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← The neuroscience of psychedelic drugs, music and nostalgia

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Showing Revision 9 created 10/01/2020 by marialadias.

  1. At various points over the past 20 years,
  2. I've studied two fundamental
    human experiences
  3. that have taught me
    an awful lot about emotion
  4. and that may hold the keys
    to a revolution in psychiatry.
  5. The first is how we experience music.
  6. The second is how we experience
    psychedelic drugs
  7. such as LSD and magic mushrooms,
  8. or psilocybin,
  9. which is the active component
    in magic mushrooms.
  10. You may be wondering what these two things
    have in common outside of Woodstock.

  11. After all, music is not
    a physical substance.
  12. It can be described as a limited set
    of vibrations in the air
  13. that can be detected by your ear.
  14. And music may seem to have more to do
    with aesthetics than with biology
  15. or chemistry.
  16. Psychedelic drugs, on the other hand,
    are physical substances.
  17. They are chemical compounds
    that you can ingest
  18. that directly interact
    with brain chemistry
  19. and change your experience of the world.
  20. This change is temporary,
  21. but the effects of this change
    can alter the course of your life.
  22. But let's face it:
  23. psychedelics have the potential
  24. to trigger unexpected
    and potentially dangerous effects.
  25. So what could these two very different
    things possibly have in common?
  26. I've found that music and psychedelics
    can impact our well-being

  27. in powerful and complementary ways.
  28. Music can have a direct
    impact on our emotions,
  29. with measurable impacts in the brain;
  30. psychedelic drugs,
    under the right circumstances,
  31. may have therapeutic effects.
  32. These effects can be manifest in patterns
  33. that we can study
    and document with brain scans.
  34. And together, and leveraged
    in a purposeful fashion,
  35. music and psychedelics may have
    an even greater healing impact
  36. on patients.
  37. What's more, these effects can be manifest
    in healthier and happier lives
  38. and more integrated personalities.
  39. I began my journey into the mental
    health benefits of music

  40. long before I ever intended
    to make such a journey.
  41. For roughly half of my life,
    I've been a musician,
  42. having played in community orchestras,
  43. community theaters,
  44. wedding bands, a salsa-merengue band.
  45. I was a member of a string band
    in Philadelphia for many years.
  46. And for the better part
    of my formative years,
  47. I was the drummer
    in a Weezer-Nirvana cover band
  48. that morphed into a hardcore punk band.
  49. (Laughter)

  50. That's right.

  51. Drummer in a punk band.
  52. But it wasn't until I really began
    my career in psychology and neuroscience

  53. that I began to also appreciate
    how widely and how deeply we as a species,
  54. both implicitly and explicitly,
  55. use music as a tool to try
    to regulate our emotions
  56. and to heal.
  57. And for some of us, music keeps us going.
  58. For others, music isn't quite enough.
  59. For me, this led to some
    fascinating questions.
  60. I began to use music as a tool
    to study emotion and memory in the brain.
  61. My first scientific study was focused
    on music-evoked nostalgia.

  62. Nostalgia's a rich and bittersweet emotion
  63. that is intimately tied up
    with our autobiographical memories.
  64. We can often encounter nostalgia
    in unexpected places.
  65. You may have had the experience
    of driving down the highway,
  66. turning on the radio
  67. or firing up your favorite music
    recommendation service,
  68. and you hear a song
    you haven't heard in ages,
  69. and you get immediately
    transported back in time
  70. and dumped into this immersive memory --
  71. something you haven't
    thought about in ages
  72. but was very meaningful to you --
  73. maybe wedding day or senior prom
  74. or the birth of your first child
  75. or the death of a loved one.
  76. Music can serve as a powerful context cue
  77. for deeply meaningful and intensely vivid
    nostalgic memories such as these.
  78. Nostalgia, in a sense,
    is deeply woven into our sense of self.

