The Ultimate Trip Sitter: Why Music is a Cornerstone of Psychedelic Therapy

What question is this article answering?

This piece talks about the core significance of music in psychedelic-assisted therapy, and how it is something that is needed as a component of the treatment process and why creating a standardized evidence-based procedure for choosing music is psychedelic science's future.

In psychedelic therapy, the soundtrack is not background music—it's a powerful tool that can direct, calm, and optimize the therapeutic experience. While nearly every psychedelic therapy regimen recognizes music as an essential element, there is surprisingly little scientific evidence on how to select it. This article explores the science behind the use of music as a "hidden therapist" and how it can shape the psychedelic experience, and provides an update on the growing need for more science to be put into developing the ideal psychedelic therapy playlist.

The Unseen Therapist in the Room

When you envision a psychedelic therapy session, you might visualize a comfortable room, a friendly therapist, and a patient wearing eyeshades, journeying inward. But there is one more essential ingredient that is almost always present: music. From the earliest experiments with psychedelics in the 1950s and 60s to the modern clinical trials of today, music has been a constant and integral companion to the psychedelic experience. It's referred to as the "hidden therapist" in the room, a silent shepherd that can help guide the emotional arc of the trip.

It was highlighted in a 2018 review in Psychopharmacology how music is a central element of psychedelic therapy, whatever psychotherapeutic model the method may be, listening to music is always there [1]. The authors show that music may fill a range of important functions, such as to reduce anxiety, elicit personal memory, and provide structure and a feeling of safety within a potentially disorienting experience. But if music is so important, how do therapists decide what to play?

The Art and Science of the Psychedelic Playlist

Currently, the art of selecting music for psychedelic therapy greatly exceeds the science. Much of the soundtracks used in clinical studies have been designed by researchers and therapists with care, typically drawing on a mix of classical, ambient, and world music. The famous Johns Hopkins psilocybin playlist, for example, is a seven-and-a-half-hour odyssey that mimics the typical trajectory of a psilocybin experience, with calming, relaxing music at the beginning and end, and more emotionally intense tracks in the middle.

Though the playlists have been successfully used in many studies, however, there is growing recognition that one playlist will probably not suit all. A 2022 article in Frontiers in Psychology called for additional research on music programming for psychedelic treatment based on the premise that a more personalized approach could lead to better results [2]. The authors suggest that the patient's own musical taste, cultural background, and treatment objectives should all be taken into account when selecting a playlist.

The Quest for Empirical Guidance 

The issue is that currently there is very little empirical evidence to back this personalization. A 2020 randomized trial in which participants were randomly placed into listening to different styles of music during a psilocybin smoking cessation session found that the style of music did not significantly impact the therapeutic outcomes [3]. But this doesn't mean that music is unnecessary. It may simply be that the specific genre is not as important as certain other facets of the music, i.e., its affective tone, its pace, and its elaborateness.

This is where the studies are heading. Researchers are now beginning to investigate the specific acoustic and affective characteristics of music most amenable to the healing process. A 2025 Frontiers in Psychiatry research explored the phenomenological experience of music in psychedelic therapy and found that participants commonly described the music as a "collaborating actor" in the process [4]. What this suggests is that the music is not merely an inactive background but a positive force that can interact with the psychedelic state in order to produce profound therapeutic effects.

The Future of Psychedelic Sound 

As psychedelic therapy approaches acceptance as a legitimate method of treatment, there will be increasing need for a more systematic, evidence-based method of choosing music. The future of psychedelic therapy could involve the use of biometric feedback to sync up the music in real-time with the patient's emotional state, or the development of a set of proved playlists for a variety of therapeutic uses. The aim is not to program the art of music selection with a mechanical algorithm, but to blend the expertise of experienced therapists with the rigor of scientific research in order to develop the most healing and supportive soundscape conceivable.

References

[1] Kaelen, M., et al. (2018). The hidden therapist: evidence for a central role of music in psychedelic therapy. Psychopharmacology, 235(2), 505-519. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5893695/

[2] Messell, C., et al. (2022). Music programming for psilocybin-assisted therapy: a guide for therapists. Frontiers in Psychology, 13. Retrieved from https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2022.873455/full

[3] Strickland, J. C., et al. (2020). A Randomized Study of Different Musical Genres in Supporting Psychedelic-Assisted Therapy. ACS Pharmacology & Translational Science, 3(6), 1236-1244. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8033606/

[4] Dwyer, J., et al. (2025). Music as a collaborating actor: new insights into the nature and role of music in psychedelic-assisted psychotherapy. Frontiers in Psychiatry. Retrieved from https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1541528/full

Disclaimer: Psychedelic Assisted Psychotherapy has not been approved by any regulatory agencies in the United States, and the safety and efficacy are still not formally established at the time of this writing.