al., 2003), and altered audi-
tory sensitivity measured with MEG under LSD
(Timmermann et al., 2017). Empirical studies further
investigated music processing after the administration
of LSD, while participants underwent functional mag-
netic resonance imaging (Barrett, Preller, Herdener,
Janata, & Vollenweider, 2017a; Kaelen et al., 2016,
2017; Preller et al., 2017). These studies revealed that
LSD alters the perception of the acoustic properties of
music. In particular, LSD increased the BOLD signal
in response to timbral complexityindicative of the
complexity of the musics spectral distributionin
brain networks associated with music perception and
emotion, i.e. the auditory cortices, inferior frontal
gyrus (IFG), insula, precuneus, striatum, and the sup-
plementary motor area (SMA; Kaelen et al., 2017).
Additionally, processing of high timbral complexity was
associated with increased coupling of the precuneus
with the right superior frontal gyrus and decreased cou-
pling of the precuneus with the right IFG and auditory
cortex after LSD administration (Kaelen et al., 2017).
LSD was further shown to influence the neural response
to the time-varying tonal structure of musican effect
that was predominantly attributable to LSDs agonist
activity on the 5-HT
receptor (Barrett et al., 2017a).
LSD enhanced tonality tracking in areas that respond to
music and speech, as well as higher cognitive areas such
as the superior temporal cortex, the IFG, medial pre-
frontal brain regions, the angular gyrus, and the amyg-
dala (Barrett et al., 2017a).
Preller et al. (2017) showed enhanced meaningful-
ness perceived in music under LSD, associated with
greater BOLD activations in regions previously linked
to music-listening, emotion, and autobiographical
memory, including the SMA, putamen, insula, and the
PCC. Kaelen et al. (2016) demonstrated that an inter-
action between LSD and music lead to increased infor-
mation flow (effective connectivity) from the
parahippocampus towards the visual cortex, and this
effect correlated with enhanced mental visual imagery
and seeing autobiographical scenes (Kaelen et al., 2016).
Together, these results indicate that psychedelics signifi-
cantly modulate the brains processing of music, and
these effects may explain the altered subjective experi-
ence of music under psychedelics (Barrett et al., 2017a;
Kaelen et al., 2016,2017; Preller et al., 2017).
How do music and psychedelics interact to
promote healing?
Music supports emotional experiences
A prime motivation for many people to listen to
music is to modulate emotion (Berlyne, 1971; Sch
Sedlmeier, St
adtler, & Huron, 2013), and the emo-
tion-arousing properties of music arguably comprise
one important motivation for the application of music
therapy in the treatment of various psychiatric
erez, G
erez, Velasco, P
erez-Campos, &
Mayoral, 2010; Erkkil
aetal.,2011; Zhao, Bai, Bo, &
Chi, 2016) and neurological diseases (Fakhoury,
Wilhelm, Sobota, & Kroustos, 2017; Hohmann, Bradt,
Stegemann, & Koelsch, 2017; Leubner & Hinterberger,
2017). Emotionally intense chill-inducingeffects of
music are common (Panksepp, 1995) and empirically
studied (Grewe, Nagel, Kopiez, & Altenm
uller, 2005;
Harrison & Loui, 2014;Mori&Iwanaga,2014;
Salimpoor, Benovoy, Longo, Cooperstock, & Zatorre,
2009). However, the mechanisms through which music
can modulate emotional experience are many
and varied.
Different classes of determinants, from acoustic
and musical features of individual stimuli (Coutinho &
Cangelosi, 2009;Hevner,1937; Leman, Vermeulen,
De Voogdt, Moelants, & Lesaffre, 2005; Maher, 1980),
to personal associations people have made with music
(Barrett et al., 2010; Janata, Tomic, & Rakowski,
2007), to more abstract concepts such as preference
traits and personality (Dollinger, 1993; Rawlings &
Ciancarelli, 1997; Rentfrow & Gosling, 2003;
Rentfrow, Goldberg, & Levitin, 2011; Zweigenhaft,
2008), have been shown to influence the emotions
that are experienced during music listening (see also
Juslin & Vastfjall, 2008). Liking, in particular (e.g. a
persons affinity for a particular piece of music), is
shown to influence the emotions experienced with
music significantly (Juslin, 2013; Juslin & Vastfjall,
2008; North & Hargreaves, 1997), and it may be the
case that liking moderates the effect of musical fea-
tures and familiarity on music-evoked emotions
(North & Hargreaves, 1995). Consistent with previous
theoretical perspectives (Berlyne, 1971), liking may act
as an index for the emotional utility of a musical
stimulus, thus functioning as a gatekeeperor filter
for the subsequent effects of the music on the
listeners emotional state.
The effects of psychedelics, however, are concep-
tualized as a relinquishment of the normal filters the
selfutilizes to regulate its internal milieu (Barrett &
Griffiths, 2018; Carhart-Harris et al., 2014). Thereby,
psychedelics may diminish the usual regulatory proc-
esses of music-evoked emotion and allow a fuller
processing of music and the features of the music
that evoke emotion. Support for this hypothesis can
be found in both psychopharmacological and neuroi-
maging investigations. In a comparative psycho-
pharmacology study, volunteers reported far greater
absorption in music, as well as greater perceived
beauty and significance of music, during the acute
effects of psilocybin than during placebo or the
acute effects of dextromethorphan (an NMDA antag-
onist and dissociative hallucinogen) (Carbonaro
et al., 2018). Kaelen et al. (2017) demonstrated an
association between intensified music-evoked emo-
tion and enhanced BOLD activation to musics tim-
bral complexitytimbre (tone colour) being
associated with conveying emotional information in
music (Eerola, Ferrer, & Alluri, 2012; Hailstone
et al., 2009).
Psychedelics indeed have been shown to not only
alter the processing of acoustic properties of music,
but also the psychological and emotional reaction to
it (Kaelen et al., 2015,2017; Preller et al., 2017).
Intensification of emotion and mental imagery by
music was a primary motivation for the use of music
in psychedelic therapy in the 1950s and 1960s (Bonny
& Pahnke, 1972), and has been most frequently
reported by patients undergoing psychedelic therapy
(Kaelen et al., 2018). To illustrate, one patient from
Kaelen et al. (2018) reported:
Under the influence of psilocybin the music
absolutely takes over. Normally when I hear a piece
of sad music, or happy music, I respond through
choice, but under psilocybin I felt almost that I had
no choice but to go with the music. (p. 10)
(For more insight in patients experiences of music,
see Supplementary materials in Kaelen et al., 2018).
One way the intensifying effects of psychedelics
on music-evoked emotion may support the therapy
is by contributing to the occurrence of mystical
experiences during psychedelic therapy sessions
(Barrett & Griffiths, 2018; Kaelen et al., 2018), which
have been associated with positive therapeutic out-
comes (Barrett & Griffiths, 2018; Johnson &
Griffiths, 2017). LSD has been shown to enhance
emotional features of mystical-experiences (Kaelen
et al., 2015,2017), and psilocybin has been shown
to enhance absorption in and the beauty and signifi-
cance of music (Carbonaro et al., 2018), and the
music-experience of patients in psychedelic therapy
has been associated with the occurrence of mystical-
experiences (Kaelen et al., 2018). Furthermore,
Lebedev et al. (2016) showed that LSD-induced
increases in entropic brain dynamics were related
with subsequent increases in personality trait open-
ness, only during the music-listening condition, indi-
cating that music may drive brain dynamics
important for the occurrence of experiences that
have long-lasting beneficial effects (Lebedev
et al., 2016).
Finally, music in therapy is effective in reducing
stress and anxiety (Chanda & Levitin, 2013), and,
consistent with earlier reports (Bonny & Pahnke,
1972), music is reported to provide a sensation of
calm, safety, and support for patients in psychedelic
therapy (Kaelen et al., 2018). Hence, in addition to
evoking strong emotionality, music may play an
important role in reducing emotional arousal too,
helping the patient to find meaningful resolutions to
transient psychological struggles that are not uncom-
mon in psychedelic therapy (Barrett, Bradstreet,
Leoutsakos, Johnson, & Griffiths, 2016; Belser et al.,
Carhart-Harris, 2017).
Music supports autobiographical meaning-making
Another potential effect through which psychedelics
and music interact on the therapeutic process was
described by Preller et al. (2017). This study showed
that LSD increases the attribution of personal mean-
ing to music, in particular to music pieces which
were not particularly meaningful to participants in
the placebo condition. This effect was associated with
an increased BOLD signal in the cortical midline
structures, brain areas which are associated with self-
referential processing (Northoff & Bermpohl, 2004;
Preller et al., 2017), and was dependent on 5-HT
receptor stimulation (Preller et al., 2017). These brain
regions have been shown to be clinically relevant in
psychiatric disorders and might also be involved in
the therapeutic response to LSD (Moeller &
Goldstein, 2014; Northoff & Bermpohl, 2004). The
ability of LSD to increase perceived meaningfulness
can contribute to mystical experiences which have
been shown to be related to beneficial therapeutic
outcome. Furthermore, by altering brain activity in
regions important for self-referential processing, as
well as at the same time increasing the meaningful-
ness of the environment, patients may become more
accepting and open to changes (Halberstadt, 2017).
Therefore, the potential of psychedelics to enhance
perceived meaningfulness could contribute to benefi-
cial therapeutic outcomes, particularly in disorders
with altered self-referential processing such as depres-
sion (Halberstadt, 2017).
A further study by Kaelen et al. (2016) showed
that LSD and music interact to increase effective con-
nectivity from the parahippocampal cortex to the vis-
ual cortex, and the magnitude of this effect correlated
with increased visual mental imagery and ratings for
seeing autobiographical scenes from the past (Kaelen
et al., 2016). LSD-induced enhancement of autobio-
graphical memories, and associated with this the
potential reversal of negative cognitive biases, might
be associated with beneficial therapy outcome
(Carhart-Harris et al., 2012b; Kraehenmann et al.,
2015; Vollenweider & Kometer, 2010). Together, these
studies offer a mechanistic explanation on how LSD
together with music stimulates autobiographically
meaningful processes, and suggests that music could
be a tool to facilitate this process during psyche-
delic therapy.
