The American psychedelic movement feels inextricably linked with popular music—whether through the musicians themselves (Pink Floyd, the Grateful Dead, John Coltrane, the Flaming Lips) or the countless musical genres the movement helped inspire. So I was astonished to learn that psychedelic therapy in clinical settings has almost universally incorporated none other than classical music. To me, tripping to Bach and Brahms seemed like a starfish-and-coffee pairing that made no sense. Why not genres like downtempo or tropicália? Why not “Revolver” or “A Love Supreme”?
“Classical music has been the go-to choice in psychedelic therapy studies for almost 80 years,” says Dr. Matthew W. Johnson, professor of psychiatry and behavioral sciences at Johns Hopkins and one of the world’s most published scientists on the effects of psychedelics. Johnson’s questions about whether classical music should always be the default choice were recently put to the test, as the lab he directs published a fascinating, first-of-its-kind study examining how different musical genres might support psychedelic therapy. Though the sample size was small (just ten people) the findings challenge the notion that classical music should be a standard component of psychedelic studies’ set and setting—or that Western concepts of instrumentation and melody are the most conducive to psychedelic exploration.
How Classical Music Became the Standard in Psychedelic Studies
In an article about classical music, music historian Robert Jackson Wood pointed out that “few art forms on earth are more indebted to class privilege than Western classical music.” Initially funded by European aristocrats, the stereotype of classical music as a soundtrack for the elites still holds true today: In fact, a 2018 survey showed that classical music listeners were the wealthiest of all the music listeners surveyed. When you consider that early American psychedelic researchers were almost universally white men with advanced degrees, the choice makes more sense. “The class divide likely played a role in why classical music was selected for use in those early studies,” says Johnson. This first cohort of clinical researchers only added music to their studies after observing how much set and setting—the inner world of the subject, as well as the subject’s external environment—affected the patient’s psychedelic journey. In 1959, Saskatchewan psychedelic research pioneers Abram Hoffer, D.B. Blewett, Nicholas Chwelos, and Colin Smith published a report in the Quarterly Journal of Studies on Alcohol on the therapeutic effects of LSD in 40 patients with alcoholism. Titled “Use of d-Lysergic Acid Diethylamide in the Treatment of Alcoholism,” the report noted “that the environment and particularly the attitude of the people around the person undergoing the LSD experience seem to influence his reaction profoundly.” In this era, research was typically conducted in what Johnson calls a “very sterile” setting. Being dosed by men in white coats and then left alone in a white-walled hospital room with fluorescent lights was not exactly conducive to a positive hallucinatory experience. While psychedelic explorers like Timothy Leary did figure out the importance of set and setting (and therefore deviated from the sterile lab approach), they were actually re-discovering what the Saskatchewan researchers had already uncovered.
Researchers took note of how much setting influenced patient experiences, and changed their protocols: “The modifications since January 1958 are as follows. The environment surrounding the patient taking LSD was changed by the addition of auditory stimuli, visual stimuli, emotional stimuli…The auditory stimuli consisted mainly of music supplied by a record player. Usually classical, semi-classical, and relaxing music was played.” Indeed, adding flowers, music, and supportive guides improved subjects’ experiences.
It was the late 1950s, so the vast majority of the music, bands, and genres we now associate with psychedelia didn’t even exist yet. A benefit of classical music was that it had no lyrics, but to an extent, the choice of classical music may also simply have reflected the tastes of the men leading the studies—and after a certain point, many researchers became hesitant, according to Johnson, to vary from the norm.
At Johns Hopkins, a Versuz Music Battle—but With Psilocybin
Seventy years later, as psychedelic research experiences a renaissance, Dr. Johnson wondered how other types of music might affect the subject undergoing psychedelic therapy. His 2020 study, “Set and Setting: A Randomized Study of Different Musical Genres in Supporting Psychedelic Therapy,” analyzed the impact of two types of musical genres played during sessions of a psilocybin study for tobacco smoking cessation: Western classical versus overtone-based recordings. (Overtones are higher frequency sound vibrations; instruments with a strong overtone signature are often described as having a “droning” sound.) The overtone-based tracks featured Tibetan singing bowls, gongs, didgeridoo, chimes, bells, sitar, and throat singing. Often there was no melody or rhythm.
