The Therapeutic Potential of Psychedelic Therapy

A consensus amongst independent research groups is that therapy outcomes are attributable to the occurrence of personally meaningful experiences during psychedelic therapy sessions.

Profoundly meaningful experiences change how an individual relates to themselves and with the world around them (21). Psychedelic therapy typically involves a small number of sessions whereby individuals are administered a high dose of a psychedelic substance that can facilitate profoundly personally meaningful experiences (1). It has been shown that treatment success is linked with the occurrence of such experiences, which support growth and learning and lead to enduring positive changes in mood and behaviour (22, 23).

This blog will explore the existing evidence that such meaningful experiences can be predictive of subsequent mental health outcomes, with or without psychedelics.  

"Nearly invariably, whenever dramatic personality change has been noted following the use of these drugs, it has been associated with this kind of experience, that is one called transcendental or visionary" ~ Sanford Unger (2)

Key Takeaways

  • Evidence suggests that the occurrence of personally meaningful experiences are predictive of the therapeutic effects of psychedelic therapies.

  • Music plays an important role in mediating long-term outcomes in psychedelic therapy.

  • Transformative experiences with music take several forms and can be explored without the use of psychedelics.

Meaningful Experiences represent a range of therapeutic states

A combination of factors influence the outcome of psychedelic therapy, including but not limited to environment, music, psychological preparation and integration, pharmacological intervention and the presence of a therapist or facilitator - all of which are capable of impacting the quality of subjective experience during a session, and its long-term therapeutic effects. 

During the 60s, a general consensus arose among researchers studying psychedelics that it was not the drug, but the experience that the drug can facilitate, which is therapeutic (24). By the mid 1960s, the types of experiences that were considered most therapeutic were identified, and these were roughly classified into two main categories: peak experiences, and autobiographical experiences (25). 

A “mystical-type experience” is an experience that differs from ordinary states of consciousness and is associated with feelings of awe, unity, and joy. Peak-experiences are characterised by moments of transcendence and are often associated with a sense of absence or resolution of inner conflict, and a sense of serenity, confidence and purpose in one’s life (1).

An “autobiographical experience” is characterised by vivid, emotionally charged memories and insights into one’s personal life, associated with an emotional release or catharsis. These experiences were often interpreted within a psychodynamic framework (16). While the breadth of psychedelic experience extends beyond these definitions, they serve as valuable markers when studying psychedelic therapy - enabling researchers to test the specifics of the relationship between mystical-type experiences and therapeutic outcomes (1).

Personally meaningful experiences as predictors of therapeutic outcomes

The direct relationship between subjective experiences and therapy outcomes has been established by early psychedelic researchers and continues to be supported by current research. 

Early studies experimenting with classic psychedelics examined the treatment of drug and alcohol dependence; their findings suggested that the occurrence of a mystical-type (i.e. peak) experience contributed towards a positive therapeutic outcome (4,5,6). When studying psychological distress associated with advanced cancer patients, researchers similarly reported a decrease in symptoms mediated by the occurrence of meaningful experience (7,8). More recently, a clinical trial using psilocybin therapy for treatment-resistant depression (TRD) investigated reports of  ‘oceanic boundlessness’ (OBN), as one of the principal factors in assessing altered states of consciousness. In this study, psilocybin-induced high OBN scores (sharing features with mystical-type experience) predicted positive long-term clinical outcomes in a clinical trial of psilocybin for TRD (1).  

Figure 1. Correlation of Oceanic Boundlessness (OBN) with change of clinical outcome (self-reported depressive symptoms) at 5 weeks (ΔQIDS-SR) (1).

Across the board, research finds that certain experiences evoked during psychedelic therapy act as an predictor of therapy success - such as reduced symptoms of depression and anxiety, reduction in addiction-related behaviour, as well as increases in well-being (9).

The role of music in mediating long-term therapy outcomes

It has been shown that with proper setting, preparation, support and dosage, meaningful experiences can be occasioned with a high probability during psychedelic therapy (14).  Therefore, both patient experiences and therapy outcomes can be optimised with a deeper understanding of context.

As a primary setting variable in psychedelic therapy, music plays an influential role in mediating patient experience. Music holds a unique capacity to facilitate a range of therapeutically-relevant states, including emotional processing, the occurrence of mental imagery, autobiographical insight, peak experience, and providing a sense of guidance, direction and support (15). In a study assessing the role of music in psychedelic experiences, researchers found that the individuals’ acute experience of the music (defined as “resonance”, i.e. openness, liking, the music being harmonious with one’s inner state) played during the session correlated with therapy outcomes (15, 16). These experiences selectively correlated with the occurrence of peak experiences and insightfulness, a finding that points to the value of a person-centred approach. There are many ways in which music can influence subjective experience and patient attitude during psychedelic therapy, which will be explored in more detail in a future article.

Facilitating personally meaningful experiences without psychedelics

The therapeutic use of music spans far and wide, with a myriad of studies reporting positive results in areas of medicine such as neurological disorders and chronic pain, to name a few. For example, music therapy interventions (e.g. using patient-preferred live music) offered within a therapeutic relationship have been shown to favourably affect pain perceptions in patients recovering from spine surgery, with researchers suggesting that individualised treatment was at the core of music therapy’s efficacy, through which patients are supported in their recovery of “self” (18).

Similarly, in a study investigating the benefits of music therapy in cancer care in the form of an improvisational music therapy program found a variety of social and psychological benefits that related to the patients’ experience of music therapy, such as facilitating peer support and group interaction, increasing self-confidence, relaxation, and generation of positive feelings such as stress relief and feelings of enhanced communication through music (19).

The therapeutic use of music without the use of psychedelics will be explored further in a separate article. 

Open questions

This article has explored the relationship between the occurrence of personally meaningful experiences and improvements in well-being, and the role of music in bringing those about. There is rising interest within the psychedelic community in the dynamic between “pharmacological” vs “experiential” inputs and their influence on therapeutic outcomes. A significant body of empirical work is still required to elucidate the therapeutic potential of music for psychedelic therapy and as a standalone method, which Wavepaths has begun to explore. 

Conclusions

Psychedelic medicines are a promising new locus of research in the field of mental health, capable of catalysing powerful therapeutic processes. In addition, it has been shown that subjective experiences, in particular experiences of personal meaning and spiritual significance, are predictive of positive outcomes. Seeing the experience itself as the therapeutic agent reveals a captivating insight, one that turns existing pharmaceutical treatment paradigms on their head - experiential therapy is an internally driven, essentially creative healing process.  

Discover more in-depth research and education in our community platform: a private social network for therapists and professionals working with music. The Wavepaths community is accessible as a part of our beta program. If you are a therapist, sign up to our waiting list.

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