Implications for psychedelic therapy
The capacity of psychedelic therapy to facilitate acute
and sustained therapeutic changes represents a prom-
ising direction in mental healthcare, and a significant
deviation from conventional treatments, both in terms
of administration of the drug and in the underlying
theoretical frameworks. Hence, an empirical under-
standing of the different components of this new
paradigm of therapy is critical to offer evidence-based
guidelines for researchers and therapists. The present
paper focuses on music, as this is one dominant com-
ponent in the therapeutic model, and this section will
discuss how the previously reviewed research on psy-
chedelics and music begins to inform an evidence-
based use of music in psychedelic therapies.
Studies reviewed previously indicate an enhanced
emotional and psychological responsivity to music
under psychedelics. While evidence exists for poten-
tial therapeutic effects of psychedelic drugs absent of
music listening (Sanches et al., 2016), patients often
emphasize the significant influence of music on their
experience in psychedelic therapy (Belser et al., 2017;
Swift et al., 2017; Watts et al., 2017). It has been dem-
onstrated that the music-experience during psyche-
delic therapy correlates with the occurrence of
mystical experiences and insightfulness during psy-
chedelic therapy, and with reductions in clinical
symptoms 1 week after the session, and that calming
effects of music are welcome and potentially beneficial
during onset, ascent, and return phases of the psyche-
delic experience (Kaelen et al., 2018). Together, these
findings provide a body of evidence that music can be
a potent medium to modulate emotion and meaning-
making, to facilitate experiences that have strong
therapeutic significance.
As the quality of the music experience has been
associated with therapy outcomes, and, more specific-
ally, a music-experience characterized by personal
resonance(Kaelen et al., 2018), the music-selection
requires a thoughtful optimization to the individual
patient. Although tailoring the music to the dynamic
needs of the individual patient is standard practice in
MDMA-assisted psychotherapy (Mithoefer, Wagner,
Mithoefer, Jerome, & Doblin, 2011), most studies
with classic psychedelics have prioritized a standar-
dized approach, where all patients listen to the same
music playlist. Although from a research perspective
this may be desirable, this can jeopardize the thera-
peutic experience of some patients significantly
(Kaelen et al., 2018). Standardization of the process
that generates patient-specific music, rather than sim-
ply standardizing the mere presence of the music,
may harmonize research-standards with the human-
centred practice inherent in the therapy model, and is
likely to optimize patient-experiences and ther-
apy outcomes.
While we have attempted to present a thorough
review of studies that inform our understanding of
the interaction between music and psychedelic experi-
ences, there are several limitations to our review.
First, many of the earlier reports of the relationship
between psychedelics and music listening lacked the
rigour of modern experimental controls (e.g. reviewed
in Eisner & Cohen, 1958 and Richards, 1979) or were
largely based on observation and clinical opinion (e.g.
Bonny & Pahnke, 1972). In addition, many recent
reports, especially those involving clinical outcomes,
were open-label studies (e.g. Bogenschutz et al., 2015;
Carhart-Harris et al., 2016a; Johnson et al., 2014;
orio et al., 2015; Sanches et al., 2016). While a
number of recent reports did involve placebo or
active control as well as single-blind (e.g. Kaelen
et al., 2015,2017) or double-blind randomized condi-
tions (e.g. Barrett et al., 2017a; Carbonaro et al., 2018;
Griffiths et al., 2016; Preller et al., 2017; Ross et al.,
2016), some of the reports cited in this review
involved multiple analyses of data from the same
sample (e.g. Barrett et al., 2017a; Carhart-Harris et al.,
2016a,2017; Preller et al., 2017; Roseman et al.,
2018). While we have reviewed the nascent literature
on the interaction between music and psychedelic
experiences, which is growing, the field has yet to
develop a literature sufficient to support a meaningful
systematic review, but we hope that this review will
stimulate further structured research in this field.
Future directions
The current state of research regarding psychedelics
and music presents several limitations and necessities
for future research. The studies reviewed were the first
to assess the combined effects of music and psyche-
delics on subjective experience and brain function, and
these findings, therefore, implicate the need of their
replication and expansion in independent future stud-
ies. Future studies that enable a better separation
between music- and drug-conditions are also necessary
to deepen our understanding of their interactive effects
on subjective experience and therapy outcomes. In
therapeutic contexts, studies involving one group of
patients undergoing psychedelic therapy with music,
and one group without any music, will be needed to
reveal both the magnitude and the nature of the thera-
peutic effects of music. With respect to the latter, stud-
ies on the nature of the therapeutic effects of music
can provide important insights into key therapeutic
processes at play, and the different ways these can be
best supported, with and without music.
Furthermore, studies are needed that compare the
relative contribution of music to the therapeutic
experience and outcome to other factors present
during therapy sessions, such as interpersonal factors
and physical environment. Future studies can help
us to better understand the interactions between the
psychological context of the patient (mood, attitudes,
expectations, personality-traits) and the patients sub-
jective experience of music, both with and without
psychedelics. Future studies must also address how
music can be tailored to the time-phase within the
drug-experience, and assess whether any music gen-
res, composition features, or acoustic features in par-
ticular are suitable for the facilitation of therapeutic
experiences. Related to this, the role of an individu-
alsmusic-listening history and its relationship to the
music-experience under a psychedelic remains to
be clarified, and, together with the above, will
aid the construction of empirical guidelines for
music-selection and playlist design during psyche-
delic therapy sessions. The choice of music in the
reviewed neuroimaging studies may have signifi-
cantly influenced their findings, and future studies
that use different genres or a multitude of musical
genres may be positioned to test hypotheses regard-
ing the effects of and appropriateness of different
styles of music in the context of psychedelic therapy.
Although individual variation in patientsmusic-
experience has been related to therapy outcomes,
there is little experimental insight into how music
can be adapted to optimize therapy outcomes.
Studying this is crucial to help define music-selection
protocols that are empirical and scalable, which
must include an accurate mapping of music with its
experience, given the psychological context of
the patient.
Finally, the subjectiveexperiences of music-listening
under a psychedelic can be remarkably profound,
indicating that their combined study may significantly
advance our understanding of human brain mecha-
nisms of music-perception and subjective experiences
of music, as well as the neural correlates of subjective
experiences that are normally difficult to access under
experimental conditions (for example, emotionally
intense peak experiences).
Psychedelics and music listening interact to produce
profound alterations in emotion, mental imagery, and
personal meaning. Research is beginning to unveil
underlying brain mechanisms, and to support a cen-
tral role of music in psychedelic therapy. Music
appears to influence the efficacy of therapy signifi-
cantly, through modulating emotion, including the
facilitating of mystical experiences, and through sup-
porting autobiographical processes. Acknowledging
the significance of music and the importance of rigor-
ous future empirical investigations in this young field
of research is key to improving our understanding of
psychedelic therapies, and key to improving the effi-
cacy of psychedelic therapies.
Disclosure statement
MK is a founder and shareholder in Wavepath Ltd. FSB
and KHP report no conflicts of interest. The authors alone
are responsible for the content and writing of the paper.
FSB was supported in part by NIH grants R03DA042336
and a grant from the Heffter Research Institute. KHP was
supported by the SNSF grant P2ZHP1_161626.
1. Classicpsychedelics produce a range of idiosyncratic
and often profound subjective effects via agonist
actions on the serotonin 2A receptor. Examples of
classic psychedelics include lysergic acid diethylamide
or LSD, psilocybin, found in hundreds of species of
psychoactive mushrooms, dimethyltryptamine or
DMT, found in the Psychotria viridis and Diplopterys
cabrerana plants used to brew ayahuasca, and
mescaline, found in some psychoactive cacti. The term
psychedelic is derived from merging the Greek word
psyche, meaning mind or soul, with delos, meaning to
unveil or make visible effects.
2. Peak experiences with psychedelic drugs were first
defined by Pahnke et al. (Pahnke, 1963; Pahnke et al.,
1969) as sharing common features with non-drug
mystical experiences. Peak/mystical experiences are
characterized by an experience of unity (with ones
self, ones surroundings, some or all people, or all that
exists), loss of ones usual sense of space and time,
deeply felt positive mood, the felt sense that the
experience involves some fundamental truth (noetic
quality), difficulty putting the experience into words
(ineffability), a felt sense of sacredness, transiency, and
paradoxicality (simultaneously containing contradictory
feelings, thoughts, experiences, or characteristics).
Frederick S. Barrett
Akers, B. P., Ruiz, J. F., Piper, A., & Ruck, C. A. P. (2011).
A prehistoric mural in Spain depicting neurotropic psilo-
cybe mushrooms? Economic Botany,65(2), 121128.
Retrieved from
Barrett, F. S., & Griffiths, R. R. (2018). Classic hallucino-
gens and mystical experiences: Phenomenology and
neural correlates. Current Topics in Behavioral
Neurosciences,36, 393430. doi:10.1007/7854_2017_474
Barrett, F. S., & Janata, P. (2016). Neural responses to nos-
talgia-evoking music modeled by elements of dynamic
musical structure and individual differences in affective
traits. Neuropsychologia,91, 234246. doi:S0028-
3932(16)30303-7 [pii]
Barrett, F. S., Bradstreet, M. P., Leoutsakos, J. S., Johnson,
M. W., & Griffiths, R. R. (2016). The challenging experi-
ence questionnaire: Characterization of challenging expe-
riences with psilocybin mushrooms. Journal of
Psychopharmacology,30(12), 12791295. doi:10.1177/
Barrett, F. S., Grimm, K. J., Robins, R. W., Wildschut, T.,
Sedikides, C., & Janata, P. (2010). Music-evoked nostal-
gia: Affect, memory, and personality. Emotion
(Washington, D.C.),10(3), 390403. doi:10.1037/
Barrett, F. S., Preller, K. H., Herdener, M., Janata, P., &
Vollenweider, F. X. (2017a). Serotonin 2A receptor sig-
naling underlies LSD-induced alteration of the neural
response to dynamic changes in music. Cerebral Cortex.