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In the 1950s, research was typically conducted in what Johnson calls a “very sterile” setting. Being dosed by men in white coats and then left alone in a white-walled hospital room with fluorescent lights was not exactly conducive to a positive hallucinatory experience.
Study participants underwent three psychedelic therapy sessions: One with the Western classical playlist and one with the overtone-based playlist. At their third session, they were asked to choose the playlist they preferred—and six of the ten participants chose the overtone-based playlist for the third session.
Participants reported more mystical experiences (e.g., feelings of unity and transcendence of space/time) during sessions with the overtone-based playlist. The study also found that smoking cessation was more successful for the participants who chose the overtone-based playlist. Eight weeks after completing their first session, two of the four patients who chose Western classical for their third session reported that they were abstinent at the end of treatment. Of those who chose the overtone-based, five of six were abstinent.
While it’s a small-scale study, these results call into question whether Western classical music should remain a staple of clinical psychedelic therapy. While music has been a key element of medicinal and ceremonial events involving psychedelic plants for millennia, many modern sound healers are tapping into live instrumentation and sound practices that are far older than classical music. “All music can be healing,” says sound healing practitioner Rachel Dugas, who studied her craft through the Sound, Voice, and Music in the Healing Arts Program at California Institute Of Integral Studies. “But in my experience, the live sound experience offers the listener a more direct, visceral experience.”
Music as Medicine
Dugas leads sound baths and plant medicine journeys, during which she sings and plays a variety of instruments: singing bowls, shakers, bells, chimes, tuning forks, drums, shruti box, and ukulele. A classically trained musician, Dugas has found that playing single instruments rich with overtones leave more room for the listener to go inward. “Overtone-heavy instruments and singing can literally vibrate the body into a relaxed state by activating the body’s relaxation response,” she says. Dugas’s instrumentation is simple and minimal: a tone, or a chime, or a series of gentle percussive sounds, whereas classical music is famously complex. Full-scale orchestras can feature as many as a hundred different musicians—and unlike psychedelia’s early researchers, not everyone enjoys or has positive associations with the classical music genre. (When asked in 2018 his opinion of classical music, Brian Eno, whose ambient compositions often appear on psychedelic playlists, responded that he found it “difficult to listen to. I can’t help but hear this structure of subservience….I just feel this sense of superiority, that they are doing the ‘right’ music.”)
“We have found that classical music is not the best route to take, especially with BIPOC communities,” says Charlotte James and Undrea Wright, founders of the Sabina Project, a Black-led platform for psychedelic education, integration, and ancestral practice. The Sabina Project uses music in their ceremonies, but tailors it to the individual experience. “One approach we have found useful is doing lineage-based sound research for individuals, especially when they want to work on intergenerational or ancestral trauma,” the pair told me. “For example, a person who comes from the African diaspora could listen to West African drumming during a journey, or a person of Indian descent could listen to Dhrupad chants. This looks like understanding their cultural lineage, and finding music from those cultures. This can help in accessing memory from across our lifetimes and embodying culturally specific movements for releasing trauma.”
“A person who comes from the African diaspora could listen to West African drumming during a journey, or a person of Indian descent could listen to Dhrupad chants. This can help in accessing memory from across our lifetimes and embodying culturally specific movements for releasing trauma.”
Perhaps the most important takeaway of the study is that we need more research on music’s impact on psychedelic experiences. Johnson is eager to compare live sound with recorded music, to study the effects of other genres, or to contrast music with silence (psychedelic pioneer Terrence McKenna strongly advocated for taking psychedelics in silence, because he felt music became too dominant: “The music becomes everything—you can’t separate it from the trip”). Outside Western scientific investigation, many types of sound and music are being integrated into psychedelic journeys. There’s even a guide to arranging psychedelic playlists, complete with clinical and traditional examples.
Johnson wants to encourage more experimental work on set and setting; to explore how music that is customized to an individual’s musical taste and personal history could improve the therapeutic effects of psychedelic therapy across diverse and varied populations: “We need to test all of this,” he says. “Even the switch from more sterile environments to ones with better set and setting was only based on clinical impression. There was no research that actually randomized people to different set and setting conditions.” Using science to explore different ideas about what music or sounds are most auspicious for psychedelic experiences promises a fascinating trip of its own.