Season 2, Episode 2: The Psychedelic Playlist

Arielle Duhaime-Ross [00:00:03] On an afternoon in Baltimore, Sughra Ahmed prepared for her very first psychedelic experience at Johns Hopkins University. Sughra is a teacher and leader within the Muslim faith. She signed up to be part of a study that measured what happened when religious leaders took psilocybin. We told you about it in our last episode. And after entering the treatment room, she took some time to pray. 

Sughra Ahmed [00:00:26] My prayer before I ingested the medicine was about healing, physical healing, spiritual healing. In Arabic, the word is shifa, complete healing. 

Arielle Duhaime-Ross [00:00:43] Then she swallowed a pill that contained psilocybin, she put on a pair of eye shades, donned the provided headphones, and laid down on the couch. From that point on, the main sensory input she received was the music playing through her headphones. 

Sughra Ahmed [00:01:01] From memory, it had a lot of Euro-Christian, a lot of, maybe Bach, and maybe Mozart. 

Arielle Duhaime-Ross [00:01:09] The music had been selected by the researchers, and most of the songs in the hours-long playlist were. 

Sughra Ahmed [00:01:17] Classical music. It felt like a brilliant choir singing in this huge cathedral. Bringing the players to life through these words that were holy and precious, I couldn’t understand the words because of the way that they were sung. 

Arielle Duhaime-Ross [00:01:38] So Sughra is hearing orchestral music, and at this other point she’s hearing a choir singing the words of an Eastern Orthodox Christian worship song. And according to Sughra, it’s all… 

Sughra Ahmed [00:01:48] Really sort of high church, this is very posh. That kind of music is not unfamiliar, it reminds me of the schools that I went to as a young girl. 

Arielle Duhaime-Ross [00:01:57] But even though the music is familiar to her, listening to these pieces, in this moment, doesn’t feel right. 

Sughra Ahmed [00:02:06] My ear is not tuned to that kind of music. A lot of this music was very melodic, and I think the sort of aspiration there would be that you have an experience with the divine, possibly. But I know I wasn’t in there.

Arielle Duhaime-Ross [00:02:21] In other words, Sughra felt her traditions weren’t reflected in the music. A number of other religions were, but not hers, even though she had asked the researchers if they could modify the playlist for her sessions. 

Sughra Ahmed [00:02:34] You know, I have Qawallis and I have other kinds of music that would be amazing if I could add to it and say, no, the same music has to be played to every person. Obviously, it’s a clinical trial. 

Arielle Duhaime-Ross [00:02:44] As the drugs started to kick in, Sughra wanted to be hearing this. Tu Jhoom, a track performed by Naseebo Lal and Abida Parveen. But instead, she was hearing this. 

Sughra Ahmed [00:03:13] I don’t regret my experience. I have such reverence for my experiences. They are my truth. And I am so curious about the fact that if I had been present in these ways that we’re talking about, whether it’s a playlist or whether it is a guide or whether it something else, what more would I have been able to move through? What trauma would I’ve been able let go of? What joys would I been able experience because I felt seen and I felt heard. 

Arielle Duhaime-Ross [00:03:41] The playlist that Sughra listened to during her sessions is pretty famous in psychedelic circles. It’s known as the Johns Hopkins playlist, and it was one of the very first music compilations curated specifically for psychedelic study participants. Versions of it have been used in clinical trials at Johns Hopkins University for more than 25 years. The playlist is on Spotify, YouTube, Tidal, basically every music streaming platform, which has allowed it to reach people far outside the lab, shaping the music that is played during private psychedelic therapy sessions, as well as what’s played when people use these substances recreationally, which for me brings up a few questions. Questions that Sughra had too. 

Sughra Ahmed [00:04:33] Maybe this is the beginning of a really important conversation about music and playlists. And how do we even decide what goes in these things? Right. Like what are we even trying to achieve.

Arielle Duhaime-Ross [00:04:42]  And that’s exactly what we’re going to explore in this episode of Altered States. I’m your host, Arielle Duhaime-Ross. Stay with us. 

Bill Richards [00:04:56] I do have the dubious distinction of being the last to give psilocybin to a patient before everything became dormant for 22 years. Talk about death and rebirth. 

Arielle Duhaime-Ross [00:05:14] This is Bill Richards. 

Bill Richards [00:05:14] Officially William A. Richards. 

Arielle Duhaime-Ross [00:05:14] When I decided to dig into the history of the Johns Hopkins playlist, he was my first stop. Bill is a clinical psychologist. He has a master’s in divinity from Yale, and he’s one of the pioneers of psychedelic assisted therapy going back to the 1960s. 

