Balancing Novelty and Familiarity | Music for Psychedelic Therapy (4)
This article explores the motivations, theories and approaches around prioritising novel, unheard music in psychedelic therapy.
Please note:
Exploring Our Creative Process: This essay is part of a series that, for the first time, reveals our approach to music composition at Wavepaths. Rather than delving into our scientific research, this series intentionally focuses on the creative, therapeutic, and occasionally philosophical motivations that shape the processes and principles behind our music compositions for/as psychedelic therapy.
Music for/as Psychedelic Therapy: To enhance readability in these articles, I’ll primarily use phrases like “music for psychedelic therapy”, “music for therapy”, “therapeutic music”, or “music for/as psychedelic therapy”. Unless otherwise specified, these terms can be understood interchangeably. Broadly, they refer to our wider work composing music for varied therapeutic settings, encompassing not only psychedelic therapy but also methods such as breathwork, body work, experiential psychotherapies, and more.
Prelude
Welcome back to this next essay in the series on music composition for/as psychedelic therapy.
In previous articles, I started to outline how our human-composed music is guided by specific compositional principles and rituals. For example, to encourage a sincere and personal engagement by the artist, or to create music that reflects the organic aliveness of nature.
Here in this article, I will explore considerations around the novelty or familiarity of the music. The general consensus amongst practitioners is to prioritise music that has not been heard before by clients - But why exactly is this the priority?
Although the concept of novelty and familiarity is often referenced in the field, I have not yet come across a detailed exploration of it (If any of you readers think I am wrong on this and have missed something, please reference this in the comment section below).
Clinical trial experiences revealed to me that this concept has in fact many layers. Although some of these may have been loosely mentioned in some of my academic publications, or at times discussed in workshops or lecture Q&A’s - this article intends to present a more comprehensive and integrative set of insights around therapeutic consequences of novelty and familiarity in music.
This essay argues that novelty and familiarity should be viewed as independent variables, each contributing unique therapeutic benefits through their interaction. It will conclude by highlighting several creative approaches of working with these concepts, aiming not only to deepen our understanding of music but also to offer new therapeutic methods when using music.
Challenges of Known Music
As we start this exploration, I’d like to share some of my own formative experiences that shaped this thinking initially. These illustrate, from patient- and therapist-perspectives, some of the potential risks and challenges when using known music in psychedelic therapy.
When I first began designing music playlists for psychedelic therapy (around 2014), I of course curiously analysed and listened to the playlist used at Johns Hopkins University. One of the featured music pieces was Samuel Barber’s Adagio for Strings.
While this piece is remarkable, brilliant and intuitively versatile for therapeutic contexts, the colleagues (therapists) with whom I discussed the music-selection with raised concerns for this piece.
This concern was based on the frequent use of this song in a wide variety of public, commercial and entertainment contexts.
I went online and indeed, its use is very widespread.
Here is that list, though likely even incomplete, summarising the different contexts this track has been used:
Movies:
Platoon (1986) – Used during several scenes to underscore emotional gravity of the Vietnam War.
The Elephant Man (1980) – Played to highlight the humanity and suffering of John Merrick.
Lorenzo's Oil (1992) – Accompanies moments of despair and hope in the story of a family seeking a cure for their son's rare disease.
The Scarlet Letter (1995) – Used to emphasise themes of sorrow and tension.
El Norte (1983) – Employed to enhance the emotional journey of immigrants fleeing violence.
Amélie (2001) – Briefly featured in a playful moment where characters attempt to understand each other.
The Company (2003) – Used to reflect the emotional depth of the main characters’ journeys.
Television:
The Simpsons – Used in several episodes, especially in moments of sadness.
Seinfeld – Featured in "The Fatigues" episode in a humorous context.
South Park – Used in various episodes to parody dramatic moments.
Commercials:
Guinness – Used in a 2006 commercial.
Nike – Briefly featured in a few campaigns.
Other Media:
Video Games: Homeworld (1999) – Used in the opening sequence.
Documentaries: Sicko by Michael Moore (2007) – Used to underscore emotional moments concerning healthcare struggles.
Internet Memes and Parodies – Finally, the piece is used online in a large variety of videos and memes.
