The hidden therapist: evidence for a central role of music in psychedelic therapy

Summary & key facts

Researchers interviewed 19 people who had psilocybin therapy for hard-to-treat depression to find out how the music played during sessions affected them. The interviews showed music often shaped the drug experience: it could bring helpful emotions, guiding images, calm, and a sense of safety, but it could also trigger unpleasant feelings or resistance. How people experienced the music was linked to having powerful, meaningful 'mystical' feelings and insights, and those music-related experiences predicted how much depression improved one week later, while the overall strength of the drug did not. The study is small and based on interviews, so it suggests music is important but does not prove exactly how or why.

Key facts:

• The study interviewed 19 people receiving psilocybin therapy for treatment-resistant depression to learn how music affected their sessions.
• Researchers asked about different ways music influenced the experience and then analyzed the interview themes.
• Many participants said the music evoked personally meaningful emotions and mental images, and helped them feel guided, open, calm, and safe.
• Some participants reported unwelcome effects of music, such as unpleasant emotions, disturbing imagery, a sense of being misguided, or resistance.
• The team rated each person on how much they liked the music, how much the music 'resonated' with their feelings, and how open they were to the music-evoked experience.
• People who had stronger, more positive music experiences were more likely to report profound, meaningful 'mystical' feelings and greater insight during the session.
• Importantly, the nature of the music experience predicted reductions in depression one week after the psilocybin session, while the general intensity of the drug did not predict this improvement.
• Because this was a small, interview-based study, it cannot prove that music caused the improvements, but it provides evidence that music may play a central therapeutic role and deserves more study.

Abstract

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.

Topics

Pain Management and Placebo Effect Paranormal Experiences and Beliefs Psychedelics and Drug Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Music therapy Neuroscience Psychology Psychotherapist

Substances

Psilocybin

Conditions & symptoms

Depression Sadness or low mood