Advance online publication. doi:10.1093/cercor/bhx257.
Barrett, F. S., Robbins, H., Smooke, D., Brown, J. L., &
Griffiths, R. R. (2017b). Qualitative and quantitative fea-
tures of music reported to support peak mystical experi-
ences during psychedelic therapy sessions. Frontiers in
Psychology,8(1238), 112. doi:10.3389/fpsyg.2017.01238
Belser, A. B., Agin-Liebes, G., Swift, T. C., Terrana, S.,
Devenot, N., Friedman, H. L., Ross, S. (2017). Patient
experiences of psilocybin-assisted psychotherapy: An
interpretative phenomenological analysis. Journal of
Humanistic Psychology,57(4), 354388. doi:10.1177/
Berlyne, D. E. (1971). Aesthetics and psychobiology. New
York: Appleton-Century-Crofts.
Blood, A. J., & Zatorre, R. J. (2001). Intensely pleasurable
responses to music correlate with activity in brain
regions implicated in reward and emotion. Proceedings of
the National Academy of Sciences of the United States of
America,98(20), 1181811823. doi:10.1073/
Bogenschutz, M. P., & Johnson, M. W. (2016). Classic hal-
lucinogens in the treatment of addictions. Progress in
Neuro-Psychopharmacology & Biological Psychiatry,64,
250258. doi:10.1016/j.pnpbp.2015.03.002
Bogenschutz, M. P., Forcehimes, A. A., Pommy, J. A.,
Wilcox, C. E., Barbosa, P. C., & Strassman, R. J. (2015).
Psilocybin-assisted treatment for alcohol dependence: A
proof-of-concept study. Journal of Psychopharmacology
(Oxford, England),29(3), 289299. doi:10.1177/
Bonny, H. L., & Pahnke, W. N. (1972). The use of music in
psychedelic (LSD) psychotherapy. Journal of Music
Therapy,9(2), 87.
Brandt, A. K., Slevc, R., & Gebrian, M. (2012). Music and
early language acquisition. Frontiers in Psychology,
3(327), 117. doi:10.3389/fpsyg.2012.00327
Bruhn, J. G., De Smet, P. A. G. M., El-Seedi, H. R., & Beck,
O. (2002). Mescaline use for 5700 years. Lancet (London,
England),359(9320), 1866. doi:10.1016/S0140-
Burkholder, J. P., Grout, D. J., & Palisca, C. V. (2010). Aoe
history of western music (8th ed.). New York: Norton.
Busch, A. K., & Johnson, W. C. (1950). L.S.D. 25 as an aid
in psychotherapy; preliminary report of a new drug.
Diseases of the Nervous System,11(8), 241. Retrieved
Carbonaro, T. M., Johnson, M. W., Hurwitz, E., &
Griffiths, R. R. (2018). Double-blind comparison of the
two hallucinogens psilocybin and dextromethorphan:
Similarities and differences in subjective experiences.
Psychopharmacology,235(2), 521534. doi:10.1007/
Carhart-Harris, R. L., Bolstridge, M., Rucker, J., Day,
C. M. J., Erritzoe, D., Kaelen, M., Nutt, D. J. (2016a).
Psilocybin with psychological support for treatment-
resistant depression: An open-label feasibility study.
Lancet Psychiatry,3(7), 619627. doi:10.1016/S2215-
Carhart-Harris, R. L., Erritzoe, D., Williams, T., Stone,
J. M., Reed, L. J., Colasanti, A., Nutt, D. J. (2012a).
Neural correlates of the psychedelic state as determined
by fMRI studies with psilocybin. Proceedings of the
National Academy of Sciences of the United States of
America,109(6), 21382143. doi:10.1073/
Carhart-Harris, R. L., Leech, R., Hellyer, P. J., Shanahan,
M., Feilding, A., Tagliazucchi, E., Nutt, D. (2014).
The entropic brain: A theory of conscious states
informed by neuroimaging research with psychedelic
drugs. Frontiers in Human Neuroscience,8(20), 122.
Carhart-Harris, R. L., Leech, R., Williams, T. M., Erritzoe,
D., Abbasi, N., Bargiotas, T., Nutt, D. J. (2012b).
Implications for psychedelic-assisted psychotherapy:
Functional magnetic resonance imaging study with psilo-
cybin. The British Journal of Psychiatry: The Journal of
Mental Science,200(3), 238244. doi:10.1192/
Carhart-Harris, R. L., Muthukumaraswamy, S., Roseman,
L., Kaelen, M., Droog, W., Murphy, K., Nutt, D. J.
(2016b). Neural correlates of the LSD experience revealed
by multimodal neuroimaging. Proceedings of the National
Academy of Sciences of the United States of America,
113(17), 48534858. doi:10.1073/pnas.1518377113
Carhart-Harris, R. L., Roseman, L., Bolstridge, M.,
Demetriou, L., Pannekoek, J. N., Wall, M. B., Nutt,
D. J. (2017). Psilocybin for treatment-resistant depres-
sion: fMRI-measured brain mechanisms. Scientific
Reports,7(1), 13187. doi:10.1038/s41598-017-13282-7
erez, S., G
erez, V., Velasco, M. C., P
Campos, E., & Mayoral, M. (2010). Effects of music ther-
apy on depression compared with psychotherapy. The
Arts in Psychotherapy,37(5), 387390. doi:10.1016/
Chanda, M. L., & Levitin, D. J. (2013). The neurochemistry
of music. Trends in Cognitive Sciences,17(4), 179193.
Chandler, A. L., & Hartman, M. A. (1960). Lysergic acid
diethylamide (LSD-25) as a facilitating agent in psycho-
therapy. A.M.A. Archives of General Psychiatry,2(3),
286299. doi:10.1001/archpsyc.1960.03590090042008
Conard, N. J., Malina, M., & M
unzel, S. C. (2009). New
flutes document the earliest musical tradition in south-
western Germany. Nature,460(7256), 737740.
Coutinho, E., & Cangelosi, A. (2009). The use of spatio-
temporal connectionist models in psychological studies
of musical emotions. Music Perception: An Interdisciplinary
Journal,27(1), 115. doi:10.1525/mp.2009.27.1.1
alyi, M. (1990). Flow: The psychology of opti-
mal experience. New York: Harper & Row.
Dalla Bella, S., Peretz, I., Rousseau, L., & Gosselin, N.
(2001). A developmental study of the affective value of
tempo and mode in music. Cognition,80(3), 1.
de Borhegyi, S. F. (1963). Pre-Columbian pottery mush-
rooms from Mesoamerica. American Antiquity,28(3),
328338. doi:10.2307/278276
Dobkin de Rios, M. (1984). Visionary vine: Hallucinogenic
healing in the Peruvian amazon. Prospect Heights, IL:
Waveland Press. Retrieved from http://catalog.hathitrust.
Dollinger, S. J. (1993). Research note: Personality and music
preference: Extraversion and excitement seeking or open-
ness to experience? Psychology of Music,21(1), 7377.
Eagle, C. T. (1972). Music and LSD: An empirical study.
Journal of Music Therapy,9(1), 2336. doi:10.1093/jmt/9.1.23
Eerola, T., Ferrer, R., & Alluri, V. (2012). Timbre and affect
dimensions: Evidence from affect and similarity ratings
and acoustic correlates of isolated instrument sounds.
Music Perception: An Interdisciplinary Journal,30(1), 49.
Eisner, B. G. (1997). Set, setting, and matrix. Journal of
Psychoactive Drugs,29(2), 213. doi:10.1080/
Eisner, B. G., & Cohen, S. (1958). Psychotherapy with lyser-
gic acid diethylamide. The Journal of Nervous and
Mental Disease,127(6), 528539. doi:10.1097/00005053-
El-Seedi, H. R., De Smet, P. A. G .M., Beck, O., Possnert,
G., & Bruhn, J. G. (2005). Prehistoric peyote use:
Alkaloid analysis and radiocarbon dating of archaeo-
logical specimens of lophophora from texas. Journal of
Ethnopharmacology,101(13), 238242. doi:10.1016/
a, J., Punkanen, M., Fachner, J., Ala-Ruona, E.,
o, I., Tervaniemi, M., Gold, C. (2011).
Individual music therapy for depression: Randomised
controlled trial. The British Journal of Psychiatry: The
Journal of Mental Science,199(2), 132139. doi:10.1192/
Estrada, A. (1981). Maria Sabina: Her life and chants. Santa
Barbara, CA: Ross-Erikson.
Fakhoury, N., Wilhelm, N., Sobota, K. F., & Kroustos, K. R.
(2017). Impact of music therapy on dementia behaviors:
A literature review. The Consultant Pharmacist: The
Journal of the American Society of Consultant
Pharmacists,32(10), 623628. doi:10.4140/
Fernandez, J. W. (1982). Bwiti: An ethnography of the reli-
gious imagination in Africa. Princeton, NJ: Princeton
University Press.
Fritz, T., Jentschke, S., Gosselin, N., Sammler, D., Peretz, I.,
Turner, R., Koelsch, S. (2009). Universal recognition
of three basic emotions in music. Current Biology: CB,
19(7), 573576. doi:10.1016/j.cub.2009.02.058
Gabrielsson, A. (2011). Strong experiences with music: Music
is much more than just music. Oxford: Oxford University
Garcia-Romeu, A., Griffiths, R. R., & Johnson, M. W.
(2015). Psilocybin-occasioned mystical experiences in the
treatment of tobacco addiction. Current Drug Abuse
Reviews,7, 164.