Because of this large list, it is a fair concern that some patients might have unpredictable prior associations with it. Those may either distract, or complicate the therapeutic work in other ways.
Or maybe it is turning out a perfect match to the moment of some patients. But taking this approach would indeed be a bit like playing Russian roulette.
We therefore decided not to include Adagio for Strings in our first psychedelic therapy playlist version. However, we did still ended up borrowing a small handful of other pieces of classical music from the Johns Hopkins University playlist, although sequenced and placed differently.
At the actual therapy sessions themselves, some of these songs ended up evoking associations, thoughts, and imagery related to World War II and the Nazi Holocaust - for a number of patients.
For example, Henryk Górecki's Symphony No. 3, also known as the Symphony of Sorrowful Songs has been publicly attributed to victims of the Holocaust, while Wagner was endorsed in nazi Germany as one of Adolf Hitler’s favourite composers.
Almost all the songs of my playlist were self-curated, resulting in a novel psychedelic therapy playlist for the first psychedelic trials trial at Imperial College London. There were additional reasons for this, that I will introduce in subsequent articles (for example, considerations around religious and cultural associations of music).
In this process of music curation, I came across ambient music compositions by Robin Guthrie and Harold Budd that had potential. Still ahead of the trial, when I later saw the film that this music was composed for and learned it being about pedophilia and complex childhood trauma, I decided to replace these songs form the present draft of the playlist.
I found myself drawn to an increasing number of contemporary composers for this playlist. There is a unique role contemporary artists play in this field, which is another theme to be explored deeper elsewhere.
I included tracks from Stars of the Lid, the ambient project by Brian McBride and Adam Wiltzie. I felt these were a wise and appropriate replacement for the pedophilia-movie soundtrack Robin Guthrie and Harold Budd
To bring this specific story full circle, I recently watched a political documentary by Adam Curtis. Within it’s dense, serious and somewhat gloomy character, the documentary featured these very tracks as part of its soundtrack.
I wanted to start with sharing these anecdotes from my early time at Imperial College London, selecting music for psychedelic therapy. It illustrates that any existing publicly available piece of music, inherently runs the risk of the possibility that listeners have encountered it before.
Potentially it links to a personal life event, or to specific themes within the respective films, documentaries or other media it was featured on. Or it may trigger reflections around the composers themselves. Or it may turn out to be perfect for others - Its a gamble.
On one hand, this is sad. The songs referenced above are powerful and beautiful works of art, each with a unique profile for usage in psychedelic therapy. And as a broader general point, when knowing how to see through the noise, there’s an impressive array of good music publicly available.
But, on the other hand, this challenge also included a creative invitation. One that opened up entirely new therapeutic opportunities that I present at the end of this article.
Novelty vs Familiarity
Before we continue, it’s essential to clarify some related but distinct terms often used in discussions about familiarity in music therapy. Terms like “familiar” and “unfamiliar” music can bring connotations that don’t precisely capture the qualities we actually aim to highlight in such discussions.
I’d like to illustrate this point by using an analogy. When a friend from California visited me and we hiked over Portugal’s coastline, she remarked on how strikingly familiar the landscape felt, reminiscent of her home’s coastlines in California. The towering, majestic cliffs rising above the ocean and the mosaic of different shades of sage greens and warm browns - the landscape made her feel connected to the land. despite it being her first time on this land, it was fully novel and yet very familiar.
Musical experiences can be viewed along similar lines.
A song we’ve never heard before can nonetheless feel deeply resonant, relatable, and familiar. In this sense, I argue that familiarity can be an independent quality, distinct from the actual novelty of the music itself for the listener. This distinction is relevant for reasons that I’ll continue to explain below.
For clarity in this article, I’ll use terms like “novel,” “original”, “new,” “unknown,” “unheard,” and “fresh” interchangeably to describe music that is objectively new and heard for the first time by the listener. On the other hand, terms such as “known” music, or music that has been “heard before” will refer to music the listener has actually encountered previously.
Challenges of Unfamiliar Music
In contrast to challenges observed with known music, subsequent clinical trial work also highlighted unique challenges with music that is novel.
Specifically, these observations highlighted effects of music that is novel and unfamiliar.
