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At various points over the past 20 years,

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I've studied two fundamental
human experiences

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that have taught me
an awful lot about emotion

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and that may hold the keys
to a revolution in psychiatry.

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The first is how we experience music.

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The second is how we experience
psychedelic drugs

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such as LSD and magic mushrooms,

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or psilocybin,

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which is the active component
in magic mushrooms.

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You may be wondering what these two things
have in common outside of Woodstock.

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After all, music is not
a physical substance.

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It can be described as a limited set
of vibrations in the air

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that can be detected by your ear.

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And music may seem to have more to do
with aesthetics than with biology

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or chemistry.

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Psychedelic drugs, on the other hand,
are physical substances.

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They are chemical compounds
that you can ingest

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that directly interact
with brain chemistry

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and change your experience of the world.

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This change is temporary,

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but the effects of this change
can alter the course of your life.

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But let's face it:

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psychedelics have the potential

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to trigger unexpected
and potentially dangerous effects.

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So what could these two very different
things possibly have in common?

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I've found that music and psychedelics
can impact our well-being

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in powerful and complementary ways.

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Music can have a direct
impact on our emotions,

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with measurable impacts in the brain;

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psychedelic drugs,
under the right circumstances,

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may have therapeutic effects.

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These effects can be manifest in patterns

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that we can study
and document with brain scans.

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And together, and leveraged
in a purposeful fashion,

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music and psychedelics may have
an even greater healing impact

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on patients.

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What's more, these effects can be manifest
in healthier and happier lives

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and more integrated personalities.

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I began my journey into the mental
health benefits of music

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long before I ever intended
to make such a journey.

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For roughly half of my life,
I've been a musician,

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having played in community orchestras,

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community theaters,

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wedding bands, a salsa-merengue band.

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I was a member of a string band
in Philadelphia for many years.

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And for the better part
of my formative years,

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I was the drummer
in a Weezer-Nirvana cover band

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that morphed into a hardcore punk band.

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(Laughter)

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That's right.

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Drummer in a punk band.

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But it wasn't until I really began
my career in psychology and neuroscience

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that I began to also appreciate
how widely and how deeply we as a species,

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both implicitly and explicitly,

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use music as a tool to try
to regulate our emotions

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and to heal.

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And for some of us, music keeps us going.

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For others, music isn't quite enough.

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For me, this led to some
fascinating questions.

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I began to use music as a tool
to study emotion and memory in the brain.

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My first scientific study was focused
on music-evoked nostalgia.

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Nostalgia's a rich and bittersweet emotion

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that is intimately tied up
with our autobiographical memories.

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We can often encounter nostalgia
in unexpected places.

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You may have had the experience
of driving down the highway,

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turning on the radio

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or firing up your favorite music
recommendation service,

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and you hear a song
you haven't heard in ages,

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and you get immediately
transported back in time

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and dumped into this immersive memory --

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something you haven't
thought about in ages

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but was very meaningful to you --

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maybe wedding day or senior prom

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or the birth of your first child

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or the death of a loved one.

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Music can serve as a powerful context cue

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for deeply meaningful and intensely vivid
nostalgic memories such as these.

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Nostalgia, in a sense,
is deeply woven into our sense of self.

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Who are we at our most authentic selves?

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By connecting us
with our emotional histories,

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nostalgia can help us
to stave off sadness, loneliness,

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existential threat

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and even the imminence of death

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and the approaching horizon
of our lives as we age.

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To try to get a better understanding
of how music may tap into nostalgia

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and what that may be doing in the brain,

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I began to work with computational
models of music cognition.

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I applied these models
to interrogate brain activity

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that was recorded
while people were listening

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to nostalgia-evoking
and nonnostalgia-evoking music.

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And importantly,
at least to a brain geek like me,

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I found that nostalgia was able
to recruit a wide network of brain regions

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involved in multiple levels
of different cognitive processes.

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Whereas nonnostalgic music
could recruit brain regions

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such as Heschl's gyrus,

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involved in basic auditory processing,

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or Broca's area,

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which is involved in processing
grammar and syntax

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not only in language but also in music,

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nostalgia was able to recruit
these brain regions and more.