Gaston, E. T., & Eagle, C. T. (1970). The function of music
in LSD therapy for alcoholic patients. Journal of Music
Therapy,7(1), 319. doi:10.1093/jmt/7.1.3
Grewe, O., Nagel, F., Kopiez, R., & Altenm
uller, E. (2005).
How does music arouse chills? Investigating strong
emotions, combining psychological, physiological, and
psychoacoustical methods. Annals of the New York
Academy of Sciences,1060, 446449. doi:10.1196/
Griffiths, R. R., Johnson, M. W., Carducci, M. A.,
Umbricht, A., Richards, W. A., Richards, B. D.,
Klinedinst, M. A. (2016). Psilocybin produces substantial
and sustained decreases in depression and anxiety in
patients with life-thretening cancer: A randomized
double-blind trial. Journal of Psychopharmacology,30(12),
Griffiths, R. R., Johnson, M. W., Richards, W. A., Richards,
B. D., McCann, U., & Jesse, R. (2011). Psilocybin occa-
sioned mystical-type experiences: Immediate and persist-
ing dose-related effects. Psychopharmacology,218(4),
649665. doi:10.1007/s00213-011-2358-5
Griffiths, R. R., Richards, W. A., McCann, U., & Jesse, R.
(2006). Psilocybin can occasion mystical-type experiences
having substantial and sustained personal meaning and
spiritual significance. Psychopharmacology,187(3), 268.
Grob, C. S., Danforth, A. L., Chopra, G. S., Hagerty, M.,
McKay, C. R., Halberstadt, A. L., & Greer, G. R. (2011).
Pilot study of psilocybin treatment for anxiety in patients
with advanced-stage cancer. Archives of General
Psychiatry,68(1), 7178. doi:10.1001/
Grof, S. (1980). LSD psychotherapy. Santa Cruz:
Multidisciplinary Association for Psychedelic Studies.
Grof, S., Goodman, L. E., Richards, W. A., & Kurland,
A. A. (1973). LSD-assisted psychotherapy in patients
with terminal cancer. International Pharmacopsychiatry,
8(3), 129144. doi:10.1159/000467984
Guerra-Doce, E. (2015). Psychoactive substances in prehis-
toric times: Examining the archaeological evidence. Time
and Mind,8(1), 91112. doi:10.1080/
Hailstone, J. C., Omar, R., Henley, S. M. D., Frost, C.,
Kenward, M. G., & Warren, J. D. (2009). Its not what
you play, its how you play it: Timbre affects perception
of emotion in music. Quarterly Journal of Experimental
Psychology (2006),62(11), 21412155. doi:10.1080/
Halberstadt, A. L. (2017). Hallucinogenic drugs: A new
study answers old questions about LSD. Current Biology:
CB,27(4), R158. doi:10.1016/j.cub.2016.12.058
Hall, I. C., Rebec, G. V., & Hurley, L. M. (2010). Serotonin
in the inferior colliculus fluctuates with behavioral state
and environmental stimuli. The Journal of Experimental
Biology,213(Pt 7), 10091017. doi:10.1242/jeb.035956
Hargreaves, D. J., & North, A. C. (1999). The functions of
music in everyday life: Redefining the social in music
psychology. Psychology of Music,27(1), 7183.
Harrison, L., & Loui, P. (2014). Thrills, chills, frissons, and
skin orgasms: Toward an integrative model of transcend-
ent psychophysiological experiences in music. Frontiers
in Psychology,5, 790. doi:10.3389/fpsyg.2014.00790
Hauser, M. D., & McDermott, J. (2003). The evolution of
the music faculty: A comparative perspective. Nature
Neuroscience,6(7), 663668. doi:10.1038/nn1080
Hevner, K. (1937). The affective value of pitch and tempo
in music. The American Journal of Psychology,49(4), 621.
Hoffer, A. (1965). D-Lysergic acid diethylamide (LSD): A
review of its present status. Clinical Pharmacology &
Therapeutics,6(2), 183255. doi:10.1002/cpt196562183
Hofmann, A. (1983). LSD: My problem child. Los Angeles,
CA: J. P. Tarcher.
Hohmann, L., Bradt, J., Stegemann, T., & Koelsch, S.
(2017). Effects of music therapy and music-based
interventions in the treatment of substance use disorders:
A systematic review. PLoS One,12(11), e0187363.
Holzinger, R. (1964). Lsd-25, a tool in psychotherapy. The
Journal of General Psychology,71(1), 920. doi:10.1080/
Hove, M. J., Stelzer, J., Nierhaus, T., Thiel, S. D., Gundlach,
C., Margulies, D. S., Merker, B. (2016). Brain net-
work reconfiguration and perceptual decoupling during
an absorptive state of consciousness. Cerebral Cortex
(New York, N.Y.: 1991),26(7), 31163124. doi:10.1093/
Hurley, L. M. (2006). Different serotonin receptor agonists
have distinct effects on sound-evoked responses in infer-
ior colliculus. Journal of Neurophysiology,96(5),
21772188. doi:00046.2006 [pii]
Hurley, L. M., & Pollak, G. D. (1999). Serotonin differen-
tially modulates responses to tones and frequency-modu-
lated sweeps in the inferior colliculus. The Journal of
Neuroscience: The Official Journal of the Society for
Neuroscience,19(18), 80718082.
Hurley, L. M., & Sullivan, M. R. (2012). From behavioral
context to receptors: Serotonergic modulatory pathways
in the IC. Frontiers in Neural Circuits,6, 58. doi:10.3389/
Janata, P., Birk, J. L., Van, H. J. D., Leman, M., Tillmann,
B., & Bharucha, J. J. (2002). The cortical topography of
tonal structures underlying western music. Science (New
York, N.Y.),298(5601), 21672170. doi:10.1126/
Janata, P., Tomic, S. T., & Haberman, J. M. (2012).
Sensorimotor coupling in music and the psychology of
the groove. Journal of Experimental Psychology General,
141(1), 5475. doi:10.1037/a0024208
Janata, P., Tomic, S. T., & Rakowski, S. K. (2007).
Characterization of music-evoked autobiographical mem-
ories. Memory (Hove, England),15(8), 845860.
doi:783520920 [pii]
Johnson, M. W., & Griffiths, R. R. (2017). Potential thera-
peutic effects of psilocybin. Neurotherapeutics: The
Journal of the American Society for Experimental
NeuroTherapeutics,14(3), 734740. doi:10.1007/s13311-
Johnson, M. W., Garcia-Romeu, A., Cosimano, M. P., &
Griffiths, R. R. (2014). Pilot study of the 5-HT2AR
agonist psilocybin in the treatment of tobacco addic-
tion. Journal of Psychopharmacology (Oxford, England),
28(11), 983992. doi:10.1177/0269881114548296
Johnson, M. W., Richards, W., & Griffiths, R. R. (2008).
Human hallucinogen research: Guidelines for safety.
Journal of Psychopharmacology (Oxford, England),22(6),
603620. doi:10.1177/0269881108093587
Juslin, P. N. (2013). From everyday emotions to aesthetic
emotions: Towards a unified theory of musical emotions.
Physics of Life Reviews,10(3), 235266. doi:10.1016/
Juslin, P. N., & Vastfjall, D. (2008). Emotional responses to
music: The need to consider underlying mechanisms.
The Behavioral and Brain Sciences,31(5), 621.
Juslin, P. N., Liljestrom, S., Vastfjall, D., Barradas, G., &
Silva, A. (2008). An experience sampling study of
emotional reactions to music: Listener, music, and situ-
ation. Emotion (Washington, D.C.),8(5), 668683.
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,232(19), 36073614. doi:10.1007/
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,235(2),
505519. doi:10.1007/s00213-017-4820-5
Kaelen, M., Lorenz, R., Barrett, F. S., Roseman, L., Orban,
C., Santos-Ribeiro, A., Leech, R. (2017). Effects of
LSD on music-evoked brain activity. bioRxiv, Retrieved
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 para-
hippocampal connectivity. European Neuropsycho-
pharmacology: The Journal of the European College of
Neuropsychopharmacology,26(7), 10991109. doi:S0924-
Koelsch, S. (2011). Toward a neural basis of music percep-
tion A review and updated model. Frontiers in
Psychology,2(110), 120. doi:10.3389/fpsyg.2011.00110
Kraehenmann, R., Preller, K. H., Scheidegger, M., Pokorny,
T., Bosch, O. G., Seifritz, E., & Vollenweider, F. X.
(2015). Psilocybin-induced decrease in amygdala reactiv-
ity correlates with enhanced positive mood in healthy
volunteers. Biological Psychiatry,78(8), 572581.
Kurland, A. A. (1985). LSD in the supportive care of the
terminally ill cancer patient. Journal of Psychoactive
Drugs,17(4), 279290. doi:10.1080/02791072.1985.
Kurland, A. A., Unger, S., Shaffer, J. W., & Savage, C.
(1967). Psychedelic therapy utilizing LSD in the treat-
ment of the alcoholic patient: A preliminary report. The
American Journal of Psychiatry,123(10), 12021209.
Lajoux, J. (1964). Leoe meraviglie del tassili Najjer.
Bergamo: Istituto Italiano dArti Grafiche.
Laukka, P., Eerola, T., Thingujam, N. S., Yamasaki, T., &
Beller, G. (2013). Universal and culture-specific factors in
the recognition and performance of musical affect
expressions. Emotion (Washington, D.C.),13(3), 434449.
Lebedev, A. V., Kaelen, M., Lovden, M., Nilsson, J.,
Feilding, A., Nutt, D. J., & Carhart-Harris, R. L. (2016).