Bill Richards [00:05:31] I just turned 85 and I’m completely incapable of retiring. 

Arielle Duhaime-Ross [00:05:39] Actually, Bill was one of the scientists who worked on the study in which Sughra Ahmed was a participant, the religious leaders study. 

Bill Richards [00:05:46] I straddled both fields, the research, psychopharmacological, psychotherapy research world, and the implications of that for religious scholarship. 

Arielle Duhaime-Ross [00:06:00] From what I understand, you are the person who put together the very first Hopkins playlist. Is that correct? 

Bill Richards [00:06:06] Yes. Yes. 

Arielle Duhaime-Ross [00:06:08] This is how Bill described the playlist to me. 

Bill Richards [00:06:12] Okay. The Hopkins playlist is designed for a moderately high or high dose psychedelic session, one where the dosage is sufficient to give access to these transcendental realms of human consciousness. And it’s designed with the different phases of the response to the psychedelic substance in mind. So in a well-designed playlist, say with psilocybin, which has usually a six hour duration of action, there’s music to be playing softly in the background when the person enters the room. Comfortable background music that doesn’t demand a lot of attention, but it’s kind of soothing. Then there’s music for that opening up, that onset, that launch period. Where some people might tend to get very frightened. So it’s music that’s steady, no surprising changes in rhythm, no words for the intellect to try to decipher. It’s just unfolding, supportive sound. I like to use the Kyrie of the Bach B Minor Mass, for example, opening up, opening up opening up transporting you. 

Arielle Duhaime-Ross [00:08:07] As a participant approaches the peak of their psilocybin experience, they hear. 

Bill Richards [00:08:13] Samuel Barber’s Adagio for Strings, kind of chromatic development, dissonance into harmony, more dissonant into harmony. Picking you up and transporting you. Just builds and builds and build and builds, and reaches a climax in a very meaningful way that speaks to the minds of most humans. About an hour in, hour and a half, you’re at the peak. In the early days, we always used at least one movement of a Brahms symphony. Often the first movement, it has this very steady progressive, you know, on with it, on with it into it, in and through, in, and through. Then in the. Transcendental, if you will, period of the drug session, if that occurs, works like Sir Edward Algar’s Nimrod, the ninth variation. The slow movement of the Mozart Clarinet Concerto, the slow movement of the Beethoven Fifth Emperor Piano concerto or the Brahms Second Piano Concerto. They just reliably work well with many different people. 

Arielle Duhaime-Ross [00:09:51] But then as a study participant comes down from the peak, Bill says there’s a little more wiggle room. 

Bill Richards [00:09:59] If it’s been a positive session, you can appreciate almost anything. And it’s even fun to listen to music that’s from different countries, different genres. And it just kind of a celebration of welcome back to earth. 

Arielle Duhaime-Ross [00:10:17] This is when participants are welcomed by songs like Here Comes the Sun by the Beatles, Storms in Africa by Enya, King of Kings by Ladysmith Black Mambazo, and What a Wonderful World by Louis Armstrong. 

Bill Richards [00:10:30] There’s an openness to, gee, play anything I’ll try it on. 

Arielle Duhaime-Ross [00:10:37] So that’s the Hopkins playlist, at least in terms of its content. And on the face of it, it makes sense that a playlist of this nature might exist because, of course, study participants are listening to music during their sessions, right? Well, when Bill first entered the world of psychedelic science, there was no guarantee that you’d listen to music at all during a session. In fact, Bill’s first experience with psilocybin 

Bill Richards [00:11:02] I was 23 years old in 1963. I went to the University of Göttingen in the western part of Germany at that time, and at that point I had not even heard the word psychedelic. I had no idea what psilocybin might be. But two friends of mine who I had just met had participated in an interesting research project in the nerve clinic or psychiatric clinic of the university, which was just around the corner from our dormitory. So anyway, I went over to the clinic and asked if I could be a research subject as well. 

Arielle Duhaime-Ross [00:11:51] What was the setup like for that experience? 

Bill Richards [00:11:54] It was terrible. It was a little basement room with a cot and end table and a chair with a window looking out over the hospital garbage cans, and I was left totally alone with a research assistant checking in on me every now and then. The only music was the garbage man emptying the metal cans outside my window, which I call tinkling temple bells. 

Arielle Duhaime-Ross [00:12:26] I’m sure that sounded lovely. Somehow, Bill still managed to have a good experience. 

Bill Richards [00:12:35] They injected me with CZ74, which was a short-acting derivative of psilocybin. To my total amazement, this very profound transcendental state of consciousness opened up in this 23-year-old kid I once was. 

