The LSD Concerto: How Music Effects Psychedelic Therapy
During my first LSD experience, I remember lying on a sofa gazing at the dancing fractal imagery morphing in front of me as The End by The Doors played through the speaker. During the immense crescendoing guitar solo, a shadow of Jim Morrison approached me and told me to "come closer into the depths of my mind." The word clichéis an understatement, but the experience made me curious about the synergy between the LSD and psychedelic rock music. Having since expanded my psychedelic endeavours and taste in music, I wonder whether particular music genres have a guaranteed symbiosis with psychedelics or whether it's entirely dependent on the individual. Was my wondrous encounter with Jim Morrison simply a product of my musical preferences? Or has there been something specific, meticulously crafted into the 60s psychedelic rock which enhances whatever effect the drug may be having on the brain?
The late Jim Morrison, lead singer of the psychedelic rock band The Doors
Set and setting is a pivotal part of psychedelics in both recreational and therapeutic contexts. Set, meaning the mindset somebody goes into a psychedelic experience with; and setting referring to their physical environment. Music alone can have a highly profound effect, meaning the music playing during a psychedelic experience is tremendously important in creating the right setting.
Psychedelic therapy has made a massive re-emergence over the past decade. During a typical therapy session, participants take the drug and lie down, listening to music for most of their psychedelic journey. With participants typically blindfolded throughout the sessions, music is their primary sense relating them to the world around them. It's therefore crucial that the music played is carefully and thoughtfully selected. Based on LSD research and his journeys exploring ayahuasca use in tribal settings, the anthropologist Marlene Dobkin de Rios quotes:
“If these hallucinogenic substances are to be used psychotherapeutically in the future, the role of music as a primary conditioning agent of the experience will have to be taken into account. Any planning for psychotherapeutic intervention in times to come would necessitate a clear musicological approach to create therapeutic states of consciousness… Music can be a major mode of managing the drug-induced altered state”
An artist’s impression of a typical psychedelic therapy setting, with the participant wearing a blindfold and listening to music.
The importance of music in the setting for psychedelic therapy has had a long history of interest. During research throughout the 50s and 60s, a key player in exploring the music and psychedelics link was Helen Bonny. Working alongside psychedelic-pioneers, such as Stan Grof, she developed a Guided Imagery and Music method to help explore different states of consciousness in a therapeutic context.
Re-examining the importance of music for therapeutic purposes, in light of today's psychedelic renaissance, is the founder of the wellbeing startup Wavepaths, Mendel Kaelen. Alongside teams from Imperial College London, Mendel's scientific research has sought to investigate the importance of and conjoined effects of psychedelics and music.
One set of experiments by Mendel and colleagues, published in 2016 set to show what happens on a neurological level when people take psychedelics and listen to music. To do this, brain scanning technology called fMRI imaged the blood flow in the brain, representative of brain activity, of study participants listening to music whilst under the influence of LSD. The results showed the flow of information from a brain area called the parahippocampus increased to the visual cortex. The parahippocampus is involved in generating complex images and memories, which could offer some degree in answering the mechanisms by which music can enhance the psychedelic experience. The findings could also indicate how music may assist in psychedelic therapy. For example, by increasing the information flow from memory centres of the brain, music could help patients re-experience and work through their memories and past traumas.
Functional connectivity changes during LSD and music, fMRI scanning shows increased connectivity between the parahippocampus and visual cortex.
In the context of my own experience, perhaps this neurological phenomenon could explain the intense geometry triggered by the memory of Jim Morrison, who I saw during my acid trip. However, during Mendel's imaging experiment, the music was limited to only a select few tracks chosen by the researchers. So it's yet to be discovered whether the brain patterns which emerge from a blend of LSD and guitar solos would have quite the same neurological signature if the researchers had played different types of music. Would the same activity flow changes happen in a psychedelic Mozart symphony?
"Trippy Mozart"
Mendel and colleagues published another essential study highlighting the critical role of music in psychedelic therapy. In the experiment, researchers interviewed patients undergoing psilocybin-assisted therapy about the various aspects of the music listened to during their experience. Amazingly, they found effects of music on the patients, but not the drug intensity, predicted whether or not the patients had decreased depression after their psychedelic experience. The music's effect on the patients could also predict whether or not the participants had a mystical experience or whether they found the psychedelic drug to be insightful.