LSD-induced entropic brain activity predicts subsequent
personality change. Human Brain Mapping,37(9),
32033213. doi:10.1002/hbm.23234
Leman, M., Vermeulen, V., De Voogdt, L., Moelants, D., &
Lesaffre, M. (2005). Prediction of musical affect using a
combination of acoustic structural cues. Journal of New
Music Research,34(1), 3967. doi:10.1080/
Leubner, D., & Hinterberger, T. (2017). Reviewing the
effectiveness of music interventions in treating
depression. Frontiers in Psychology,8, 1109. doi:10.3389/
Levitin, D. J., & Menon, V. (2003). Musical structure is
processed in languageareas of the brain: A possible
role for Brodmann area 47 in temporal coherence.
NeuroImage,20(4), 21422152. doi:S1053811903004828
Luo, B., Hu, L., Liu, C., Guo, Y., & Wang, H. (2016).
Activation of 5-HT2A/C receptor reduces glycine recep-
tor-mediated currents in cultured auditory cortical neu-
rons. Amino Acids,48(2), 349356. doi:10.1007/s00726-
Maher, T. F. (1980). A rigorous test of the proposition that
musical intervals have different psychological effects. The
American Journal of Psychology,93(2), 309327.
Maroukis, T. C. (2005). Peyote and the yankton sioux: The
life and times of sam necklace. Norman, OK: University
of Oklahoma Press.
Mehr, S. A., Song, L. A., & Spelke, E. S. (2016). For 5-
month-old infants, melodies are social. Psychological
Science,27(4), 486501. doi:10.1177/0956797615626691
Merriam, A. P. (1964). The anthropology of music.
Evanston, IL: Northwestern University Press.
Mithoefer, M. C., Wagner, M. T., Mithoefer, A. T., Jerome,
L., & Doblin, R. (2011). The safety and efficacy of
{þ/}3,4-methylenedioxymethamphetamine-assisted psy-
chotherapy in subjects with chronic, treatment-resistant
posttraumatic stress disorder: The first randomized con-
trolled pilot study. Journal of Psychopharmacology
(Oxford, England),25(4), 439452. doi:10.1177/
Moeller, S. J., & Goldstein, R. Z. (2014). Impaired self-
awareness in human addiction: Deficient attribution of
personal relevance. Trends in Cognitive Sciences,18(12),
635641. doi:10.1016/j.tics.2014.09.003
Mori, K., & Iwanaga, M. (2014). Resting physiological
arousal is associated with the experience of music-
induced chills. International Journal of Psychophysiology:
Official Journal of the International Organization of
Psychophysiology,93(2), 220226. doi:10.1016/
Mote, J. (2011). The effects of tempo and familiarity on
childrens affective interpretation of music. Emotion
(Washington, D.C.),11(3), 618622. doi:10.1037/
Nettl, B. (1956). Music in primitive culture. Cambridge:
Harvard University Press.
North, A. C., & Hargreaves, D. J. (1995). Subjective com-
plexity, familiarity, and liking for popular music.
North, A. C., & Hargreaves, D. J. (1997). Liking, arousal
potential, and the emotions expressed by music.
Scandinavian Journal of Psychology,38(1), 4553.
Northoff, G., & Bermpohl, F. (2004). Cortical midline struc-
tures and the self. Trends in Cognitive Sciences,8(3),
102107. doi:10.1016/j.tics.2004.01.004
orio, F. D. L., Sanches, R. F., Macedo, L. R., dos Santos,
R. G., Maia-de-Oliveira, J. P., Wichert-Ana, L.,
Hallak, J. E. (2015). Antidepressant effects of a single
dose of ayahuasca in patients with recurrent depression:
A preliminary report. Revista Brasileira De Psiquiatria
(Sao Paulo, Brazil: 1999),37(1), 1320. doi:10.1590/1516-
Pahnke W. N. (1963). Drugs and mysticism: An analysis of
the relationship between psychedelic drugs and the mys-
tical consciousness. Cambridge, MA: Harvard University
Pahnke, W. N., Kurland, A. A., Goodman, L. E., &
Richards, W. A. (1969). LSD-assisted psychotherapy with
terminal cancer patients. Current Psychiatric Therapies,9,
Panksepp, J. (1995). The emotional sources of chills
induced by music. Music Perception: An Interdisciplinary
Journal,13(2), 171207. doi:10.2307/40285693
Panksepp, J. (2009). The emotional antecedents to the evo-
lution of music and language. Musicae Scientiae,13(2),
229259. doi:10.1177/1029864909013002111
Patel, A. D. (2008). Music, language, and the brain. Oxford:
Oxford University Press.
Penman, J., & Becker, J. (2009). Religious ecstatics, Deep
listeners, and musical emotion. Empirical Musicology
Review,4, 70.
Preller, K. H., Herdener, M., Pokorny, T., Planzer, A.,
Kraehenmann, R., Stampfli, P., Vollenweider, F. X.
(2017). The fabric of meaning and subjective effects in
LSD-induced states depend on serotonin 2A receptor
activation. Current Biology,27(3), 451457. doi:S0960-
Rawlings, D., & Ciancarelli, V. (1997). Music preference
and the five-factor model of the NEO personality inven-
tory. Psychology of Music,25(2), 120132. doi:10.1177/
Rentfrow, P. J., & Gosling, S. D. (2003). The do re misof
everyday life: The structure and personality correlates of
music preferences. Journal of Personality and Social
Psychology,84(6), 12361256. doi:10.1037/0022-
Rentfrow, P. J., Goldberg, L. R., & Levitin, D. J. (2011). The
structure of musical preferences: A five-factor model.
Journal of Personality and Social Psychology,100(6),
11391157. doi:10.1037/a0022406
Richards, W. A. (1979). Psychedelic drug-assisted psycho-
therapy with persons suffering from terminal cancer.
Journal of Altered States of Consciousness,5(4), 309319.
Richards, W. A., Rhead, J. C., DiLeo, F. B., Yensen, R., &
Kurland, A. A. (1977). The peak experience variable in
DPT-assisted psychotherapy with cancer patients. J
Psychedelic Drugs,9, 10.
Riga, M. S., Bortolozzi, A., Campa, L., Artigas, F., &
Celada, P. (2016). The serotonergic hallucinogen 5-
methoxy-N,N-dimethyltryptamine disrupts cortical activ-
ity in a regionally-selective manner via 5-HT(1A) and 5-
HT(2A) receptors. Neuropharmacology,101, 370378.
Roseman, L., Nutt, D. J., & Carhart-Harris, R. L. (2018).
Quality of acute psychedelic experience predicts thera-
peutic efficacy of psilocybin for treatment-resistant
depression. Frontiers in Pharmacology,8, 974.
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T.,
Cohen, B., Schmidt, B. L. (2016). Rapid and sus-
tained symptom reduction following psilocybin treatment
for anxiety and depression in patients with life-
threatening cancer: A randomized controlled trial.
Journal of Psychopharmacology,30(12), 1180.
Rouget, G. (1985). Music and trance: A theory of the rela-
tions between music and possession. Chicago: University
of Chicago Press.
Salimpoor, V. N., Benovoy, M., Larcher, K., Dagher, A., &
Zatorre, R. J. (2011). Anatomically distinct dopamine
release during anticipation and experience of peak emo-
tion to music. Nature Neuroscience,14(2), 257262.
Salimpoor, V. N., Benovoy, M., Longo, G., Cooperstock,
J. R., & Zatorre, R. J. (2009). The rewarding aspects of
music listening are related to degree of emotional
arousal. PLoS One,4(10), e7487. doi:10.1371/
Salimpoor, V. N., van den Bosch, I., Kovacevic, N.,
McIntosh, A. R., Dagher, A., & Zatorre, R. J. (2013).
Interactions between the nucleus accumbens and audi-
tory cortices predict music reward value. Science (New
York, N.Y.),340(6129), 216219. doi:10.1126/
Samorini, G. (1992). The oldest representations of hallu-
cinogenic mushrooms in the world. Integration,2/3,
Sanches, R. F., de Lima Os
orio, F., dos Santos, R. G.,
Hallak, J. E. C. (2016). Antidepressant effects of a sin-
gle dose of ayahuasca in patients with recurrent depression:
ASPECTstudy.Journal of Clinical Psychopharmacology,
36(1), 7781. doi:10.1097/JCP.0000000000000436
Sandstrom, G. M., & Russo, F. A. (2013). Absorption in
music: Development of a scale to identify individuals
with strong emotional responses to music. Psychology of
Music,41(2), 216. 228. doi:10.1177/0305735611422508
afer, T., Sedlmeier, P., St
adtler, C., & Huron, D. (2013).
The psychological functions of music listening. Frontiers
in Psychology,4, 511. doi:10.3389/fpsyg.2013.00511
on, D., Gordon, R., Campagne, A., Magne, C., Ast
esano, C.,
Anton, J., & Besson, M. (2010). Similar cerebral networks in
language, music and song perception. NeuroImage,51(1),
450461. doi:10.1016/j.neuroimage.2010.02.023
Schultes, R. E., Hofmann, A., & R
atsch, C. (2001). Plants of
the gods: Their sacred, healing, and hallucinogenic powers
(2nd ed.). Rochester, VT: Healing Arts Press.
Silverman, J. (1971). Research with psychedelics. Some bio-
psychological concepts and possible clinical applications.
Archives of General Psychiatry,25(6), 498510.
Snowdon, C. T., Zimmermann, E., & Altenm
uller, E. (2015).
Music evolution and neuroscience. Progress in Brain
Research,217,1734. doi:10.1016/bs.pbr.2014.11.019
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 dis-
tress. Journal of Humanistic Psychology,57(5), 488519.
Tang, Z. Q., & Trussell, L. O. (2015). Serotonergic regula-
tion of excitability of principal cells of the dorsal coch-
lear nucleus. The Journal of Neuroscience: The Official
Journal of the Society for Neuroscience,35(11),
45404551. doi:10.1523/JNEUROSCI.4825-14.2015
Timmermann, C., Spriggs, M. J., Kaelen, M., Leech, R.,
Nutt, D. J., Moran, R. J., Muthukumaraswamy, S. D.
