October 14, 2022

The Pivotal Role of Music in Ketamine and Psychedelic Treatments

Written by

Diamond Johnson, M.S., & Dr. Alison McInnes, M.D.

There’s no debate that music can alter your mood—excite you or calm you down, enhance creativity, and help encode and spark memories.

“Music replays the past memories, awakens our forgotten worlds and make our minds travel.”

– Michael Bassey Johnson

Music by itself is therapeutic, and is a powerful tool in psychedelic-assisted therapy, including ketamine therapies.

Unlike more traditional talk therapy or medications, psychedelic-assisted therapies are experiential in nature. Psychedelic researchers have established the direct relationship between subjective experiences and therapy outcomes, which continues to be supported by current research.

Mindset (the patients’ thoughts, mood, and expectations for therapy) and setting (the external environment including lights, furniture, and music) can make or break a therapy session. However, the current landscape of research on music’s role in psychedelic treatments is limited.

This article explores the research, patient experience, and efficacy of music and psychedelic-assisted therapies.

You’ll learn:

  • The state of research in music and psychedelic-assisted therapies
  • Emotions evoked for patients with music and ketamine therapies
  • Music recommendations and playlists you can use in your practice

Why we conducted this survey, and why now?

A growing body of voices—emerging from community forums for clinicians, researchers, and patients—believe music is a vital part of these treatments.

The Osmind Patient Community is no exception. This forum is a peer-to-peer platform comprised of thousands of patients who are interested in mental healthcare and innovative mental health treatments. Among members, music for ketamine infusion therapy (KIT) is one of the most actively discussed topics, generating tens of thousands of views.

While it is generally acknowledged that set and setting are vital components to therapeutic outcomes—studies that provide practical guidance for clinicians are limited.

Of the various aspects of set and setting, the role of music is perhaps easier to study since it’s an easier variable to control.

Thus, with curiosity—Osmind surveyed our growing community of mental health clinicians and patients regarding their attitudes and preferences about the use of music during ketamine treatments. Results and discussion are explored below.

Patient reports on the efficacy of music in their treatment journey

When asked about music’s impact on treatment, an overwhelming majority of patient respondents (87%) endorsed that listening to music improves the efficacy of their treatment.

Further, in response to the question, “How do you think music improves the efficacy of your treatment?”, most patients (76%) indicated that music allows them to delve deeper into their session.

Clinician attitudes toward music’s efficacy in treatment

Similar to patients, most clinician respondents (65%) believe music improves their patients response to treatment. Over a dozen clinicians used the open-ended response section of the survey to emphasize that music is integral to successful treatment. Conversely, based on the open-ended responses, only one respondent doesn't let their patients listen to music because ‘they're not sure it helps.’

survey statistic "a large majority of patient respondents (87%) listening to music improves the efficacy of treatment.

Mismatch between clinician and patient attitudes toward music’s efficacy in treatment

It’s also important to note that 22% fewer clinicians than patients believe that music improves patient’s response to ketamine treatments.

We think this mismatch highlights a potential lack of communication between patients and clinicians around music.

Music is so personal, so we encourage clinicians to discuss music choices with patients to enhance clinical care.

Not only does music enhance treatment efficacy, it enhances enjoyment. The vast majority (87%) of clinicians indicated they included music in their treatment sessions because they believe music makes the experience more enjoyable.

While most patient and clinician respondents are in agreement that music has an impact on treatment response, some were skeptical and curious to learn more about the nuances and interaction effects.

A few clinicians asked about measuring the efficacy of music use during treatment sessions and the existing research surrounding efficacy, posing questions like:

  • “Has there been a direct correlation between music and treatment outcomes?”
  • “Can music be a distraction and hinder patients from the full benefits from treatment?”
  • “Does (music) detract from the inward journey?”

These are healthy questions to explore, and there are currently no clear answers. The current evidence suggests that music is vital in psychedelic treatments whether to be a source of comfort and safety or to help direct a heightened emotional experience. We explore these questions more in-depth below.

Emotions evoked from music

In addition to believing that music allows them to delve deeper into their session, many patients (71%) also believe it improves efficacy by providing comfort.

Almost all (98%) patient respondents reported that they utilize music to evoke a certain mood during treatment. The most common moods patients are trying to evoke are calm (72%) and peace (69%).

graphic of two circles showing a statistic: The most common moods respondents are trying to evoke with music are calm (72%) and peace (69%)

Patients’ uniform desire to evoke feelings of both calm and comfort (“It adds to my relaxation to be able to ride with the experience.”) suggests that patients may be in distress during treatment more frequently than clinicians are aware of.

Several clinicians also went on to highlight how music can be a supportive agent to patients in distress. Thoughts included:

  • “Music I feel is essential to a healing journey that both helps the journey unfold and also touch on some emotional and spiritual subjects that can be difficult to navigate without music.”
  • "Patients seem more able to relax and push through tough feelings if they have music. It also seems to give them a sense of control.”

Calming anxiety

Patients highlighted they struggle with anxiety around treatment, both in the structured questions and in the open-ended responses.

“I believe for myself that music is super helpful when I feel fear, or like I ‘might die’ during my infusions."

Most patients (70%) feel music helps them with feelings of anxiety. Similarly, one clinician noted, “I feel like the music helps soothe [patients] in the beginning to decrease their anxiety coming into the infusion.”