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Brain regions such as the substantia nigra
involved in reward processing

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or the anterior insula involved
in the visceral experience of emotion

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or brain regions
in the inferior frontal gyrus

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that are involved
in autobiographical memories.

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Nostalgia was also able to recruit
a wide network of brain regions

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in prefrontal, frontal, cingulate,
insular, parietal, occipital

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and subcortical brain regions

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that span nearly all
of our cognitive faculties.

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This may explain why nostalgia
can have such an outsized impact on us.

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But as powerful as it is in the moment,

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the salve of music-evoked
nostalgia eventually fades.

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Nostalgia may be more of a Band-Aid,

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less of an antibiotic

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and typically far from a surgical
intervention for our emotional health.

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Music can draw out nostalgia

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and music and nostalgia
can move our feelings,

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but how do we make these feelings stick?

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After studying the nostalgic brain,

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I joined a team
at Johns Hopkins University

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that was studying the effects
of psychedelic drugs,

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and I quickly began to learn how deeply
a piece of music could impact a person

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during a psychedelic experience.

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I was previously vexed by the difficulty
in predicting precisely

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what musical stimulus would evoke
precisely what response

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within a given individual.

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A song that evokes nostalgia in one person
could just as easily evoke disinterest

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or disgust in another person.

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I began to learn how deeply most music
seemed to impact most people

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during psychedelic experiences.

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Since at least the late '50s,

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the value of using music to help people

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to navigate psychedelic
experiences was clear.

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We continue this tradition
in our modern research,

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asking volunteers to listen to music

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during the course
of a psychedelic therapy session,

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and despite most people being
mostly naive to the music that we play

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before they get into the sessions,

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after these sessions,

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our volunteers practically
beg us for the playlists.

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And some of them report
returning to the songs

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that were most impactful to them
during their psychedelic experience

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weeks, months and even many years
after the experience.

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Somehow, these songs
can turn into touchstones

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that can rekindle the most powerful
and impactful and insightful experiences

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that people encountered
during their psychedelic sessions.

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Of course, I had to know
what was going on here.

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I began to deploy
my batteries of questionnaires

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and my carefully crafted experiments

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and my big, fancy MRI machines

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to try to determine
just what could be happening

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during these experiences

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that could explain the depth
of impact that people were encountering.

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At a basic psychological level,

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my colleagues and I determined that,

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for instance, LSD can increase
positive emotions

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that are uniquely encountered
during music listening.

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This may have relevance just by itself
for healthy individuals

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as well as people suffering from mood
and substance-use disorders.

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But what was happening in the brain?

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Earlier we learned that the entire brain
listens to nostalgic music.

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When applying computational models
of music cognition

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to interrogate brain activity
that was recorded during music listening

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under the effects of LSD,

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we found that the entire brain
was listening to music

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and psychedelics were turning up the gain.

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Where nostalgia could recruit
brain regions involved in language,

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memory and emotion,

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psychedelics were recruiting
these brain regions

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at least twice as strongly.

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Brain regions such as the thalamus,

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that's involved in basic
sensory processing

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or the medial prefrontal cortex

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and the posterior singular cortex,

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which can be involved in memory
and emotion and mental imagery.

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These brain regions were recruited
up to four times as strongly

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during the effects of LSD
than without LSD.

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Psychedelics turn the knob up to 11.

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Sensory information
is more richly experienced in the brain;

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emotions, memories
and mental imagery are supercharged,

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and it may be the wholesale
and strong recruitment

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of a wide range of brain regions
during these experiences

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that is the necessary key
to unlocking change

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that sets these drugs
and these experiences apart from others.

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And the effects can be long-lasting.

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In a study of healthy individuals,

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I demonstrated that a single
high dose of psilocybin

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could reduce negative affect in volunteers
for at least a week after psilocybin,

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and increase positive affect

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for at least a month
after a single high dose of psilocybin.

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The reduction in negative affect

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that we observed after
psilocybin administration

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was accompanied by a reduction,
one week after psilocybin,

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in the response of a primitive
brain region called the amygdala

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to emotional stimuli.