Arielle Duhaime-Ross [00:12:56] Even without music, Bill says he had a transformative experience, but eventually the sessions he took part in became less garbage dungeon and more soothing therapy, thanks to another scientist that Bill met in the winter of 1964, a psychiatrist named Walter Pahnke. 

Bill Richards [00:13:14] He suggested that we do another experiment and raise the dosage a little bit and bring me out of the basement into a room with some plants, and he’d be there to hold my hand if I needed it, and we used music for the first time. 

Arielle Duhaime-Ross [00:13:33] To be clear, Pahnke didn’t come up with the idea of playing music during psilocybin sessions in a research setting. This is just how Bill gets introduced to the combination of music and psychedelics. 

Bill Richards [00:13:45] With Walter Pahnke, we use the Brahms Requiem, which I love. The way it richly unfolds moving forward, especially the first two choruses. “Wie lieblich sind deine Wohnungen”, “How lovely is thy dwelling place.” It’s really a requiem for the living, and it’s not the words really. It’s the music itself that just unfolds in a very rich and supportive manner. 

Arielle Duhaime-Ross [00:14:25] It’s probably clear by now, but Bill is a classically trained musician. He plays piano and the organ. How was your experience made different because there was obviously a very different set and setting, but also because there was music? 

Bill Richards [00:14:42] I don’t think the music causes content, but the music provides nonverbal support that enables many people, I think, to go more deeply within consciousness than they otherwise would. Sort of like a strong flowing river if you’re a piece of driftwood. If you just relax into the music. It takes you places. It enables you to go much more deeply than you otherwise might if the music is well chosen. 

Arielle Duhaime-Ross [00:15:23] That insight about music helping people go deeper with psychedelics. That’s the nugget of information that eventually leads him to make the Johns Hopkins playlist decades later. But Sughra might never have listened to this specific playlist had it not been for another person’s contributions. A colleague of Bill’s who worked with him at the Maryland Psychiatric Research Center in the late sixties and early seventies, a woman named Helen Bonny. 

Bill Richards [00:15:51] She was our music therapist at the Maryland Psychiatric Research Center. She was a very fine music therapist and she developed the first playlists. 

Arielle Duhaime-Ross [00:16:05] Bill told me that Helen was the first person that he knew of who’d made a playlist specifically for a psychedelic session. Unfortunately, I couldn’t speak with her about that because she died in 2010. Today, making a playlist might sound like a small thing, but you got to think of the context, right? I mean, we’re talking late sixties. So playing music means playing records. 

Bill Richards [00:16:30] We didn’t know what a playlist was, you know, we had 33 RPM records and that’s one reason we needed two therapists in the room that if one was holding the patient’s hand, someone else had to change the record. 

Arielle Duhaime-Ross [00:16:46] Oh, wow. 

Arielle Duhaime-Ross [00:16:49] I’ve always wondered about the two therapists thing and how that was quite common back then. 

Bill Richards [00:16:54] Well, some would say you need two because these drugs are so dangerous and you might have to control the person if they get psychotic and more psychoanalytically trained people would say, you need a mother to project on and a father to project on, but I think the real reason was we needed help to change records. Though we took it very seriously and we were very self-important, we were really playing disk jockey as well as therapist all the time. 

Arielle Duhaime-Ross [00:17:29] And so Helen, she changed that. She got these psychedelic therapists to use. 

Bill Richards [00:17:36] Cassette tapes, they were labeled things like Peak Experience and Affect Release and Comforting anaclitic and so on. Death Rebirth. And she put these tapes together as her dissertation for her doctorate. 

Arielle Duhaime-Ross [00:17:56] Did Helen come up with this idea of making these tapes? 

Bill Richards [00:17:59] I think so. Yeah, the cassettes. 

Arielle Duhaime-Ross [00:18:03] That’s not the only contribution Helen made during this period. She also contributed the structure of the psychedelic experience that became popularized and enshrined in the Hopkins playlist itself. That whole thing about the build to the peak and then the come down and then timing of it. That’s her and Walter Pahnke. She talked about this at a conference in North Carolina in 1995, 15 years before she died. 

Helen Bonny [00:18:30] My first task was to try to find out what music was best for what part of the drug reactivity. 

Bill Richards [00:18:37] When she arrived, she could see what we had been using. We used a lot of music in our psychedelic research there. 

Helen Bonny [00:18:48] And I did a little research with the therapist and through this process of finding what they thought was best at what time came together with a body of music. 

Bill Richards [00:18:59] And then she made suggestions and introduced us to some new things and developed the tapes. 

Helen Bonny [00:19:07] We almost immediately found out that the classical music was better than any other kind. We would use favorites for people at the beginning and at the end when they were in a fairly normal state. So we more or less eliminated all but the classical selections. 

