Psychedelics and music : neuroscience and therapeutic implications
Frederick S. Barrett, Katrin H. Preller & Mendel Kaelen
International Review of Psychiatry, 2018
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.
KEYWORDS : Psychedelic; hallucinogen; LSD; psilocybin; music; music therapy;neuroscience
Classic psychedelic drugs1 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.,
2016a; Osorio 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 clinician-rated disorder severity (Bogenschutz et al., 2015; Carhart-Harris et al., 2016a; Griffiths et al., 2016; Osorio et al., 2015; Ross et al., 2016; Sanches et al., 2016), physiological outcomes, including breath carbon 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 mediate (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 psychedelic 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 meaningmaking (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., 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 rigorous 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 support 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-evolution 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) in music are also brain regions critical for language processing (Levitin & Menon, 2003; Patel, 2008; Sch€on et al., 2010).
Alternative evolutionary theories focus on social functions of music or view music as a product of sexual 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 indicates 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). Crosscultural 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, ranging from work, entertainment, and social settings to medicine and spirituality (Hargreaves & North, 1999; Merriam, 1964; Nettl, 1956).
For the present discussion, the medicinal and spiritual usage of music is particularly relevant. Although
the use of music may be diverse, traditionally cultures often place a special emphasis on music’s capacity to facilitate altered states of consciousness, and historically music-making has been a respected role reserved for priests or medicine-men (Nettl, 1956).
Contemporary research on music listening has begun to address music’s capacity to engender or support altered states, including emotionally intense peak experiences (Gabrielsson, 2011), absorption (Sandstrom & Russo, 2013), groove and flow states (Csıkszentmihalyi, 1990; Janata, Tomic, & Haberman, 2012), trance (Hove et al., 2016; Rouget, 1985), and states of religious ecstasy (Penman & Becker, 2009).