October 14, 2022
Diamond Johnson, M.S., & Dr. Alison McInnes, M.D.
“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.
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.
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.
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.’
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:
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.
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%).
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:
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.”
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.
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.
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.
Instead of re-inventing the wheel, here are two Spotify playlists you can access for free:
1) Osmind’s Ketamine treatment playlist:
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
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.
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:
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.
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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