Arielle Duhaime-Ross [00:19:25] It’s during this period that the practice of using classical music during a psychedelic session became a standard at the psychiatric center. Thanks to this newish invention, cassette tapes. This was something that hadn’t been done before. Before you were using records, she puts together these tapes and you start using them in the context of psychedelic therapy. Is that what happened? 

Bill Richards [00:19:46] Yes, not necessarily exclusively using them, but they were one resource. I still have her cassettes. 

Arielle Duhaime-Ross [00:19:54] You do? Really? 

Arielle Duhaime-Ross [00:19:56] You’ve kept them. How did having those tapes change things for the work that you were all doing at the psychiatric center? 

Bill Richards [00:20:06] Well, it freed up the therapist to stay centered, to be present with the patient rather than being distracted by what shall I choose next? The record’s almost over as I call it playing disc jockey all day. 

Arielle Duhaime-Ross [00:20:26] By 1970, the federal government had made most psychedelics illegal. By 1976, psychedelic studies had stopped altogether at the Maryland Psychiatric Research Center. But by then, Helen had already moved on to something new, because while she was at the psychiatric center, Helen began testing something she had been thinking about for some time. That music, on its own, without psychedelics, could produce an altered state. She actually tested her theory out with the family members and friends who accompanied patients when they came in for a psychedelic session. 

Helen Bonny [00:21:03] When there were couples, one of the persons would have a session, the other person had to wait all the 10 or 12 hours because I was a woman and I took care of them. 

Arielle Duhaime-Ross [00:21:12] She would take the accompanying person into a room and basically mimic an LSD session without the drug. She describes testing this out in the talk she gave in 1995. 

Helen Bonny [00:21:22] So I remember this day, this woman came in and I laid her down on the couch and I said, now I will just pretend I’m giving you the drug and I’ll start playing some of the music that we use. Well, for three hours, we listened to music. 

Arielle Duhaime-Ross [00:21:41] She said the people she tried this with would often have these really strong experiences. And again, no drugs involved, just music. 

Helen Bonny [00:21:49] She was talking the whole time, giving me all this wonderful imagery that was happening for her. And that’s when the light bulb went off for me. 

Arielle Duhaime-Ross [00:21:59] For Helen, the benefit of just listening to music was clear. 

Helen Bonny [00:22:03] Afterwards, they get the husband and wife together. And of course, he’d had amnesia. He didn’t have anything to share from the drug experience. And she was, she was talking away. 

Arielle Duhaime-Ross [00:22:15] She said that her patients tended to remember these experiences more strongly than the people who would come out of an LSD session. 

Helen Bonny [00:22:23] It doesn’t help unless you have a memory for what you’ve gone through. 

Arielle Duhaime-Ross [00:22:29] These tests that she ran on the side, they became the foundation for an entirely new form of therapy that she called guided imagery and music. She founded this new modality in the seventies and it gained traction in psychology and music therapy circles in the US and abroad. Here she is describing a session in a documentary made by Bonny Institute Productions. 

Helen Bonny [00:22:54] I’m watching Jill’s breathing patterns change. Her body is becoming progressively more relaxed. She is going deeply. Very fast. 

Helen Bonny [00:23:11] Very heavy. Just let it be heavy. Let yourself go as completely as you can. In just a short while, you’re going to be hearing the music. You let yourself go with the music and let the music take you wherever you need to go. My mind is fully concentrated on her experience. I try in my imagination to see what she is seeing, feel what she is feeling to keep in touch. 

Arielle Duhaime-Ross [00:23:43] Today, the Bonnie method of guided imagery and music is still considered an effective form of music therapy. In the year 2000, psychedelic science resumed in earnest in the US. Researchers at Johns Hopkins, where Bill Richards worked, secured government approval to study psychedelics in healthy people who’d never taken these substances. And to prepare for this big moment, Bill made a playlist. 

Bill Richards [00:24:11] The challenge in making a playlist is to separate the very good from the excellent. It’s not black and white, right, wrong kind of thing. And when most people say, boy, that was really helpful, then you think, man, maybe there’s something universal in this music that within our minds, there are layers of human consciousness. That are just kind of genetically given, if you will, perhaps encoded in our DNA and it has nothing to do with our personal preferences or the preferences of our therapists for that matter. You know, it’s just something in the very structure of the sound itself that is facilitative and supportive and helpful. And that’s what those of us who make playlists try to find, I think. You know, what is it that speaks to these universal tendencies deep within us? 

Arielle Duhaime-Ross [00:25:21] And was there a basis for the playlist itself in terms of the research? Like what were you sourcing from? 