When viewing music as a non-verbal language, each person in turn developed an authentic and individual music language that is the result of complex individual, cultural as well as innate/universal influences. This language determines the degree to which music is experienced as familiar, while the music may be known or unknown.
From this perspective, we can view unfamiliar music as representing a non-verbal language (a style) that is highly foreign, difficult if not impossible to understand and hence, be influenced by accordingly.
Here, the music piece itself might not even be totally novel to the listener, but importantly, it embodies compositional or acoustic qualities they have never or rarely been exposed to before. Although not excluding the possibility to learn a new language, at least on first exposures such music would be experienced as mostly “foreign”.
Below I list three distinct reactions that that specifically the unfamiliar dimension of music can evoke. Moving forward, I aim to make these points more concrete by including illustrative and real quotes from patients in psychedelic therapy trials.
1. Alienation
When selecting music for therapeutic purposes, one overarching insight is to exercise carefulness with choices that are highly foreign to the individual (highly unfamiliar), because they run the risk of making the music too, or entirely, unrelatable.
Here, some of the possible experiences the care-seeker may experience in return include feeling isolated, misunderstood, mocked, abandoned, scared, or a distancing themselves from the music. An analogy for this would be visiting a therapist who speaks an unknown foreign language to you, let's say Chinese, while you only speak English.
“I don't really understand opera. I think if you appreciate opera, Classic FM, you would have got something else. To me it can be a bit inaccessible, a bit highbrow.”
“I didn’t really like the sort of world music stuff. The ethnic and cultural music. There was some sort of Indian-style music [...] I found it a bit creepy at the time.”
“I couldn’t connect with the music.”
"The music didn't feel real. I was sort of feeling bad, because I wanted to work with it. I sensed the potential for a really profound experience, but I couldn't meet it.”
2. Analysis
Alternatively or in parallel to alienation, when the non-verbal language characteristics of the music and the listener are too strong of a mismatch, not only may this lead to psychological distancing from the music, but a mental effort for understanding the music and its “strange” qualities - a shift away from direct experiencing into analytical thinking.
“Creating puzzlement rather than just accepting the music. […] ‘Why is that person singing it in that particular way?’ and I felt myself spending a lot of time thinking about that. Trying to work out why she was singing it in that particular”
3. Transcendence
Finally, I’ve encountered some cases where music styles were played that were highly unfamiliar to the care-seeker (For example, highly culturally specific music such as Indian classical music), yet the music resonated powerfully and led to strong, personally and spiritually significant experiences. Despite the music’s novelty and apparent unfamiliarity, these styles nevertheless demonstrated a capacity to support the therapeutic process effectively.
There are a few hypotheses that emerged for this phenomenon. A person’s openness to new experiences in context of prior somewhat-related musical experiences may form a fruitful foundation for an in-the-moment extension/acquisition of musical language. Alternatively, certain musical traditions have developed compositional styles over many generations that are specifically tailored to facilitate altered states of consciousness - such ongoing experimental iterations might have resulting in tapping into musical qualities that contain degree of universality. Meaning, the music here may be personally unfamiliar, yet trans-personally very familiar. This is a theme in itself that I will explore in more detail in one of the next articles.
“[being not familiar with Indian music] I was seeing an Indian temple [and the] the [Indian] music was influencing the movements and influencing the setting. [...] During that same Indian piece, that’s when I was dancing for Shiva and then I was Shiva [..] Saying that it made me sad or it made me happy, those words are actually irrelevant, a little too mild almost to explain what it was. I felt ecstasy.”
Key motivations to prioritise music that is novel and familiar
The interplay of novelty and familiarity in music seems to occupy a unique and significant role in music selection for psychedelic therapy. We may view this as a sweet spot, with specific nuances and exceptions outlined below.
While the novelty of the music protects the explorative qualities of the therapeutic “journey into the unknown”, with possibly confronting, scary or emotionally painful experiences to go through - the qualities of familiarity can simultaneously hold the experience together within a sense of support, belonging and care.
With this balance, the music is not uncommonly experienced as an empathic companion, implicitly re-assuring and trusting. And in some cases conveying an implicit sense of and “coming home” - As illustrated by the patient quotes below.