(2017). LSD modulates effective connectivity and
neural adaptation mechanisms in an auditory oddball
paradigm. Neuropharmacology. Advance online publica-
tion. doi:10.1016/j.neuropharm.2017.10.039.
Torres, C. M. (1998). Psychoactive substances in the
archaeology of northern Chile and northwest Argentina:
A comparative review of the evidence. Chungar
a (Arica),
30(1), 4963. doi:10.4067/S0717-73561998000100004
Trehub, S. E. (2001). Musical predispositions in infancy.
Annals of the New York Academy of Sciences,930,116.
Trehub, S. E., & Trainor, L. J. (1998). Singing to infants:
Lullabies and play songs. Advances in Infancy Research,
Umbricht, D., Vollenweider, F. X., Schmid, L., Gr
ubel, C.,
Skrabo, A., Huber, T., & Koller, R. (2003). Effects of the 5-
HT2A agonist psilocybin on mismatch negativity gener-
ation and AX-continuous performance task: Implications
for the neuropharmacology of cognitive deficits in schizo-
phrenia. Neuropsychopharmacology: Official Publication of
the American College of Neuropsychopharmacology,28(1),
170181. doi:10.1038/sj.npp.1300005
Vollenweider, F. X., & Kometer, M. (2010). The neurobiol-
ogy of psychedelic drugs: Implications for the treatment
of mood disorders. Nature Reviews. Neuroscience,11(9),
642651. doi:10.1038/nrn2884
Wasson, R. G., Hofmann, A., & Ruck, K. A. P. (1978). The
road to Eleusis. Berkeley, CA: North Atlantic Books.
Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-
Harris, R. (2017). Patientsaccounts of increased
Connectednessand Acceptanceafter psilocybin for
treatment-resistant depression. Journal of Humanistic
Psychology,57(5), 520564. doi:10.1177/0022167817709585
Weber, K. (1967). Alteration of music perception in experi-
mental psychosis (psilocybin.). Confinia Psychiatrica.
Borderland of Psychiatry. Grenzgebiete Der Psychiatrie.
Les Confins De La Psychiatrie,10(3), 139176.
Zhao, K., Bai, Z. G., Bo, A., & Chi, I. (2016). A systematic
review and meta-analysis of music therapy for the
older adults with depression. International Journal of
Geriatric Psychiatry,31(11), 11881198. doi:10.1002/
Zweigenhaft, R. L. (2008). A do re mi encore. Journal of
Individual Differences,29(1), 4555. doi:10.1027/1614-
... Substances administered in (psycho-)therapeutic contexts include serotonergic psychedelics (e.g., LSD and psilocybin) sharing a primary mechanism of action at the 5-HT2A receptor (Geyer and Vollenweider, 2008;Nichols, 2016;Preller et al., 2018), NMDA antagonists with dissociative properties like ketamine (Krupitsky and Grinenko, 1997;Serafini et al., 2014), serotonergic entactogens like MDMA (Thal and Lommen, 2018), and atypical and pharmacologically complex psychedelics like ibogaine (Alper, 2001). ...
... Musicmost often delivered through headphoneshas been a consistent feature (Barrett, Preller and Kaelen, 2018) and method for guidance and support (Bonny and Pahnke, 1972;Eisner and Cohen, 1958) across different models of SAPT with potential influences on the psychoactive experience itself and the therapeutic outcome (Kaelen et al., 2015;Kaelen et al., 2016Kaelen et al., , 2018Preller et al., 2017;Swift et al., 2017;Watts et al., 2017). It was suggested by Kaelen et al. (2018) that optimal music may personalize the experience and foster the expression of meaningful therapeutic content. ...
... Musicmost often delivered through headphoneshas been a consistent feature (Barrett, Preller and Kaelen, 2018) and method for guidance and support (Bonny and Pahnke, 1972;Eisner and Cohen, 1958) across different models of SAPT with potential influences on the psychoactive experience itself and the therapeutic outcome (Kaelen et al., 2015;Kaelen et al., 2016Kaelen et al., , 2018Preller et al., 2017;Swift et al., 2017;Watts et al., 2017). It was suggested by Kaelen et al. (2018) that optimal music may personalize the experience and foster the expression of meaningful therapeutic content. ...
Full-text available
Background: Clinical trials are currently investigating the potential of substance-assisted psychotherapy (SAPT) as treatment for several psychiatric conditions. The potential therapeutic effects of SAPT may be influenced by contextual factors including preparation prior to and integration after the substance-assisted therapy sessions. Aims: This systematized review outlines recommendations for current practice in preparatory sessions in SAPT including safety measures and screening procedures, preparation of set and setting, session contents, methods, and roles, prerequisites, and appropriate conduct of therapists. Methods: A systematized review of the literature was conducted based on PRISMA guidelines. MEDLINE (OVID), PsycINFO (OVID), and Cochrane Library were searched and clinical trials, treatment manuals, study protocols, case studies, qualitative studies, descriptive studies, theoretical papers, reviews, book chapters, and conference proceedings published until February 1, 2022 were retrieved. Results: The final synthesis included k = 83 sources. Information about safety measures including screening of participants, set and setting, contextual-, physiological-, and psychological preparation, roles, competencies, prerequisites, and characteristics of the therapists, and the establishment of a therapeutic relationship were summarized and discussed. Conclusion: It is concluded that there is a consensus in the literature about the importance of adequate preparation before the administration of psychoactive substances in SAPT. However, the extent and approaches for these sessions vary across different models and there is a need for timelier and more rigorous qualitative and quantitative investigations assessing different approaches and techniques for the optimal preparation of clients in SAPT.
... Despite the recent abundance of quantitative research on psychedelics, it often centers on health-related outcomes, rather than understanding subjective patient experience (see Luoma et al. 2020). Quantitative approaches enable determination of treatment efficacy (Barrett, Preller, and Kaelen 2018), whereby qualitative or combined mixed methods approaches show promise in portraying the rich phenomenal landscape of the psychedelic experience. ...
... Across all substances, music and nature amplified positive experience. Music and nature use is common in Indigenous ceremonial practices and ritual (particularly nature) is fundamental across cultures (Hartogsohn 2021), with music widely seen as facilitating physical and spiritual healing (Barrett, Preller, and Kaelen 2018). Research echoes the importance of both nature (Kettner et al. 2019) and music (Barrett, Preller, and Kaelen 2018) as integral aspects of the psychedelic "setting." ...
... Music and nature use is common in Indigenous ceremonial practices and ritual (particularly nature) is fundamental across cultures (Hartogsohn 2021), with music widely seen as facilitating physical and spiritual healing (Barrett, Preller, and Kaelen 2018). Research echoes the importance of both nature (Kettner et al. 2019) and music (Barrett, Preller, and Kaelen 2018) as integral aspects of the psychedelic "setting." Neurologically, psychedelics induce a heightened sensitivity to context (Hartogsohn 2018), priming individuals to find meaning (Hartogsohn 2018). ...
Research on the therapeutic potential of psychedelic substances is expanding. A limitation within this field is the unpredictability of individual responses to psychedelics. Better understanding of factors predicting psychedelic experience is essential to clinical progress and wider harm reduction frameworks. Ketamine, MDMA, LSD and psilocybin were selected for comparison due to their promising therapeutic effects and different mechanisms of action. This study aimed to (a) identify factors that produce positive and adverse psychedelic experience, and (b) compare these potential predictors across four psychedelic substances. A thematic analysis was conducted on twenty-two first-person reports of psychedelic use (six per substance), sourced from the Erowid database. This revealed three external predictors (nature, music, and preparation) and three internal predictors (understanding, mind-set, and motivation). Each factor identified contained two sub-themes that further elucidated meaning and impact. Nature and music emerged as potential tools for de-escalating adverse reactions to psychedelics. Substance-specific perceptual and sensorial effects were also examined. Finally, the importance of, and interrelationship between, preparation, mind-set, understanding, and motivation was examined as common themes that emerged. The broader clinical and sociological implications are discussed, with reference to developing harm reduction frameworks. These findings constitute an early step in developing a more nuanced understanding of factors shaping psychedelic experience.
... tradicional indígena, lo que coincide con las conclusiones de las revisiones efectuadas porBarret et al. (2018),Rucker et al. (2018) yGandy et al., (2020).La revisión crítica realizada porGandy et al. (2020) acerca de los efectos sinérgicos entre los psicodélicos y el contacto con la naturaleza, propone mejorar la preparación e integración con elementos de inmersión en la naturaleza, tales como ejercicios de horticultura para preparar y la práctica japonesa Shinrin-Yoku (Baño de bosque) en el caso de la integración (sirviendo también como ejercicio de mindfulness).A partir de su revisión, el autor establece que la administración de psicodélicos para fines terapéuticos en los que se han establecido contacto con la naturaleza, muestran una asociación a mecanismos neurobiológicos como mayor conectividad entre regiones cerebrales, reducción de rumiación y reducción de actividad de áreas cerebrales implicadas en la Red Neural Predeterminada (DMN), así como la presencia de mecanismos psicológicos que incrementan la sensación de conexión, definida como un sentido empático y encarnado de cercanía con uno mismo, los demás, el mundo y el universo, y entendida como un predictor de bienestar. Las dos prácticas revisadas -contacto con la naturaleza y Mindfulness-se han asociado con experiencias de tipo místico. ...
... Las dos prácticas revisadas -contacto con la naturaleza y Mindfulness-se han asociado con experiencias de tipo místico. La experiencia de asombro e incremento de capacidades encontrados en el mindfulness, han sido asociadas a resultados positivos en salud mental y mejoría del bienestar, lo mismo que el contacto con la naturaleza, que por sí mismo también se asocia con satisfacción de vida, comportamientos pro sociales y reducciones de estrés; las experiencias místicas son experiencias contenidas de sentimientos profundos de unidad, sensación de santidad, estado de ánimo positivo, sensación de trascendencia del espacio tiempo, inefabilidad y cualidades noéticas.La revisión deBarret et al., (2018) aporta el análisis del papel de la música en la experiencia psicodélica como proceso terapéutico y concluye que la música aumenta la probabilidad de experiencias emocionales durante la terapia psicodélica como una experiencia de tipo místico o una catarsis emocional. En los modelos de psicoterapia asistida por psicodélicos se da por hecho que la calidad de la experiencia subjetiva predice y media los resultados terapéuticos y que la música se ha posicionado con un ...