Bill Richards [00:25:28] My own knowledge of music. 

Arielle Duhaime-Ross [00:25:31] And of course, Helen’s tapes. 

Bill Richards [00:25:34] I certainly used pieces of many of her tapes. For example, her peak experience playlist includes many, probably most of the works in the Hopkins playlist. I’d have to listen to it to find out. Actually, I don’t think I have a cassette player to listen to it on anymore. 

Arielle Duhaime-Ross [00:25:57] The thing that Sughra and I both wish to understand was about the history of the playlist, but also how it ended up being so specific. So I asked Bill, there is quite a bit of classical music in the playlist, including songs that I think maybe there’s a little bit of an over-representation of songs that some people would characterize as having a little of a Christian bent. Some of them have, you know, they’re actual masses. We’re talking about like. Vivaldi’s Gloria in D major. There’s the Mass in B Minor by Bach. I think there’s even the St. Petersburg choir as well, right? Was that intentional to have Christian music in the playlist? 

Bill Richards [00:26:38] Well, when we first made it, most of our volunteers were Christian. In fact, even including Christian clergy, and it was music I was personally fond of and I chose it. Subsequent variations, for example, we just completed a study at Hopkins with religious leaders from different world religions. And the playlist we used for that was much less Christian. 

Arielle Duhaime-Ross [00:27:11] But this more toned down playlist still registered as very Christian for Sughra. So it kind of sounds like, you know, by virtue of who was putting together this music in the sixties and seventies, and then you coming back to it in 1999, that’s why there were quite a few Christian songs. 

Bill Richards [00:27:30] Yes, in the early days we were working primarily with treatment of alcoholism and narcotic addiction. And many of those people did have Christian backgrounds. 

Arielle Duhaime-Ross [00:27:42] Okay. So that felt appropriate for those individuals. 

Bill Richards [00:27:45] That’s right. 

Arielle Duhaime-Ross [00:27:47] If someone, if they already know what’s going to be played before the session starts, or if they’re in the session and they say, Hey, I really don’t like this song, what would you counsel a music therapist to do or a guide rather? 

Bill Richards [00:28:01] Thanks for asking that. Because often there is the experience of saying, I can’t stand the screeching soprano, please change the music. I hate this music. The way I’ve learned to deal with that is to encourage the person to hate it with passion. 

Arielle Duhaime-Ross [00:28:23] Wait, what do you mean by that? 

Bill Richards [00:28:25] Hate it with passionate. It will be over soon. No peace goes on forever. The playlist will change, but right now just go ahead and hate it. You know, I mean, there are extreme situations where I might change it, but generally I have learned that when I encourage the person to just hate it and keep continuing, many times the person will say, Oh, that’s so much better, thank you. And it’s the same music playing. So what is going on often is that something frightening at the growing edge of that person’s development is emerging and the music is facilitating it and the person wants to avoid it, escape from it, turn it off. And they think by changing the music, they can escape it. Where, if they stay with it, maybe with a little extra support from the therapist, the very same music is experienced as helpful. 

Arielle Duhaime-Ross [00:29:36] I’m glad you brought up the religious leaders study because we actually spoke to one of the participants of that study, Sughra, do you remember her? 

Bill Richards [00:29:43] Oh, yes, lucky you. 

Arielle Duhaime-Ross [00:29:45] Yeah, no, she’s fantastic. And she herself mentioned to us that a lot of the music had a Christian bent and, you know, she talked about how she felt that it was a little churchy, you now, cathedral music, very Euro-Christian. And she said that she would have preferred to hear music that was more part of her own tradition, right? Islamic musical tradition. She said she’s Punjabi, that it would have been nice to hear maybe the dhol, those kinds of instruments, but that that was not possible. And so I’m curious, what’s your reaction to that? I’m sure you were already aware of her saying that, but yeah, what do you think of that? 

Bill Richards [00:30:21] I agree with her a hundred percent, you know, if we could have designed the playlist for each person separately, it certainly we would have had more Islamic music for her. I wish we could’ve done better. If there’s a defense, it’s that there’s only 24 hours in a day and I’m just one person and I do the best I can, but there are. I’m sure there are other playlists that can be every bit as effective. 

Arielle Duhaime-Ross [00:30:53] Why wasn’t it possible to have individual playlists for every participant? 

Bill Richards [00:30:57] Well, we like to standardize things in the research world. 

Arielle Duhaime-Ross [00:31:02] Bill explained to me that there are already lots of variables to take into account, like people’s ages, different dosages, and so whatever they can keep the same across participants, they do. 

Bill Richards [00:31:14] And yet the study was written to allow for clinical judgment that the therapist, if justified, could deviate. 