Results from experiment showing how different aspects of music and how drug intensity affected aspects of psychedelic therapy. Yellow boxes indicate that there was a relationship between music aspect/drug intensity and the therapy outcome
As well as highlighting the essential nature of music in psychedelic therapy, the experiment also shed light on how music can facilitate negative, as well as positive, aspects of the experience. 50% of the participants reported that music negatively intensified their experience, 32% reported that music was in discordance with their internal emotional balance and 47% reported a sense of rejecting the musical evoked experience. The overall findings demonstrate that music is a potent force that has the capacity to both advantage and disadvantage a psychedelic therapy session.
It is important to consider that the researchers had designed the playlist in Mendel's experiment rather than the patients themselves. Although careful work had gone into choosing the music, 58% of the participants made comments in the interviews related to the disliking and not appreciating of music genres, styles, and playlist design. If the participants had chosen the music themselves, with the genres and styles they chose themselves, would there have been fewer reports of negative intensification, discordance and/or rejection?
A distinguishing feature of psychedelic therapy is the patient-centred approach which conventional medicine seems to discard. Psychedelic therapy is often designed to combat an individual's own personal issues instead of simply treating their diagnostic symptoms in a one-box-fits-all approach. Although they share some common symptoms, the root cause or the manifestation of a mental health disorder in one individual might be completely different from another. Yet, both patients often end up receiving the same psychiatric treatment. Psychedelic therapy, in its essence, is about tailoring to the individual, offering a different approach to that of the depersonalised features from modern Western psychiatry. The music played in a psychedelic therapy session should be no different. Psychedelic therapists shouldn't just prescribe certain genres or playlists because historically, these have worked for people. Music taste and preferences are highly personal and varied. What may be an eargasm of psychedelic bliss to one person could cause another person to be highly agitated.
A recent study examining psilocybin therapy for addiction showed the music genre played during the therapy session did not affect whether people remained addicted or not after the follow-up, demonstrating that the type of music itself is not the deciphering factor of therapy outcome. What seems to be important is that person's relationship to the music and how that relationship crafts their psychedelic experience.
A study investigating psilocybin to treat tobacco addiction showed the genre of music played during therapy did not affect whether the patient gave up smoking or not.
Of course, there are some general guidelines when it comes to choosing music for psychedelic therapy. For example, one would rationally think to avoid intense and distressing music. A patient going through psychedelic therapy should feel calm, safe and ease into the psychedelic experience. I fail to see a situation where these goals could be aided by playing, for example, Doom Metal during a session (yet having said that, a context could exist). It's generally recommended to avoid songs with lyrics, as words could be a source of distraction away from the patient's own emerging thoughts and ideas. Rational language and familiarity could also be a source of hindrance to psychedelic therapy - Mendel quoted in an interview:
“If music is too familiar, it can reduce the ability to have a new experience, because you already had an experience with that song before in your life.”
Psychedelics and music researcher, Mendel Kaelen
There are certainly some universalities to music and general principles which factor into choosing the right tracks for a psychedelic therapy playlist. However, music taste is hugely varied. Just psychedelic therapy has traditionally used specific music genres, we shouldn't presume they are suitable for everyone. Maybe somebody might want to begin their therapy session with the complex harmonies of jazz and end on some 2000s pop sing-along nostalgia when returning to their own. Perhaps a patient might want to listen to the sound of a particular instrument they like or the ambient sounds of a forest to feel in touch with nature. And possibly, a patient doesn't even want to listen to music at all. The therapist should work with the patient to decide the accompanying music of the therapy session together. They should also allow the music choice to be flexible and changed if it becomes unpleasant or hinder a patient's psychedelic experience.
So returning to my initial questions - it's a romantic notion to suggest that when The Doors composed The End, they engineered sounds specifically to create a chemical explosion that I could only access through the power of LSD. It's more likely that instead, my own positive relationship to the song is what created the enhancement. Maybe somebody using LSD could have had an uncannily similar experience listening to Last Christmas, with George Micheal dragging them further into their subconscious. Neurologically it's challenging to know whether the same effects would occur as the limited research into imaging the effects of music and psychedelics doesn't account for the vast scope of different music genres. However, what experiments have shown, conducted by Mendel alongside others, is that psychedelic therapy is of paramount importance.
There's no right or wrong answer regarding what tracks to play during psychedelic therapy, but in light of working in a patient-centred approach, I believe firmly the music shouldn't simply be a prescription, but rather a well-thought collaborative decision between therapist and patient.