Full-text available
Revisión de la literatura sobre la Teoría de Set y Setting y su impacto sobre la experiencia psicodélica, se presenta una sistematización de los factores no farmacológicos individuales y ambientales que componen el set y el setting en estudios sobre consumo de drogas psicodélicas. Palabras Clave: Set y Setting, drogas psicodélicas, experiencia mística, mal viaje, reducción de riesgos y daños.
... Music has been recommended as an integral part of psychedelic sessions since the early psychedelic studies (Gaston and Eagle, 1970). Today music is still recommended as part of the psychedelic setting (Johnson et al., 2008) and the role of music is becoming more salient in psychedelic research (Barrett et al., 2018). It is currently unknown, whether alternative approaches, e.g., silence or nature surroundings can be used interchangeably with music, but since most psychedelic studies use music as part of the intervention setting, gaining more insight into the facilitating potential of music is important. ...
Full-text available
The psychedelic drug psilocybin has been successfully explored as a novel treatment for a range of psychiatric disorders. Administration of psilocybin requires careful attention to psychological support and the setting in which the drug is administered. The use of music to support the acute psychoactive effects of psilocybin is recommended in current guidelines, but descriptions of how to compile music programs for the 4–6 h long sessions are still scarce. This article describes the procedural steps and considerations behind the curation of a new music program, the Copenhagen Music Program, tailored to the intensity profile of a medium/high dose psilocybin. The method of Guided Imagery and Music is presented as a music therapeutic framework for choosing and sequencing music in music programming and the Taxonomi of Therapeutic Music is presented as a rating tool to evaluate the music-psychological intensity of music pieces. Practical examples of how to organize the process of music programming are provided along with a full description of the Copenhagen Music Program and its structure. The aim of the article is to inspire others in their endeavours to create music programs for psychedelic interventions, while proposing that an informed music choice may support the therapeutic dynamics during acute effects of psilocybin.
Full-text available
Background Ketamine and its enantiomer esketamine represent promising new treatments for treatment-resistant depression (TRD). Esketamine induces acute, transient psychoactive effects. How patients perceive esketamine treatment, and which conditions facilitate optimal outcomes, remains poorly understood. Understanding patient perspectives on these phenomena is important to identify unmet needs, which can be used to improve (es)ketamine treatments.AimsTo explore the perspectives of TRD patients participating in “off label” oral esketamine treatment.Materials and methodsIn-depth interviews were conducted with 17 patients (11 women) after a six-week, twice-weekly esketamine treatment program, and subsequently after six months of at-home use. Interviews explored participants’ perspectives, expectations, and experiences with esketamine treatment. Audio interviews were transcribed verbatim and analysed following an Interpretative Phenomenological Analysis (IPA) framework.ResultsKey themes included overwhelming experiences; inadequate preparation; letting go of control; mood states influencing session experiences; presence and emotional support, and supportive settings. Patients’ attempts to let go and give into vs. attempts to maintain control over occasionally overwhelming experiences was a central theme. Multiple factors influenced patients’ ability to give into the experience and appeared to impact their mood and anxiety about future sessions, including level of preparation and education, physical and emotional support, and setting during the session.Conclusion Better preparation beforehand, an optimized treatment setting, and emotional and psychological support during (es)ketamine sessions can help patients to “let go” and may lead to better quality of care and outcomes. Recommendations to improve quality of patient care in (es)ketamine treatment are provided, including suggestions for the training of nurses and other support staff.
Full-text available
Drawing on perspectives from music psychology, cognitive neuroscience, philosophy, musicology, clinical psychology, and music education, Music and Mental Imagery provides a critical overview of cutting-edge research on the various types of mental imagery associated with music. The four main parts cover an introduction to the different types of mental imagery associated with music such as auditory/musical, visual, kinaesthetic, and multimodal mental imagery; a critical assessment of established and novel ways to measure mental imagery in various musical contexts; coverage of different states of consciousness, all of which are relevant for, and often associated with, mental imagery in music, and a critical overview of applications of mental imagery in health, educational, and performance settings. By both critically reviewing up-to-date scientific research and offering new empirical results, this book provides a unique overview of the different types and origins of mental imagery in musical contexts, various ways to measure them, and intriguing insights into related mental phenomena such as mind-wandering and synaesthesia. This will be of particular interest for scholars and researchers of music psychology and music education. It will also be useful for practitioners working with music in applied health and educational contexts.
Full-text available
Research of psychedelic assisted therapies is at an all-time high, though few studies highlight extra-pharmacological factors that may affect treatment efficacy. One critical set of attributes includes the therapeutic setting itself, which describe the physical and socio-cultural environments in which the drug-assisted session occurs. Despite enduring consensus of the influence of setting, recommendations for establishing and reporting key setting variables remain sparse across clinical trial protocols and published research methodologies. The purpose of this paper is to: (1) present what is known of the influence and implications of setting to psychedelic-assisted therapies, with a particular focus on 3,4-methylenedioxymethamphetamine (MDMA); and (2) propose a set of reporting guidelines for operationalizing and reporting key setting variables in clinical trials of psychedelic-assisted therapies, based on recommendations emerging from clinical trials of MDMA for PTSD. In fact, recommendations should be expanded to “set” - the subject's mood, expectations, and broader psychological condition - once this is more fully developed in the field. The proposed reporting guidelines offer a means of increasing the volume and variability of data necessary for future empirical examination of key setting attributes influencing treatment efficacy, while preserving practitioner and patient autonomy to co-construct adaptive therapy settings according to their respective needs and expertise.
Full-text available
Recent studies have recognized the importance of non-pharmacological factors such as setting to induce or promote mystical experiences or challenging experiences among ayahuasca users. This study aimed to evaluate the association between the setting in which ayahuasca is consumed and the intensity of mystical and challenging experiences considering three ayahuasca using traditions (União do Vegetal, Santo Daime and neo-shamanic groups). A cross-sectional analysis was performed on survey data collected online from 2,751 participants. The Setting Questionnaire for the Ayahuasca Experience (SQAE) was used to evaluate six dimensions of the setting characteristics. The Mystical Experience Questionnaire (MEQ) and the Challenging Experience Questionnaire (CEQ) were used to quantify the psychedelic experience. Ratings on every SQAE setting dimension were negatively correlated with ratings of the CEQ (r values between 0.21 and 0.36) for all ayahuasca using traditions. Regression analysis revealed that ratings on four SQAE dimensions (Social, Comfort, Infrastructure and Decoration) explained 41% of the variance in CEQ ratings. Associations between SQAE and MEQ ratings were relatively weak and confined to the dimensions Leadership and Comfort, explaining 14% of the variance in MEQ ratings. Ratings of Social context were higher among members of União do Vegetal compared to Santo Daime and neo-shamanic members. Ratings of Infrastructure, Comfort and Decoration were more consistently correlated with MEQ in the neoshamanic tradition compared to the other traditions. This study shows that the setting is an important moderator of a challenging experience under ayahuasca. Maximizing the quality of the setting in which ayahuasca is taken will reduce the chance of a challenging experience while contributing positively to a mystical experience. The present findings can be considered when designing rituals and the (social) environment of ayahuasca ceremonies, and indicate that the SQAE questionnaire can be employed to monitor the influence of ceremonial settings on the ayahuasca experience.
Background: Classic psychedelics, such as psilocybin and LSD, and other serotonin 2A receptor (5-HT2AR) agonists evoke acute alterations in perception and cognition. Altered thalamocortical connectivity has been hypothesized to underlie these effects, which is supported by some functional MRI (fMRI) studies. These studies have treated the thalamus as a unitary structure, despite known differential 5-HT2AR expression and functional specificity of different intrathalamic nuclei. Independent Component Analysis (ICA) has been previously used to identify reliable group-level functional subdivisions of the thalamus from resting-state fMRI (rsfMRI) data. We build on these efforts with a novel data-maximizing ICA-based approach to examine psilocybin-induced changes in intrathalamic functional organization and thalamocortical connectivity in individual participants. Methods: Baseline rsfMRI data (n=38) from healthy individuals with a long-term meditation practice was utilized to generate a statistical template of thalamic functional subdivisions. This template was then applied in a novel ICA-based analysis of the acute effects of psilocybin on intra- and extra-thalamic functional organization and connectivity in follow-up scans from a subset of the same individuals (n=18). We examined correlations with subjective reports of drug effect and compared with a previously reported analytic approach (treating the thalamus as a single functional unit). Results: Several intrathalamic components showed significant psilocybin-induced alterations in spatial organization, with effects of psilocybin largely localized to the mediodorsal and pulvinar nuclei. The magnitude of changes in individual participants correlated with reported subjective effects. These components demonstrated predominant decreases in thalamocortical connectivity, largely with visual and default mode networks. Analysis in which the thalamus is treated as a singular unitary structure showed an overall numerical increase in thalamocortical connectivity, consistent with previous literature using this approach, but this increase did not reach statistical significance. Conclusions: We utilized a novel analytic approach to discover psilocybin-induced changes in intra- and extra-thalamic functional organization and connectivity of intrathalamic nuclei and cortical networks known to express the 5-HT2AR. These changes were not observed using whole-thalamus analyses, suggesting that psilocybin may cause widespread but modest increases in thalamocortical connectivity that are offset by strong focal decreases in functionally relevant intrathalamic nuclei.