Arielle Duhaime-Ross [00:31:23] Okay, but it still wasn’t possible to add more songs from her own tradition. 

Bill Richards [00:31:28] Well, if we had thought about it more, maybe we might have. 

Arielle Duhaime-Ross [00:31:35] My conversation with Bill yielded a lot of answers to some major questions, but it also brought up some new ones about what music in general does for our brains while taking psychedelics. Do we actually know? How is it contributing to people’s experiences exactly? And has anyone looked at which types of music are better or worse? Hear, what I found out after the break. 

Fred Barrett [00:32:06] I’ve played the trumpet the longest. I also play the drums and the guitar and the bass and the violin. 

Fred Barrett [00:32:14] This is Fred Barrett. 

[00:32:16] And according to the state of Pennsylvania, I can play and teach all standard band and orchestra instruments up to a third grade level. But it’s been a while.

Arielle Duhaime-Ross [00:32:24]  Fred is a musician, but he also works at Johns Hopkins University. He’s actually the director of the Johns Hopkins Center for Psychedelic and Consciousness Research. 

Fred Barrett [00:32:36] I am trained as a cognitive neuroscientist who’s completed a fellowship in behavioral pharmacology. 

Arielle Duhaime-Ross [00:32:43] His research focuses on memory, music, and psychedelics, a mix of topics he’s passionate about. 

Fred Barrett [00:32:50] Just recognizing that all of these things, musical experiences, emotions, memories, pharmacologically mediated or not, really cut to the core of who we are as people sometimes. And that’s endlessly fascinating to me. I honestly have trouble thinking of anything more interesting or important that I could be doing with my life. 

Arielle Duhaime-Ross [00:33:10] With that background and passion, Fred seemed like the ideal person to walk me through the science of what music does to our brains while tripping. When he started at Johns Hopkins, Fred had a lot of thoughts and ideas. 

Fred Barrett [00:33:22] So here I come in 2013, arriving from UC Davis, having completed a PhD, spending six years of my life deeply invested in the question of what music does to people and how to select music to evoke specific experiences. And so I sat down and I asked Roland, what’s going on with the music? 

Arielle Duhaime-Ross [00:33:38] Along with Bill Richards, Roland Griffiths was an early psychedelic researcher who led the religious leaders study, the one that Sughra Ahmed was in. So during Fred’s first days on the job, Roland told him that the purpose of the playlist was partly to standardize the study setting. 

Fred Barrett [00:33:54] I remember him kind of briefly explaining this to me. And I said, well, that’s interesting. Making everybody listen to the same music is all but guaranteeing that everyone’s going to have a different experience because people respond to music differently, they do. And this is no knock on Bill or the playlist. 

Arielle Duhaime-Ross [00:34:11] What do we know about the Hopkins playlist? What has been studied about it? 

Fred Barrett [00:34:16] So there’s a pretty famous landmark study here at Hopkins. 

Arielle Duhaime-Ross [00:34:20] The study that Fred told me about was actually an offshoot of a clinical trial on tobacco use disorder that had a pretty big impact on how we think about treating substance use disorders as a whole. The music study was sort of a side project. The researchers had the participants listen to two different playlists during their sessions. 

Fred Barrett [00:34:40] Over the first few sessions, participants heard either the Johns Hopkins playlist or an overtone playlist, a playlist with a bunch of performances of music by instruments that had a great number of overtones, including things like didgeridoo and certain types of gong. And then for the third session, participants got to choose which playlist they heard. 

Arielle Duhaime-Ross [00:35:01] The researchers found that people chose the overtone playlist for their third session at about the same rate as they chose the Hopkins playlist. 

Fred Barrett [00:35:08] Listening to the overtone playlist did not impair the therapeutic response long-term and that at its very least, people didn’t necessarily prefer the Hopkins playlist reliably over the overtone playlist. 

Arielle Duhaime-Ross [00:35:22] That study was published in 2020 and according to Fred. 

Fred Barrett [00:35:26] That was the first, at least somewhat rigorous analysis of whether there’s something really special about this playlist compared to other playlists. That’s really as much as has been done so far. 

Arielle Duhaime-Ross [00:35:37] The impact of having so little research on this is that scientists still don’t know all that much about the different ways in which music can impact the psychedelic experience. 

Fred Barrett [00:35:46] With the caveat that there are a number of practitioners in the world who are quite convinced that they know how to select music to facilitate and best guide and optimize the psychedelic experience. And I don’t doubt that some of them are definitely skilled in that regard. The problem is that doesn’t mean we understand it in a way that we can translate it or operationalize it. It doesn’t that we necessarily know the best way to train others to do this. And so as a shameless self-plug, a few of us at Hopkins published a scoping review of work done on set and setting. This was published in 2022. 