Circle graph at displays the stat: "most patient respondents (70%) feel that music helps them with feelings of anxiety."

Summary of emotions and music:

Overall, survey responses demonstrated that patients are seeking comfort, hoping to feel peace and calm, and are aiming to address feelings of anxiety. In addition to using music to create a supportive environment, many (67%) respondents also indicated that having a provider available during treatment is helpful.

Best types of music for psychedelic-assisted therapy

Counter to counter-culture of the 60s, the best “set and setting” for psychedelic-assisted therapy may not be The Beatles or Pink Floyd.

While nearly all respondents endorsed the use of music during treatment, there’s variability among the types of music clinicians and patients believe is most beneficial.

By far the most popular music genre respondents use to enhance their treatment experience is "Relaxing Electronic"—such as Ambient, Downtempo, or New Age (52%).

Other popular choices included: (Music that contains) binaural beats (37%) and classical music (31%).

It’s worth noting that some clinician respondents (52%) chose to nuance their answer by selecting 'Other' when asked, “Which genre of music they play during treatment sessions?”

While there was a wide range of 'Other' submissions, 'spa music' seemed to be a common theme.

Despite disparities regarding optimal music choice, clinicians and patients alike seem to agree the music is a necessary part of the experience.

What about silence?

When considering silence as an alternative, one clinician left the following open-ended response:

“The only time I don’t use music is in the rare case that the patient prefers silence. I respect their decision but make sure they know that music can drastically alter the experience, for both better and worse depending on selection.”

While music has the ability to soothe anxiety and foster feelings of calm and peace, it can invite stronger emotion for a more challenging but transformational healing experience.

Choice of music has the power to significantly influence the psychedelic experience. As such, music is a treatment decision that should be thoughtfully made with consideration of both therapeutic goals and the patient’s emotional state.

Playlists you can use for psychedelic-assisted therapy:

Instead of re-inventing the wheel, here are two Spotify playlists you can access for free:

1) Osmind’s Ketamine treatment playlist:

Osmind: The Pivotal Role of Music in Ketamine Treatments

This seven hour and 30-minute playlist is a collection of survey respondents’ preferred musical selections for ketamine treatments. It is intended for educational, and not therapeutic purposes.

2) Jon Hopkins’ psilocybin playlist

Psilocybin Research: Johns Hopkins, Sacred Knowledge, William A. Richards

This seven-hour and 40-minute playlist, developed by researchers at Johns Hopkins, is comprised of mainly classical music. The playlist seeks to express the sweeping arc of the typical medium- or high-dose psilocybin session.

Psychedelics and music: state of research

Researchers have explored the relationship between the relationship between music and psychedelic medicine for the past 50 years. Here is a summarized timeline for context:

  • Helen Bonny, Ph.D. and Walter Pahnke M.D., Ph.D. (1972) were among the earliest researchers to explore the role of music in psychedelic medicine. From this work and more, Helen Bonny devised the Bonny Method of Guided Imagery and Music which is a “music-centered, consciousness-expanding therapy.”
  • Research from Robin Carhart-Harris, PhD, Ralph Metzner Distinguished Professor of Neurology and Psychiatry at UCSF, also provides context into potential underlying explanations for how music impacts psychedelic treatments. In his study assessing the ability of psilocybin to aid in emotional insight, Carhart-Harris was able to generate data to support the hypothesis that psychedelic drugs aid in an individual’s ability to access core memories and emotions. Detailed in another of his studies “Neural correlates of the LSD experience revealed by multimodal neuroimaging,” Carhart-Harris highlighted that psychedelics have a profound impact on well-established brain networks, some of which regulate emotion.
  • Research conducted by by Kaelen and Carhart-Harris suggests that this change to brain networks may contribute to enhanced responsiveness to stimuli intended to generate emotion, like music. When considering the role of ego dissolution in psychedelic treatments, music can help guide patients through the most poignant and impactful emotional and cognitive content. This may in turn contribute to therapeutic outcomes.

Methodology of the current survey

Osmind conducted a survey that collected qualitative data and obtained N=102 responses. The sample included 55 patients & 47 clinicians. The vast majority (95%) of patient respondents underwent some form of ketamine (KIT or ketamine-assisted psychotherapy [KAP]) treatment, most often KIT.

All clinician respondents utilize some form of ketamine (KIT or KAP) as their primary healing mode. Patients were recruited directly through the Osmind Patient Community. Clinicians were recruited through the Osmind Platform. Participants were paid upon completion of the survey.

Conclusion:

  • Results from the current survey suggest that music plays a vital role in enhancing efficacy of ketamine therapies—supported by both clinicians and the patients.
  • Music elicits many emotions in therapy, depending on the music. Clinicians and patients favored genres like classical, ambient, “spa-music”, and music containing binaural beats.
  • These types of music most often facilitated feelings of peace and calm, easing patients anxiety.

Ketamine treatments are gaining traction for treatment-resistant depression, and research from the Osmind platform is already helping to set new standards for mental health interventions. We look forward to further exploring the relationship of music, and set and setting more broadly in the near future.

“Music is the literature of the heart; it commences where speech ends.”

– Alphonse de Lamartine

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