Full-text available
Music is a highly dynamic stimulus, and consists of distinct acoustic features, such as pitch, rhythm and timbre. Neuroimaging studies highlight a hierarchy of brain networks involved in music perception. Psychedelic drugs such as lysergic acid diethylamide (LSD) temporary disintegrate the normal hierarchy of brain functioning, and produce profound subjective effects, including enhanced music-evoked emotion. The primary objective of this study was to investigate the acute effects of LSD on music-evoked brain-activity under naturalistic music listening conditions. 16 healthy participants were enrolled in magnetic resonance imaging (fMRI) while listening to a 7-minute music piece under eyes-closed conditions on two separate visits (LSD (75 mcg) and placebo). Dynamic time courses for acoustic features were extracted from the music excerpts, and were entered into subject-level fMRI analyses as regressors of interest. Differences between conditions were assessed at group level subsequently, and were related to changes in music-evoked emotions via correlation analyses. Psycho-physiological interactions (PPIs) were carried out to further interrogate underlying music-specific changes in functional connectivity under LSD. Results showed pronounced cortical and subcortical changes in music-evoked brain activity under LSD. Most notable changes in brain activity and connectivity were associated with the component timbral complexity, representing the complexity of the music’s spectral distribution, and these occurred in brain networks previously identified for music-perception and music-evoked emotion, and showed an association with enhanced music-evoked feelings of wonder under LSD. The findings shed light on how the brain processes music under LSD, and provide a neurobiological basis for the usefulness of music in psychedelic therapy.
Full-text available
Rationale: Recent studies have supported the safety and efficacy of psychedelic therapy for mood disorders and addiction. Music is considered an important component in the treatment model, but little empirical research has been done to examine the magnitude and nature of its therapeutic role. Objectives: The present study assessed the influence of music on the acute experience and clinical outcomes of psychedelic therapy. Methods: Semi-structured interviews inquired about the different ways in which music influenced the experience of 19 patients undergoing psychedelic therapy with psilocybin for treatment-resistant depression. Interpretative phenomenological analysis was applied to the interview data to identify salient themes. In addition, ratings were given for each patient for the extent to which they expressed "liking," "resonance" (the music being experienced as "harmonious" with the emotional state of the listener), and "openness" (acceptance of the music-evoked experience). Results: Analyses of the interviews revealed that the music had both "welcome" and "unwelcome" influences on patients' subjective experiences. Welcome influences included the evocation of personally meaningful and therapeutically useful emotion and mental imagery, a sense of guidance, openness, and the promotion of calm and a sense of safety. Conversely, unwelcome influences included the evocation of unpleasant emotion and imagery, a sense of being misguided and resistance. Correlation analyses showed that patients' experience of the music was associated with the occurrence of "mystical experiences" and "insightfulness." Crucially, the nature of the music experience was significantly predictive of reductions in depression 1 week after psilocybin, whereas general drug intensity was not. Conclusions: This study indicates that music plays a central therapeutic function in psychedelic therapy.
Full-text available
Introduction: It is a basic principle of the “psychedelic” treatment model that the quality of the acute experience mediates long-term improvements in mental health. In the present paper we sought to test this using data from a clinical trial assessing psilocybin for treatment-resistant depression (TRD). In line with previous reports, we hypothesized that the occurrence and magnitude of Oceanic Boundlessness (OBN) (sharing features with mystical-type experience) and Dread of Ego Dissolution (DED) (similar to anxiety) would predict long-term positive outcomes, whereas sensory perceptual effects would have negligible predictive value. Materials and Methods: Twenty patients with treatment resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin). The Altered States of Consciousness (ASC) questionnaire was used to assess the quality of experiences in the 25 mg psilocybin session. From the ASC, the dimensions OBN and DED were used to measure the mystical-type and challenging experiences, respectively. The Self-Reported Quick Inventory of Depressive Symptoms (QIDS-SR) at 5 weeks served as the endpoint clinical outcome measure, as in later time points some of the subjects had gone on to receive new treatments, thus confounding inferences. In a repeated measure ANOVA, Time was the within-subject factor (independent variable), with QIDS-SR as the within-subject dependent variable in baseline, 1-day, 1-week, 5-weeks. OBN and DED were independent variables. OBN-by-Time and DED-by-Time interactions were the primary outcomes of interest. Results: For the interaction of OBN and DED with Time (QIDS-SR as dependent variable), the main effect and the effects at each time point compared to baseline were all significant (p = 0.002 and p = 0.003, respectively, for main effects), confirming our main hypothesis. Furthermore, Pearson's correlation of OBN with QIDS-SR (5 weeks) was specific compared to perceptual dimensions of the ASC (p < 0.05). Discussion: This report further bolsters the view that the quality of the acute psychedelic experience is a key mediator of long-term changes in mental health. Future therapeutic work with psychedelics should recognize the essential importance of quality of experience in determining treatment efficacy and consider ways of enhancing mystical-type experiences and reducing anxiety. Trial Registration: ISRCTN, number ISRCTN14426797,
Full-text available
Music therapy (MT) and music-based interventions (MBIs) are increasingly used for the treatment of substance use disorders (SUD). Previous reviews on the efficacy of MT emphasized the dearth of research evidence for this topic, although various positive effects were identified. Therefore, we conducted a systematic search on published articles examining effects of music, MT and MBIs and found 34 quantitative and six qualitative studies. There was a clear increase in the number of randomized controlled trials (RCTs) during the past few years. We had planned for a meta-analysis, but due to the diversity of the quantitative studies, effect sizes were not computed. Beneficial effects of MT/ MBI on emotional and motivational outcomes, participation, locus of control, and perceived helpfulness were reported, but results were inconsistent across studies. Furthermore, many RCTs focused on effects of single sessions. No published longitudinal trials could be found. The analysis of the qualitative studies revealed four themes: emotional expression, group interaction, development of skills, and improvement of quality of life. Considering these issues for quantitative research, there is a need to examine social and health variables in future studies. In conclusion, due to the heterogeneity of the studies, the efficacy of MT/ MBI in SUD treatment still remains unclear.
Full-text available
Rationale: Although psilocybin and dextromethorphan (DXM) are hallucinogens, they have different receptor mechanisms of action and have not been directly compared. Objective: This study compared subjective, behavioral, and physiological effects of psilocybin and dextromethorphan under conditions that minimized expectancy effects. Methods: Single, acute oral doses of psilocybin (10, 20, 30 mg/70 kg), DXM (400 mg/70 kg), and placebo were administered under double-blind conditions to 20 healthy participants with histories of hallucinogen use. Instructions to participants and staff minimized expectancy effects. Various subjective, behavioral, and physiological effects were assessed after drug administration. Results: High doses of both drugs produced similar increases in participant ratings of peak overall drug effect strength, with similar times to maximal effect and time-course. Psilocybin produced orderly dose-related increases on most participant-rated subjective measures previously shown sensitive to hallucinogens. DXM produced increases on most of these same measures. However, the high dose of psilocybin produced significantly greater and more diverse visual effects than DXM including greater movement and more frequent, brighter, distinctive, and complex (including textured and kaleidoscopic) images and visions. Compared to DXM, psilocybin also produced significantly greater mystical-type and psychologically insightful experiences and greater absorption in music. In contrast, DXM produced larger effects than psilocybin on measures of disembodiment, nausea/emesis, and light-headedness. Both drugs increased systolic blood pressure, heart rate, and pupil dilation and decreased psychomotor performance and balance. Conclusions: Psilocybin and DXM produced similar profiles of subjective experiences, with psilocybin producing relatively greater visual, mystical-type, insightful, and musical experiences, and DXM producing greater disembodiment.
Under the predictive coding framework, perceptual learning and inference are dependent on the interaction between top-down predictions and bottom-up sensory signals both between and within regions in a network. However, how such feedback and feedforward connections are modulated in the state induced by lysergic acid diethylamide (LSD) is poorly understood. In this study, an auditory oddball paradigm was presented to healthy participants (16 males, 4 female) under LSD and placebo, and brain activity was recorded using magnetoencephalography (MEG). Scalp level Event Related Fields (ERF) revealed reduced neural adaptation to familiar stimuli, and a blunted neural 'surprise' response to novel stimuli in the LSD condition. Dynamic causal modelling revealed that both the presentation of novel stimuli and LSD modulate backward extrinsic connectivity within a task-activated fronto-temporal network, as well as intrinsic connectivity in the primary auditory cortex. These findings show consistencies with those of previous studies of schizophrenia and ketamine but also studies of reduced consciousness - suggesting that rather than being a marker of conscious level per se, backward connectivity may index modulations of perceptual learning common to a variety of altered states of consciousness, perhaps united by a shared altered sensitivity to environmental stimuli. Since recent evidence suggests that the psychedelic state may correspond to a heightened 'level' of consciousness with respect to the normal waking state, our data warrant a re-examination of the top-down hypotheses of conscious level and suggest that several altered states may feature this specific biophysical effector.
Classic psychedelic drugs (serotonin 2A, or 5HT2A, receptor agonists) have notable effects on music listening. In the current report, blood oxygen level-dependent (BOLD) signal was collected during music listening in 25 healthy adults after administration of placebo, lysergic acid diethylamide (LSD), and LSD pretreated with the 5HT2A antagonist ketanserin, to investigate the role of 5HT2A receptor signaling in the neural response to the time-varying tonal structure of music. Tonality-tracking analysis of BOLD data revealed that 5HT2A receptor signaling alters the neural response to music in brain regions supporting basic and higher-level musical and auditory processing, and areas involved in memory, emotion, and self-referential processing. This suggests a critical role of 5HT2A receptor signaling in supporting the neural tracking of dynamic tonal structure in music, as well as in supporting the associated increases in emotionality, connectedness, and meaningfulness in response to music that are commonly observed after the administration of LSD and other psychedelics. Together, these findings inform the neuropsychopharmacology of music perception and cognition, meaningful music listening experiences, and altered perception of music during psychedelic experiences.