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

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.