Picture this: Your favorite song comes on. Music that you’ll love forever. You’ve heard it a thousand times, but right now it’s amplified. You recognize patterns that previously escaped you. Oh yes, and you’re high— gleefully so. It’s commonly known that cannabis enhances the senses, and its connection with music is well established, having inspired many of our greatest artists.

But just as cannabis can be a psychedelic, it can also be therapeutic. Medical cannabis helps manage everything from insomnia to epilepsy. While its powers are great, it’s not alone. Other psychedelics such as psilocybin and ayahuasca are being increasingly used therapeutically. And just like cannabis, music can enhance, or even hinder that experience.

Psychedelic-assisted psychotherapy, or PAP, uses psychedelics therapeutically to treat conditions such as depression, PTSD, addiction, and anxiety. In particular, substances such as ketamine, MDMA, and LSD show promise for treatment-resistant depression. While legalities prevent such treatments from being widely available, they are at times used in clinical settings under the supervision of a doctor. Other times, those in search of healing travel to South America for ayahuasca ceremonies, or they create their own microdosing regimen.

“Sound is a key element of psychedelic ceremony; it’s an easily controlled and tremendously powerful variable of the setting.”

In both group and individual settings, music plays a vital role in psychedelic-assisted therapy. “Sound is a key element of psychedelic ceremony; it’s an easily controlled and tremendously powerful variable of the setting,” says occultist and psychedelic researcher Julian Vayne. “In a therapeutic context, a common approach is to use a diverse range of pre-recorded tracks so that the patient has time to explore a range of feelings and associations.”

Within psychedelic-assisted psychotherapy, the psychedelics act as the vessel or boat which carries you through the experience and takes your mind places, ideally healing, which it may not travel to under everyday conditions. Music can be seen as the tides; it helps direct the boat. “Music carries us through the experience, it is the road for the spirit to pass over,” Vayne says. “It provides a series of emotionally salient inputs to encourage a wide range of novel neuronal connections.”

Within clinical settings, music can be best tailored to the experience and a supervisor is there to ensure your boat is taking you on the most healing path. Songs with words can be distracting to the process, so don’t expect to hear Top 40 while ingesting psilocybin for depression or during an ayahuasca circle. “The music favored by many therapists is often instrumental only, ranging from classical to mid-tempo electronic sounds. In a more analog shamanic setting, the healer will sing, rattle, play the drums or whatever in a way that follows the trajectory of the medicine and the apparent needs of the client,” Vayne says.

During ketamine infusions, which can treat PTSD and treatment-resistant depression, patients are often instructed to listen to music during the IV. “I always suggest fun music. Not a meditation tape, not Chopin. I don’t want you wandering off into some dark place. I just want you to be distracted,” says Glen Brooks, MD., of NY Ketamine Infusions. Brooks differentiates ketamine from psychedelics such as shrooms or LSD. Ketamine IVs are not about the dissociative experience itself, but the chemical effects of the medicine. “Ketamine is building the dendrites and synapses. That doesn’t even begin for eight to ten hours after the infusion,” Dr. Brooks says.

“I always suggest fun music. Not a meditation tape, not Chopin. I don’t want you wandering off into some dark place. I just want you to be distracted.”

Even though ketamine works differently than something such as ayahuasca, it can still float you down a challenging path, which is why Dr. Brooks encourages fun music. “Going to that dark place serves no therapeutic purpose; I don’t want my patients working through things,” he says. “The purpose of the music is more distracting than anything else.”

While ketamine treatment takes place within a clinical setting, with nurses on call, and Freddie Mercury is allowed to distract you, traditional ayahuasca ceremonies are rooted in the moment and use sound to carry you through the experience. “The vibration of the music, of the voice, the drum, is like a key to a door that leads to another perception,” says psychedelic activist and organizer Eva Césarová of her ayahuasca experiences.

During a DMT therapeutic experience, she recalls having an ego death amplified by music. “I had an ego death through voice. I was making a sound, and the sound went up and I kind of died through that. I felt like the only thing that made sense is to sing,” Césarová says. “I never sing in my life.”

While both clinical and anecdotal research on psychedelic-assisted psychotherapy is promising, we need much more of it. Due to legalities, many people self-administer psychedelics for therapeutic reasons, although that’s not recommended by medical professionals. “I went from Alcoholics Anonymous into psychedelic therapy. I found that space to be very lacking and I found a lot of hope in the research I was seeing coming out of Johns Hopkins, etc. I decided to throw up a couple middle fingers and find my own way,” says Kevin*, who asked to remain anonymous for privacy and legal reasons.

While he says MDMA and psilocybin help treat his alcoholism, in a few group ayahuasca settings he found the music distracting. It pushed him back into the dark past Dr. Brooks hopes to steer patients away from. Within the general psychedelic community, there is an expression that there are no bad trips, only “challenging” ones. Such an idea suggests that you get the trip that you need, not that you want. Research on patients taking psilocybin for treatment-resistant depression found that music had both “welcome” and “unwelcome” effects on patients experience.

So while music can amplify a therapeutic trip, it can also steer your mind down a dark path. Turning the wrong corner down memory lane may act as difficult but important processing tool for some, but it can also just lead to a bad trip or a very uncomfortable therapy session.

Until psychedelics become more acceptable as a mainstream treatment option, conducting large double blind studies on the exact effect of music remains tricky. Some research on psilocybin patients suggests that musical experience was predictive of a reduction in depression, even when drug intensity was not. “When music and psychedelics come together in a good way, it’s divine,” Kevin says.

But the best indicator of how music shapes your experience is you. The next time you’re using cannabis, try adding music to your meditation. And if a song bums you out? Steer your own ship and skip to the next one.

By Sophie Saint Thomas

December 12, 2019

Sophie Saint Thomas is a freelance writer based in Brooklyn originally from the US Virgin Islands. Her writing is published in GQ, Playboy, VICE, Cosmopolitan, Forbes, Allure, Glamour, Marie Claire, and more.