Optimizing music for psychedelic-assisted therapy: Examining contemporary practices, traditional entheogenic rituals, and musically-induced peak experiences

Music has been integral to psychedelic experiences across history, from shamanic rituals to modern psychedelic-assisted therapy (PAT), yet standardized protocols for its use are lacking. This interdisciplinary review compared musical features in three contexts: modern PAT, traditional entheogenic rituals, and musically-induced peak experiences. Conflicting features emerged: PAT music peaks with simplicity, consistency, and slow tempo; ritual music uses simple forms with rhythmic complexity, subtle variations, and fast tempo; peak-experience music is complex, surprising with large dynamic changes, and fast. These differences likely stem from music's assumed role and the associated non-ordinary state of consciousness.

Study at a glance

Abstract

Abstract Background and Aims Music has been associated with psychedelic experiences throughout human history, from ancient shamanic healing rituals to contemporary psychedelic-assisted therapy (PAT), and is considered integral for positive therapeutic outcomes. Yet optimized protocols and best practice standards for the use of music in PAT are lacking. Methods This interdisciplinary literature review identifies the role, characteristics, hypothesized mechanisms, and relevant contextual factors of music associated with (1) modern PAT practices, (2) traditional entheogenic rituals, and (3) musically-induced peak experiences. Results The findings reveal conflicting musical features across these three contexts. Modern PAT music is designed to mirror the subjective intensity of drug effects with a peak phase marked by simplicity, consistency, and slow tempo. Entheogenic ritual music exhibits simple compositional forms with elements of rhythmic complexity, constancy with subtle variations, and fast tempo. Peak experience-inducing music is complex, surprising (with large dynamic changes), and fast. These differences in music may be due to differences in the assumed role of music and the associated non-ordinary state of consciousness. Conclusions Preliminary recommendations for clinical PAT practice include: tailoring music to the drug, the individual, and the desired experience; drawing on mechanism-based theories from music psychology; and considering the ethics of integrating Indigenous musical practices. In general, there is a dearth of research directly comparing different types of music during PAT, particularly along key dimensions such as familiarity, complexity, and constancy, suggesting a need for further experimental studies with diverse populations.