Participants’ Music Experiences Associated With Psychedelic-Assisted Psychotherapy for Life-Threatening Illness: Interpretivist Research

In a randomized controlled trial of psychedelic-assisted psychotherapy for depression and anxiety in life-threatening illness, music played a central role. A music therapist-led thematic analysis of interviews with 31 participants generated four themes: music during psilocybin ingestion can connect, interplay, and integrate with deep multisensorial, somatic, and mental realms; awareness of these realms (one's essence) can be catalyzed by music and PAP; this awareness can be revelatory, fragmenting, or both; and music can access PAP legacy sensations, spawning ongoing processing. Participants felt more intensely connected to music in psilocybin compared to control sessions. The findings extend conceptualizations about music in PAP.

Study at a glance

Abstract

Limited evidence supports treatment for distress in life-threatening illness. Psychedelic-assisted psychotherapy (PAP) may help. Despite music's presence in PAP, sparse accounts of music-related experiences exist. Such research is needed to optimize music's presence within PAP. This qualitative analysis aimed to understand participants' music-related accounts of their PAP experiences within a randomized controlled trial (RCT) for depression and anxiety associated with life-threatening illness, and participants' perceived mechanisms of change attributed to music during PAP. Participants undergoing an 11-session, manualized PAP RCT (with open-label extension) engaged in semi-structured interviews post-dose one (psilocybin or control ingestion) and post-dose two (psilocybin). Interviews examined participants' PAP experiences. A music therapist-led thematic analysis informed by grounded theory was conducted on music-related interview content. Thirty-one participants gave at least one post-dose interview. Four themes were generated: music during psilocybin ingestion can connect, interplay, and integrate with deep multisensorial, somatic, and mental realms; awareness of these far-reaching realms (one's essence) can be catalyzed by music and PAP; awareness of this essence can be revelatory, fragmenting, or both; and music can access PAP legacy sensations, spawning ongoing processing. Participants felt more intensely connected to music in psilocybin compared to control sessions. A data display illustrates participants' perceived mechanisms of change attributed to music during PAP preparation, dosing, and integration. Findings were compared with a psychiatrist-led phenomenologically framed analysis of the same data set. Both analyses extend conceptualizations about music in PAP and managing discordant inter-rating in qualitative research. Implications for music therapy and PAP, informed by the authors' collaboration, are considered.