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In a separate study in patients
with major depressive disorder,

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not only did we observe a substantial
decrease in depression severity

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in most of our patients
after two doses of psilocybin,

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but we also observed a reduction
in the amygdala response

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to negative affective
stimuli, specifically,

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one week after psilocybin.

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This reduction in amygdala response

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was associated with an enduring
reduction in depression severity

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for at least three months
after psilocybin administration,

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but frankly, we're still counting.

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So what does this all mean?

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It means that music
and psychedelics may be able

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to alter the entire brain
for a period of time,

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and that may lead to a change
in neural circuitry

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that may be stuck in patterns
of negative emotional bias.

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This may be able to give people
a period of relief

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from the grip and the claws
of negative emotion.

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And that may be just enough to give
someone access to new perspectives

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on their selves and their lives

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and begin on the road to healing
from years of depression.

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These drugs are early
in stages of research,

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but they're now being researched
for a wide range of medical indications.

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There's evidence growing

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that psychedelics may be effective
in helping to treat mood disorders

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such as major depressive disorder,

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treatment-resistant depression

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and the depression and anxiety

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that accompany a late-stage
cancer diagnosis.

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There's also evidence accumulating
that psychedelics may be effective

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in helping to treat a wide range
of substance-use disorders,

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including smoking, drinking
and cocaine use.

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Additional studies
are either being planned

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or are already underway

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to determine whether psychedelics
may be effective in treating

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an even wider range
of intractable disorders

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such as OCD, PTSD,

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opioid-use disorder and anorexia.

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At this point it might be reasonable
to take a step back

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and say, "Are psychedelics
being sold as a panacea?"

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And if so, we should
be rightfully skeptical.

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Why should we expect such a small family
of compounds to be so effective

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in treating such a wide range
of disparate disorders?

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Here's a perspective we might consider.

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Some of these disorders
share a common thread.

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At some level,

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mood disorders and substance-use disorders
involve negative affect

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and a disconnection
from our most authentic selves.

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Psychedelics may break that mold.

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Psychedelics and music
may represent a one-two punch

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that can operate on psychological
neural processes such as negative affect

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that cut across and contribute
to multiple disorders.

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It may be that targeting
such transdiagnostic processes

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is what's necessary to really help people

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to develop the resources
that they need to begin to recover

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from years of depression
and substance use.

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They say you never get a second chance
to make a first impression,

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and that may be true
for psychedelic drugs.

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After all, no matter
how much data come out

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for the potential of therapeutic
effects of these drugs,

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there are still some who are stuck
on the stigma from the '60s and '70s:

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myths of the wildly addictive
properties of these drugs

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or myths of genetic abnormalities

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or birth defects after
being exposed to these drugs,

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or fears that people
are going to lose their minds

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and go insane --

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or maybe even most pervasive

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is the sense that these effects
are necessarily real

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and that they're a necessary outcome
of having been exposed to these compounds.

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It may be time to change
our thinking on that point.

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No one should expect psychedelic
drugs to work for everyone.

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No one should expect psychedelic
drugs to work for everything.

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They're powerful compounds

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that need to be administered
under carefully controlled circumstances.

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And there are almost certainly
people in this world

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for whom psychedelics
are incredibly dangerous.

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But ...

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antibiotics administered to the wrong
person under the wrong conditions

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can be incredibly dangerous, if not worse.

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But administered to the right person
under the right conditions,

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antibiotics save lives.

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Administered to the right people
under the right conditions,

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psychedelic drugs may save lives.

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It can often feel like it's impossible
to heal our hearts and our minds

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and to grow,

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but I truly believe that we all have
the resources within ourselves

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to do just that.

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The challenge is often identifying
and connecting with those resources,

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and it may be that psychedelics
and music can help people

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to do just that.

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Together, psychedelics and music
may be able to open our minds to change

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and direct that change,

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reconnect us with our most
authentic selves

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and allow us access to the things

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that really allow us to make
meaning in this world

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and reconnect

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with our most authentic selves.

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Thank you.

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(Applause)