  79. Who are we at our most authentic selves?
  80. By connecting us
    with our emotional histories,
  81. nostalgia can help us
    to stave off sadness, loneliness,
  82. existential threat
  83. and even the imminence of death
  84. and the approaching horizon
    of our lives as we age.
  85. To try to get a better understanding
    of how music may tap into nostalgia

  86. and what that may be doing in the brain,
  87. I began to work with computational
    models of music cognition.
  88. I applied these models
    to interrogate brain activity
  89. that was recorded
    while people were listening
  90. to nostalgia-evoking
    and nonnostalgia-evoking music.
  91. And importantly,
    at least to a brain geek like me,
  92. I found that nostalgia was able
    to recruit a wide network of brain regions
  93. involved in multiple levels
    of different cognitive processes.
  94. Whereas nonnostalgic music
    could recruit brain regions
  95. such as Heschl's gyrus,
  96. involved in basic auditory processing,
  97. or Broca's area,
  98. which is involved in processing
    grammar and syntax
  99. not only in language but also in music,
  100. nostalgia was able to recruit
    these brain regions and more.
  101. Brain regions such as the substantia nigra
    involved in reward processing
  102. or the anterior insula involved
    in the visceral experience of emotion
  103. or brain regions
    in the inferior frontal gyrus
  104. that are involved
    in autobiographical memories.
  105. Nostalgia was also able to recruit
    a wide network of brain regions
  106. in prefrontal, frontal, cingulate,
    insular, parietal, occipital
  107. and subcortical brain regions
  108. that span nearly all
    of our cognitive faculties.
  109. This may explain why nostalgia
    can have such an outsized impact on us.
  110. But as powerful as it is in the moment,

  111. the salve of music-evoked
    nostalgia eventually fades.
  112. Nostalgia may be more of a Band-Aid,
  113. less of an antibiotic
  114. and typically far from a surgical
    intervention for our emotional health.
  115. Music can draw out nostalgia
  116. and music and nostalgia
    can move our feelings,
  117. but how do we make these feelings stick?
  118. After studying the nostalgic brain,

  119. I joined a team
    at Johns Hopkins University
  120. that was studying the effects
    of psychedelic drugs,
  121. and I quickly began to learn how deeply
    a piece of music could impact a person
  122. during a psychedelic experience.
  123. I was previously vexed by the difficulty
    in predicting precisely
  124. what musical stimulus would evoke
    precisely what response
  125. within a given individual.
  126. A song that evokes nostalgia in one person
    could just as easily evoke disinterest
  127. or disgust in another person.
  128. I began to learn how deeply most music
    seemed to impact most people
  129. during psychedelic experiences.
  130. Since at least the late '50s,

  131. the value of using music to help people
  132. to navigate psychedelic
    experiences was clear.
  133. We continue this tradition
    in our modern research,
  134. asking volunteers to listen to music
  135. during the course
    of a psychedelic therapy session,
  136. and despite most people being
    mostly naive to the music that we play
  137. before they get into the sessions,
  138. after these sessions,
  139. our volunteers practically
    beg us for the playlists.
  140. And some of them report
    returning to the songs
  141. that were most impactful to them
    during their psychedelic experience
  142. weeks, months and even many years
    after the experience.
  143. Somehow, these songs
    can turn into touchstones
  144. that can rekindle the most powerful
    and impactful and insightful experiences
  145. that people encountered
    during their psychedelic sessions.
  146. Of course, I had to know
    what was going on here.

  147. I began to deploy
    my batteries of questionnaires
  148. and my carefully crafted experiments
  149. and my big, fancy MRI machines
  150. to try to determine
    just what could be happening
  151. during these experiences
  152. that could explain the depth
    of impact that people were encountering.
  153. At a basic psychological level,
  154. my colleagues and I determined that,
  155. for instance, LSD can increase
    positive emotions
  156. that are uniquely encountered
    during music listening.
  157. This may have relevance just by itself
    for healthy individuals
  158. as well as people suffering from mood
    and substance-use disorders.
  159. But what was happening in the brain?
  160. Earlier we learned that the entire brain
    listens to nostalgic music.