Arielle Duhaime-Ross [00:36:26] Fred and his team went looking for all the set and setting studies they could find and they went way back, even digging up research papers dating back to the 1930s. 

Fred Barrett [00:36:36] We basically scoured the published literature from as far back as we could reach. 

Arielle Duhaime-Ross [00:36:41] And what they found was underwhelming. After they removed the studies that didn’t actually test anything or compare at least two different environmental conditions, the researchers were left with fewer than 30 studies. 

Fred Barrett [00:36:53] And one of the things that we realized upon digging through all this literature is that there’s a lot of received wisdom. Oh, obviously set and setting is important. Obviously music is important, obviously you should do things this way and that way. Well, why do you say that? Well, because, because it’s obvious or because maybe someone experienced it and is reporting that back or because they heard it from someone else who trained them. And again, not knocking clinical experience or expertise, but that doesn’t mean that we actually truly know it. 

Arielle Duhaime-Ross [00:37:22] At least from a scientific standpoint, right? 

Fred Barrett [00:37:24] Exactly. There’s a bit of a vein of if it ain’t broke, don’t fix it. To a degree, the set and setting model we have right now obviously has generated the results that everybody’s excited about. It works. What’s the big deal? We should just continue doing this, but you know, it also isn’t that simple because psychedelic therapy doesn’t work for everyone. And some of the aspects of set and settings, if they could be changed or optimized or modified, could we do a lot better? 

Arielle Duhaime-Ross [00:37:51] Not only that, but most of the work that has been done was done on what scientists call WEIRD populations: Western, Educated, Industrialized, Rich and Democratic. And Fred says that means the findings don’t necessarily apply to a global population. What questions do you think we still need to answer when it comes to the Hopkins playlist specifically in its use? 

Fred Barrett [00:38:16] I think it’d be helpful to understand what’s necessary in the playlist and what’s not, whether you can tailor it at least at some level by giving people an option to opt out of the things that they could a priori identify as problematic for them, whether it truly tracks the time course of drug effect for most people. Can we pick and choose songs to keep or drop based on whether a participant has late onset of psychedelic experience? Or abbreviated peak period? And or are there other songs that we could insert at various times to kind of increase the likelihood that a person has a peak experience? And are there clearly identified populations for whom the playlist really just doesn’t work? What does the music do without drug on board and without the expectation that you’re going to have a psychedelic experience? 

Arielle Duhaime-Ross [00:39:05] I was very surprised to hear that last bit. So I told Fred the Helen Bonny story about her doing mock LSD sessions with music alone. 

Fred Barrett [00:39:14] I’d never heard that story before, but it makes perfect sense. And it aligns with something else I haven’t told you yet, which is we’re in the process of writing this up right now, but we conducted a pilot study and this study is no drug on board, just music under this mild sensory deprivation context. We lined people up with an hour of music listening in the style of a psychedelic therapy session. And that doesn’t sound quite like what Helen Bonny did, but. We bring people in for a preparation session. We then invite them for an hour long music listening session where we lie them down on a couch with eye shades and headphones tucked into a warm comfy blanket and listening to music turn inward, be present for whatever arises in consciousness. We’re also collecting EEG data, some other psychophysiological measurements and a host of questionnaires the day of the next day and a week later to see if any of these playlists, just the music listening has an impact on people short or long term. 

Arielle Duhaime-Ross [00:40:11] Fred says the preliminary findings are quite remarkable. The researchers witnessed participants crying, sobbing, laughing to tears, a full range of human emotion. 

Fred Barrett [00:40:22] And some people even, this is a 30 participant study, some people, even reported experiencing synesthesia. 

Arielle Duhaime-Ross [00:40:30] Meaning that some people had sensory crossovers, like feeling or tasting colors. Fred told me that the way the study was built, each participant took part in four different sessions. Everyone listened to the Hopkins playlist in one of their sessions. Then in another session, participants listened to music that was personally meaningful to them. In the remaining two sessions, participants listened to either nature sounds, electronic music, overtone music, classic psychedelic rock. Or a playlist that was built for the study by a sound healer. 

Fred Barrett [00:41:03] Suffice to say, the music is definitely doing something. And we’re hoping this paper will be real kind of eye opener and real talking point for people because compared to psychedelics, I think we often expect the music alone to really not be driving a lot of this. But that has yet to be seen. 

Arielle Duhaime-Ross [00:41:24] When I was speaking with Bill Richards, he was telling me, for him, music is really the safety net, the supportive thing that helps move you along, that transports you, but it doesn’t cause any of the content. And I would love to know what you think of that. 

