Music and non-music approaches in psilocybin-assisted psychotherapy: The sound of silence
Sara G. Gloeckler, Julien Thibault Lévesque, Alexandre Lehmann, Houman Farzin, Kyle T. Greenway
Journal of Psychedelic Studies May 15, 2025 DOI: 10.1556/2054.2024.00421 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 2 |
| Population | Breast cancer patients undergoing psilocybin therapy under Canada's compassionate access program |
| Interventions | psilocybin therapy intentional periods without music mindfulness exercises |
| Duration | 30-min silent period |
| Topics | Psilocybin Psychedelic-assisted therapy |
| Keywords | Silence Sound geography Music therapy Psychotherapist |
| Citations | 3 |
| Key findings | Integrating silent intervals in psilocybin-assisted psychotherapy can enhance mindfulness practices and therapist-patient interactions, potentially offering distinct therapeutic benefits. |
Abstract
Abstract Music is integral to Psilocybin-assisted psychotherapy (PAP), believed to enhance therapeutic outcomes by structuring experiences and facilitating emotional expression. However, the effects of conducting PAP without music are underexplored. This study examines the experiences of two breast cancer patients undergoing psilocybin therapy under Canada's compassionate access program, specifically focusing on sessions that incorporated intentional periods without music. Patients had previously experienced psychedelics in therapeutic contexts but only with continuous music, as is common practice. Here, each patient participated in a 30-min silent period involving mindfulness exercises and therapist discussions. These periods of relative silence resulted in both challenges and benefits. One patient found that the absence of music was difficult initially, but that the relative silence allowed for engagement with mindfulness exercises that were experienced as highly meaningful. The other patient reported that music had evoked challenging past memories early in the dosing session, which were then productively explored with her guides during the subsequent period without music. These findings suggest that integrating silent intervals in PAP can enhance mindfulness practices and therapist-patient interactions, potentially offering distinct therapeutic benefits. Further research is necessary to delineate the differential impacts of music, silence, and guided activities in PAP, given that these three common treatment activities can be understood as both complementary and competing. Finally, we emphasize the importance of more detailed reporting on session components in psychedelic research publications, particularly regarding the balance between patients listening to music and interacting with their guides, which is often not clearly detailed in existing studies.
Comparable studies
Other case reports and case series on psilocybin and psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Prolonged adverse effects from repeated psilocybin use in an underground psychedelic therapy training program: a case report | 2025 | Case study | |
| Suicide of a patient shortly after psilocybin-assisted psychedelic therapy: A case report 60-year-old man with recurrent depression and history of delusions | 2025 | Case study | n = 1 |
| Refractory CRPS pain treated with psilocybin: A case report A patient with refractory complex regional pain syndrome | 2024 | Case study | n = 1 |
| Underground small-group therapy of treatment-resistant depression and complex post-traumatic stress disorder (C-PTSD) with psilocybin—A retrospective case study A woman in her early forties with early complex trauma and treatment-resistant depression | 2023 | Case report | n = 1 |
| Psilocybin-assisted psychotherapy for methamphetamine dependence: a case report involving daily methamphetamine use A 36-year-old transwoman who was a daily methamphetamine user | 2024 | Case study | n = 1 |
Citations in the library
Cited by 3
- Psychedelic minimalism: the case against music in psychedelic therapy settings. Frontiers in Psychiatry August 26, 2025
- The Research Deficit and Expert Disagreement Regarding Music Selection for Psychedelic Assisted Therapy. ACS Pharmacology & Translational Science October 10, 2025
- Holding space between notes: Music, silence, and cultural attunement in psychedelic-assisted therapy Psychedelics April 2, 2026
Cites 21
- Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder JAMA Psychiatry November 4, 2020
- Human hallucinogen research: guidelines for safety. Journal of Psychopharmacology July 1, 2008
- Single-Dose Psilocybin for a Treatment-Resistant Episode of Major Depression. New England Journal of Medicine November 3, 2022
- Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology November 8, 2017
- Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors Journal of Psychopharmacology October 11, 2017
and 16 more in the library