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Today’s lead story looks at a new Stanford study on how psychedelic therapy playlists follow the template popularized by Johns Hopkins University. But the findings suggest that what patients need, and how they personally experience music, may matter more than the template itself. You’ll find that piece(and some bigger questions about music and psychedelics) just below!

If you keep scrolling you’ll find stories on psychedelics and VR, the American consumption of psilocybin, and why most mainstream Americans believe psychedelics are addictive.

Happy fall 🍂
Mary Carreón
Editor-in-Chief

Psychedelic therapy playlists are built to mirror a trip, but, a new Stanford analysis finds that they rarely do. Is it even possible for music to capture the ineffable rise, peak, and return of a psychedelic experience?

The rise of psychedelic-assisted therapy over the past decade has sparked a new genre of music, along with a playbook for how practitioners should use it in curated playlists. Much of that playbook traces back to one of the most widely reported on playlists of all time: The seven-hour Johns Hopkins playlist, specifically built for psilocybin-assisted therapy research. It popularized a three-act format for psychedelic therapy playlists, where clam music eases patients into a journey, sweeping music holds them as they peak, and familiar music brings them home. At least in theory. A Stanford University analysis suggests that playlists don’t follow that script.

In a study published on Oct. 8 in Scientific Reports, researchers at the Stanford University School of Medicine used machine learning to analyze 45.1 hours of audio from eight playlists used in psilocybin research. The playlists came from Johns Hopkins University, Imperial College London, the Chacruna Institute, the University of Copenhagen, and Compass Pathways. Across 369 tracks, the team reported finding little consistency around acoustic or emotional differences between music at the onset, peak, or return phases of a trip. Matching music to the arch of psychedelics is one of the field’s core assumptions, although it has rarely been tested.

That assumption originally dates back to the Bonny Method of Guided Imagery and Music, which was developed fro LSD psychotherapy in the early ‘70s. The method holds that wordless, emotionally evocative music should move with the effects of psychedelics. At Johns Hopkins, psychologist Bill Richards, whose been involved in psychedelic research since the ‘60s, built the university’s playlist. Researchers at NYU Langone Health and the Usona Institute have since adapted. The Hopkins prescription says that music at the onset should be stable and predictable, with little rhythm and no lyrics; music at the peak of a psychedelic experience should feel expansive and transcendent; and music at the end of a journey should become more familiar, with lyrics reintroduced.

The research team at Stanford tested whether those phases actually show up in the audio. They trained a computer model to identify search track’s phase by its sound alone, and it did barely better than random guessing. Meaning, half of the onset tracks were indistinguishable from music meant for the peak or the return. A more complex model using 65 low-level acoustic features beat a baseline guess but still misclassified 62% of onset tracks. When algorithms grouped together the music without phase labels, almost no structure emerged. Only three of the eight playlists showed phase organization above baseline, and the playlists were hard to tell apart from one another.

None of this means that music is irrelevant to psychedelic therapy. In fact, we know the opposite to the be true.

“These findings should not, however, be taken to imply that music lacks therapeutic importance in psychedelic therapy,” the study’s author’s wrote. “Existing qualitative, phenomenological, and clinical evidence strongly supports the view that music is an integral aspect of psychedelic sessions.”

Research from 2018 backs that up. Imperial College London published a study where 19 patients with treatment-resistant depression found that how patients experience music during psychedelic therapy predicted reductions in depression one week after a session, while intensity of the experience (ie: higher dosage) did not. A 2020 Johns Hopkins Study of smokers compared Western Classical music with an overtone-heavy playlist featuring singing bowls, gongs, didgeridoo, and bells. Six of 10 participants chose the overtone music for a third session, and that group had slightly higher confirmed abstinence from smoking at 66.7% versus 50%.

But, what the recent research out of Stanford may be pointing out is that the playlist template was only ever a rough draft, the first iteration, of how music should be integrated into clinical psychedelic work. According to the analysis, even the playlists designed around the three-part model rarely follow that logic in practice — perhaps because no one has defined what onset, peak, and return music sound like. But much like how language often falls short of accurately describing emotions, can music adequately capture the ineffable arc of the psychedelic experience? It’s hard to say. But as our understanding of these experimental therapies evolves, so too might our understanding of the music that carries patients through them.

“One possibility is that the therapeutic relevance of music during psychedelic therapies depends less on generalized acoustic trajectories than on subjective emotional resonance between listener and music,” the researchers wrote. “Under this interpretation, effective therapeutic music is likely to depend more on personalization and adaptation to a patient’s current needs than on phase-based templates.”