“The music was spot on with my feeling.”
“[The music] was following my emotion at the time.”
“I did feel as if I was being held”
“[The music] took my thinking and my experience to uncomfortable places, but I was kind of reassured in the experience.”
“There was something there that meant that, you know, was saying ‘I’m going to take you on a ride here, but I promise I won’t abandon you.’ That seemed to be what the music was saying to me.”
“The music took you to the places you needed to be.”
Below I outline three distinct benefits that music that is both novel and familiar can offer simultaneously when used in psychedelic therapies.
1. Preventing irrelevant associations
When a piece of music has been heard before, it inevitably activates memories and associations linked to those past listening experiences. The extent of this effect isn’t solely correlated with how often the piece has been heard, but rather with the significance of the context in which it was first encountered.
For therapists, the primary benefit of selecting novel music lies in minimising the risk of uncontrolled associations that might arise from such previous listening experiences. As I will emphasise in the end of this article, prior associations are not inherently bad, and in fact they could be used therapeutically. But prioritising novel music helps ensure that the selected music has the highest likelihood to prevent inappropriate and distracting associations to derail the focus of the patient and the sessions.
2. Stimulating Openness
Another significant advantage of using unheard music in therapeutic work lies in its capacity to ensure the sessions maintain an open-ended explorative element for the care-seeker. For the therapeutic process to be approached with little prior expectations and (unconscious) desires or defences to control the experience. Known music, by its known structure and predictable qualities, offers a path already paved.
In contrast, novel music preserves the session as a blank canvas, or a fresh field of snow without trials (yet), in which the listener is invited to decide and explore new territories and access new experiences.
As I’ve discussed elsewhere, the process of personal projection into musical abstractions is a core element of music’s therapeutic power. Music can act as a mirror to the mind, making subconscious processes more accessible and directly felt. Novel music, in particular, offers the strongest potential to invite such a deep personal engagement and immersion, by encouraging listeners to connect fully with whatever presents itself spontaneously within the present moment.
3. New Memories
Finally, when a piece of music is first heard during a highly personally significant event in a therapy session, it becomes an integral part of this new memory formed. When combined with psychedelics, known to enhance neuroplasticity, this effect is likely to become even more significant to consider.
This brings a unique and distinct therapeutic opportunity in integration therapy. It can enable care-seekers to reconnect not only with the specific experiences that the music evokes, but also with the processes it initiated.
These emotionally charged musical memories thereby can start to serve as entry-points, reinforcing experiences and processes accessed previously in the therapy room, while grounding them in the context of their actual daily lives.
Examples
Here I will present a selection of examples that illustrate how we prioritise novel and exclusive music compositions, balance familiarity, and designed new implementations alongside these themes.
1. Original and Exclusive Music
In summary of the above, when music is novel and sufficiently familiar, while simultaneously appropriately matching the therapeutic experience and process of the patient, we define the music as being “resonant” and most therapeutically significant.
Therefore, one important principle to music composition at Wavepaths is for every musical contribution created for Wavepaths to be entirely original (fully novel) and exclusive (only available within the platform).
2. Dynamic music (Degrees of Novelty)
Importantly, we’ve developed several approaches that allow our music to convey a sense of familiarity and relatability, while remaining original. One of these ways is via our software, that makes the music flexible and dynamic - being created in the moment. Even if a version of certain musical building blocks has been used before for a client’s session, the nature of how the compositions are shaped up in real-time within each session, ensures that each musical experience contains a good degree of novelty.
3. Thematic music
We are (more recently) actively remixing versions of our musical library. These variations enable musical themes to emerge and evolve fluidly - within one single session or across multiple sessions. This approach resembles music scored to a film, where recurring motifs and subtle variations convey an evolution around a particular subjective “narrative” (in our case, language-free and in the form of the processes conveyed by the music).
By enabling the music to evolve along these lines, the software can create a dynamic and organic therapeutic environment with each session having not only novel music, but degrees of familiarity and a clear thematic interconnectedness.
Rather than the session-music to become a selection of unrelated songs, thrown into one-by-one, the session itself becomes one integrated self-referencing musical piece.