Fred Barrett [00:41:39] That’s an interesting assertion. And I don’t believe that’s been tested. 

Arielle Duhaime-Ross [00:41:46] Dr. Richards also told me that a therapist heeding a request to change the music during a session should be extremely rare. That there have been instances where people have told me, I really hate this music. And that his response was, then hate it with a passion. What do you make of that? 

Fred Barrett [00:42:02] It gives me pause due to the potential that a therapist insisting that to be the case is ignoring safety signals in a participant’s experience. You know, I’m not aware of instances where those things have really caused harm, but I worry that it leads to some element of self-blame or victim blaming, like you’re having this experience because it’s something in yourself that you have to work through. 

Arielle Duhaime-Ross [00:42:23] Well, that’s exactly what he said actually, that maybe it’s coming up for a reason and that that is what you need to work through. 

Fred Barrett [00:42:30] The problem becomes when the therapist makes that decision rather than the individual. 

Arielle Duhaime-Ross [00:42:36] Do you think that there’s such a thing as an ideal playlist to take shrooms? 

Fred Barrett [00:42:40] No. 

Fred Barrett [00:42:40] No, absolutely not. 

Arielle Duhaime-Ross [00:42:41] Not something that could actually work really well for everybody. 

Fred Barrett [00:42:45] I think the missing pieces here in the kind of thought process are whether or not you believe that this music will make everyone feel the same way and not just you, or whether or you acknowledge that people have varying reactions to music. And the reason people don’t react to the music the same ways is because we have this filter of preferences and idiosyncratic relationships. So I think, you know, one hypothesis that I’ve been working on is that psychedelics to some degree remove that filter. They remove the gatekeeper of liking so that you may experience the music in a more pure or less kind of socio-culturally, socio-economically biased or filtered fashion. That’s certain to not be true in all cases, but I wonder to what degree psychedelics, you know, remove the filter or like open the filter up a little bit. 

Arielle Duhaime-Ross [00:43:37] This reminded me of something that came up in my conversation with Sughra. When I spoke with her, she told me that she had no affinity for the Christian music in the playlist. So I found myself wondering if her filter had stayed intact during and after her session and whatever she experienced maybe happened despite the music. At the end of the talk, Helen Bonny gave in 1995, she took questions from the audience and this one person basically asked her if there are any risks to using music other than classical music in these therapy sessions to which Helen answers. 

Helen Bonny [00:44:17] I used to be pretty adamant about classical music just because I felt comfortable with it and we had tested with it. I didn’t want to hold this too close to me because I didn’t know all the possibilities and I still don’t. I trust you all to try. I think that we can all try music and we learn from that process. I want people who are trained and able to go and explore this and certainly to explore it musically, classical music and other musics. So, try it! See if it works. 

Arielle Duhaime-Ross [00:44:51] Before her death, Helen Bonny became open to the use of other musical genres. And when I spoke with Bill Richards, he also seemed willing to make bigger changes to the Hopkins playlist to better support study participants in the future. After speaking with Bill and Fred and learning about Helen Bonny, I can totally understand researchers wanting to play music that study participants aren’t familiar with during sessions. I can also totally understand study participants wanting to listen to music that feels appropriate for their sessions. And if that means culturally appropriate, then so be it. Ultimately, I think that we still have a lot of unanswered questions about the impacts of music during psychedelic sessions and what kind of music is best for what kind session. And my hope is that we’re gonna find out a whole lot more in the coming years and decades. 

Arielle Duhaime-Ross [00:45:55] Altered States is a production of the UC Berkeley Center for the Science of Psychedelics and PRX. This episode was reported and produced by me, Arielle Duhaime-Ross. Adizah Eghan is our senior editor. Our executive editor is Malia Wollan. Jennie Cataldo is our senior producer. Our researcher is Cassady Rosenblum. Our associate producer is Jade Abdul Malik. Our audio engineers are Terence Bernardo and Jennie Cataldo. Fact-checking by Graham Hacia. Special thanks to Michael Pollan from BCSP. Our executive producers are Malia Wollan and Jocelyn Gonzalez. And our project manager is Edwin Ochoa. Our theme music is by Tao Nguyen and Nate Brenner. I’m your host, Arielle Duhaime-Ross. Be sure to subscribe, rate, and review Altered States wherever you get your podcasts. We’ll be back next week. 

Arielle Duhaime-Ross [00:46:45] Most well-known psychedelics remain illegal around the world, including the United States, where it is a criminal offense to manufacture, possess, dispense, or supply most psychedelics, with few exceptions. Altered States does not recommend or encourage the use of psychedelics or offer instructions in their use.