Music to your brain: how music is instrumental in psychedelic therapy
Illustration by Neka King
by Jessica Beachkofsky, MD
You’re familiar with using music as a tool: the workout mix, the breakup playlist, and road-trip tunes. But music might be the only way to gain profound insight during certain cutting-edge mental health treatments. I’m talking about the importance of music paired with psychedelics for treatment of depression, anxiety, or even post-traumatic stress disorder.
As a psychiatrist, I’ve been reading the ever-growing piles of research surrounding psychedelic treatments and can’t help being swept up in the excitement of what these breakthroughs may mean for improving mental wellness in so many who suffer. Just a few treatments may lead to overcoming a lifetime of struggles. Follow me down the rabbit hole to learn how music grants the wish of psychedelic treatment.
What does psychedelic treatment look like?
Here’s the basic formula for most psychedelic treatments: therapist (or two) + psychedelic compound (ketamine, psilocybin, MDMA, or LSD) + a carefully curated playlist, all combined in a treatment space that feels like a living room. This is not a typical 50-minute session; this one lasts for hours and the music is the guide.
If you’re lucky enough to have the sought-after mystical experience, it’s likely your insights from a single treatment will last months and maybe even benefit the rest of your life. Plus, the extra hours of therapy surrounding treatment can help keep you on track.
So why does the music matter?
These are not your average playlists. They are designed by therapists and researchers, just for you, based on decades of data. Certain songs encourage emotional release and others can help reduce feelings of fear and anxiety, which are common experiences with psychedelic substances.
The music selections are specifically designed to take you on a journey that slowly builds toward a peak, which is when the most emotionally enhancing music is played. Then the playlist calms back down as the treatment session closes. The music is designed to build up to an emotional apex, helping the brain create mental imagery (with the aid of an eye-mask) and deepen the entire experience.
But what if you don't really like that kind of music? Turns out it's not about liking the songs; it's about the music's unique ability to induce a profound, mystical state tailored to your emotional needs. It's the soundtrack to a journey that engages your brain to unlock profound insight and emotional release.
What’s the mystical experience?
This mystical experience is the deep, transcendental part of the treatment, and research says this is at the heart of psychedelic treatment. Feeling a sense of oneness with the universe, encountering an ultimate truth, or feeling more significant in daily life; this is the magic that the music brings forth. The mystical experience is not just nice to have, it's the event that makes psychedelic therapy truly transformative.
How does the brain respond to music in psychedelic therapy?
Just like the current antidepressants I prescribe to my patients, psychedelics also work on the serotonin system, but at a pace that is mind boggling. Effects can begin almost immediately and may provide life-long results (versus the weeks to months required with conventional treatments).
A lot of brain functions are hierarchical, which means the top logical thinking part is often separated from the more reactive, run-for-our-lives part. When music is paired with psychedelics, there’s a flattening effect that enhances connections and encourages the free flow of information across different areas of the brain.
Listening to music activates circuits involved in reward, emotion, and memory processing, namely the limbic and mesolimbic circuits. These areas also link to the amygdala, ventral striatum, and orbitofrontal cortex explaining the intense complex imagery and emotions that can be brought out. And this provides the fodder for therapy and introspection over the next few weeks.
What does psychedelic treatment feel like?
My cutting-edge colleague has been engaging in treatments with ketamine and had an existential “awakening” just days after one of her treatments. “I understood my meaning and purpose,” she says. But treatment without the music? Non-negotiable. The music allows her to safely “look at the dark, dirty stuff and see the really beautiful things inside yourself, as well.” The ketamine provides the detachment necessary to view trauma without horror while the music carries the brain along that winding path.
Where do we go from here?
At this point we’re still waiting to see how everything pans out with research results, FDA approvals, and accessibility. I’m excited by the possibility of prescribing treatment that could take just a fraction of the months to years required for traditional psychiatric medication and therapy. Although ketamine is currently the only psychedelic available, 2024 is bringing more novel ways to make mental wellness attainable beyond imagination.
This isn't the playlist for dance parties and road trips; it's the soundtrack to your life's journey for personal healing and self-discovery. As we await treatment breakthroughs in mental health, psychedelics are next in line and music is leading the way.