4. Boundaries for Accessibility
One other motivation for our music to be exclusive, relates to ensuring the music is reserved for intentional therapeutic experiences only. By confining our music to our platform alone, it communicates a ceremonial boundary, an auditory space that is set apart only for this work.
This exclusivity imbues the music with a certain symbolic weight. Together with the thoughtfulness and details we put into their compositions, it conveys to care-seekers a recognition of the significance of their experience and the work they are embarked to do.
For the care-seekers themselves too, this functions like an implicit invitation and encouragement to approach the experience with an increased sense of intentionality, reverence and focus.
5. Music for Integration Therapy
As previously discussed, novel music encourages the formation of novel memories, offering a unique therapeutic opportunity in subsequent integration therapy. It enables care-seekers to reconnect with the specific experiences and processes the music evokes, and helps to engage with these potent musical memories as entry points to reinforce ongoing therapeutic work in daily life.
Despite each session creating novel music, our software enables a recording of the exact music, and a flexible way of sharing this with care-seekers for at home listening. Therapists can in addition add voice-overs, notes, or create new music sessions for remote or in-office introspective listening sessions as a musical adjunct and ongoing support within the integration therapy phase.
6. Personalised Music (Degrees of Familiarity)
Last but not least, I started Wavepaths with the vision to design capacities for dynamically fine-tuning session music to the unique musical language of each care-seeker. By calibrating acoustic and compositional qualities, we can create music that is both entirely novel and familiar, as well as control variations and degrees of music’s familiarity.
This work has been ongoing, with a major milestone set for release around the new year, introducing a new product version that will offer advanced functionalities specifically for this feature.
Is there a case left for using known music in psychedelic therapy?
In short: yes. While I advocate for prioritising novel music in therapy (a stance shared by many in the field), I recognise ways that known music may hold a distinct therapeutic potential. There is some initial anecdotal evidence that I have seen and present below, that suggest potential use-cases for known music and highly familiar music.
When clients choose songs that are related to a specific event or experience in life, this may be a means for re-accessing such experiences in the session(s). In addition, playing a personally favourite song during a certain phases of a session could add an extra layer of reassurance and safety to the session.
Finding ways to come to a better understanding of the care-seeker’s unique musical instincts, will be an invaluable guidance in selecting music for their sessions. Both this process, and the actual selection of client-selected music, might further enhance the therapeutic alliance, and help the care-seeker in question to feel acknowledged and included in impactful choices around the music.
By no means am I suggesting it to be a wise idea to let entire sessions be designed by self-selected music from the client. For reasons that I introduced in this article. But implementing a small and thoughtful selection of known pieces of music, may for some clients and for some situations, be a unique added value.
Finally, it needs to be noted too that the psychedelic state can promote perceiving totally new layers and nuances in known music, enabling clients to experience the music in a new ways. The evidence at hand does suggest a mixed bag with known music (as illustrated with some of the patient quotes above), but it adds important nuance and validity to the idea that there might be a unique value for certain personally favourite and meaningful pieces of music from the care-seeker to in fact be selected and included consciously and collaboratively.
While contrastingly, it needs also to be emphasised, that a known and previously highly enjoyable piece music, may very well be an absolutely disastrous mismatch when this person finds herself in a state of consciousness that is radically different to the the state of consciousness this piece was originally selected in.
Postlude
In this essay, we explored the nuanced role of novelty and familiarity in music selected for psychedelic therapy. I presented distinct benefits for prioritising novel music, minimising pre-existing associations, maximising an open therapeutic engagement, and for the formation of potent new memories. Known music might still play a role, when carefully and collaboratively selected, for some people, purposes and phases of the session.
As I’ll emphasise in many of these essays, much remains to be explored in this field, and much more research is needed. Correlating with my own growing understandings, I do increasingly recognise the need to avoid strict, black-and-white judgments or recommendations on many of these topics. To this point, in next articles in this series I will discuss the use of lyrics and words in music, as well as the use of highly culturally specific music.
Using Barber’s Adagio for Strings is a brilliant example. It's beautiful yet popular enough to carry non-novel biases, making neutrality challenging.
If I were to hear the soundtrack of Requiem for a Dream under a psychedelic, thoughts of substance use disorder and mental illness would flood my mind.