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Best Music Playlists For Psychedelic Therapy Are Explored In New Johns Hopkins Study

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Psychedelic therapy sessions often incorporate music—and typically that music is of the classical genre. But new research out of the Johns Hopkins University School of Medicine suggests there may in fact be no special value in playing a Mozart concerto or Chopin étude for tripping patients.

Gongs could work just as well, if not better, the study found.

“Western classical music has long been assumed to be the standard in psychedelic therapy,” researchers wrote in the study, published Tuesday in the American Chemical Society (ACS) journal Pharmacology and Translational Science. “The present data challenge this notion that Western classical music, or for that matter any specific genre of music, is an intrinsically superior form of music to support psychedelic therapy, at least for all people at all times.”

Analyzing a 10-person trial involving the use of psilocybin therapy to help people quit smoking tobacco, the Johns Hopkins team compared sessions featuring classical music with those involving overtone-based music, featuring instruments such as gongs, Tibetan singing bowls or the didgeridoo, among others.

“Although we found no significant differences between the two musical genres studied here,” the team wrote, “several trends suggested that the overtone-based playlist resulted in somewhat better outcomes and was preferred by a larger portion of this small sample of participants.”

In other words, while the results don’t prove that overtone-based music yields better outcomes than classical, the findings nevertheless “call into question whether Western classical music typically played in psychedelic sessions holds unique benefit.”

As one of the study’s authors, Johns Hopkins researcher Matthew Johnson, put it in a recent tweet: “Apparently classical music is not such a sacred cow for psychedelic therapy.”

The researchers said the study “provides the first contemporary and within-subject experimental manipulation of session set and setting factors in psychedelic research” and is the “first fully randomized test of different musical genres supporting psychedelic therapy.”

Participants each had three therapy sessions, one featuring classical music, another featuring overtone music and a third session for which they could choose between the two genres. Psilocybin doses were between 20 milligrams and 30 milligrams per 70 kilograms of body weight.

Among the data researchers analyzed were participants’ evaluations of their own experiences, including “mystical experiences”—such as feelings of unity and transcendence of time and space—as well as “challenging experiences,” such as feelings of panic or losing sanity.

“Visual inspection of individual and average data indicated higher overall scores for overtone-based sessions compared to Western classical sessions,” the authors wrote. “This difference was of a medium effect size but was not statistically significant.”

Researchers also analyzed smoking abstinence outcomes based on the music genre participants selected for their third psychedelic therapy session, after sampling both genres. Participants who chose to listen to overtone music during the third session were more successful at quitting smoking—both immediately after treatment (83.3 percent) and over a period of about 30 months afterward (66 percent). By comparison, half of participants who chose Western classical music quit smoking immediately, and all of those people were still not smoking after 30 months.

Experts have long stressed the role of set and setting in a psychedelic experience, noting how both a person’s psychological state as well as their environment can affect the behavioral and clinical effects of entheogenic drugs. “Traditional laboratory contexts that contain overtly ‘sterile’ stimuli (e.g. white walls and medical equipment,” the authors note as one example, “have been suggested to increase the likelihood of negative reactions.”

While music is a standard feature of clinical psychedelic therapy, the new study says, the default by therapists to predominantly Western classical playlists is “likely due to recommendations present in early guidelines,” which specifically mentioned classical music.

But it may not be music at all, but instead a collection of sounds, that complements the psychedelic experience.

“The lack of superiority of the Western classical playlist is even more interesting considering that some of the overtone-based playlist tracts consisted of sounds without traditionally identifiable melody and/or rhythm and therefore might not be classified as songs or music by some,” the study says. “This suggests that the sounds capable of supporting psychedelic therapy sessions may go beyond the bounds of traditionally defined musical genres.”

The researchers concluded that the study lends support to the idea that “developing a process for generating patient-specific musical selections rather than providing standardized music may improve therapeutic outcomes.”

“For example, future work could evaluate how patient-selected music impacts therapeutic effects or identify individual factors predictive of response to varying musical genres or musical features other than genre to individualize session selections,” the wrote. “More broadly, these findings emphasize the need for the parametric study of psychedelic session components to either provide improved standardized conditions, or to individualize conditions to improve the therapeutic effects of psychedelic therapy across diverse and varied populations.”

Johns Hopkins University, where the study analysis was done, is widely regarded as a leading institution on psychedelic research. In 2000, it became the first U.S. institution to gain federal approval to reinstitute research into psychedelic drugs using subjects who didn’t already have a history of using the drug, and last year it launched the country’s first-ever psychedelic research center.

Canada Will Let Health Care Professionals Legally Use Psychedelic Mushrooms, Health Minister Says

Photo courtesy of Wikimedia/Workman

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Ben Adlin is a Seattle-based writer and editor. He has covered cannabis as a journalist since 2011, most recently as a senior news editor for Leafly.

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