  161. When applying computational models
    of music cognition
  162. to interrogate brain activity
    that was recorded during music listening
  163. under the effects of LSD,
  164. we found that the entire brain
    was listening to music
  165. and psychedelics were turning up the gain.
  166. Where nostalgia could recruit
    brain regions involved in language,
  167. memory and emotion,
  168. psychedelics were recruiting
    these brain regions
  169. at least twice as strongly.
  170. Brain regions such as the thalamus,
  171. that's involved in basic
    sensory processing
  172. or the medial prefrontal cortex
  173. and the posterior singular cortex,
  174. which can be involved in memory
    and emotion and mental imagery.
  175. These brain regions were recruited
    up to four times as strongly
  176. during the effects of LSD
    than without LSD.
  177. Psychedelics turn the knob up to 11.
  178. Sensory information
    is more richly experienced in the brain;
  179. emotions, memories
    and mental imagery are supercharged,
  180. and it may be the wholesale
    and strong recruitment
  181. of a wide range of brain regions
    during these experiences
  182. that is the necessary key
    to unlocking change
  183. that sets these drugs
    and these experiences apart from others.
  184. And the effects can be long-lasting.

  185. In a study of healthy individuals,
  186. I demonstrated that a single
    high dose of psilocybin
  187. could reduce negative affect in volunteers
    for at least a week after psilocybin,
  188. and increase positive affect
  189. for at least a month
    after a single high dose of psilocybin.
  190. The reduction in negative affect
  191. that we observed after
    psilocybin administration
  192. was accompanied by a reduction,
    one week after psilocybin,
  193. in the response of a primitive
    brain region called the amygdala
  194. to emotional stimuli.
  195. In a separate study in patients
    with major depressive disorder,
  196. not only did we observe a substantial
    decrease in depression severity
  197. in most of our patients
    after two doses of psilocybin,
  198. but we also observed a reduction
    in the amygdala response
  199. to negative affective
    stimuli, specifically,
  200. one week after psilocybin.
  201. This reduction in amygdala response
  202. was associated with an enduring
    reduction in depression severity
  203. for at least three months
    after psilocybin administration,
  204. but frankly, we're still counting.
  205. So what does this all mean?

  206. It means that music
    and psychedelics may be able
  207. to alter the entire brain
    for a period of time,
  208. and that may lead to a change
    in neural circuitry
  209. that may be stuck in patterns
    of negative emotional bias.
  210. This may be able to give people
    a period of relief
  211. from the grip and the claws
    of negative emotion.
  212. And that may be just enough to give
    someone access to new perspectives
  213. on their selves and their lives
  214. and begin on the road to healing
    from years of depression.
  215. These drugs are early
    in stages of research,

  216. but they're now being researched
    for a wide range of medical indications.
  217. There's evidence growing
  218. that psychedelics may be effective
    in helping to treat mood disorders
  219. such as major depressive disorder,
  220. treatment-resistant depression
  221. and the depression and anxiety
  222. that accompany a late-stage
    cancer diagnosis.
  223. There's also evidence accumulating
    that psychedelics may be effective
  224. in helping to treat a wide range
    of substance-use disorders,
  225. including smoking, drinking
    and cocaine use.
  226. Additional studies
    are either being planned
  227. or are already underway
  228. to determine whether psychedelics
    may be effective in treating
  229. an even wider range
    of intractable disorders
  230. such as OCD, PTSD,
  231. opioid-use disorder and anorexia.
  232. At this point it might be reasonable
    to take a step back

  233. and say, "Are psychedelics
    being sold as a panacea?"
  234. And if so, we should
    be rightfully skeptical.
  235. Why should we expect such a small family
    of compounds to be so effective
  236. in treating such a wide range
    of disparate disorders?
  237. Here's a perspective we might consider.
  238. Some of these disorders
    share a common thread.
  239. At some level,
  240. mood disorders and substance-use disorders
    involve negative affect
  241. and a disconnection
    from our most authentic selves.
  242. Psychedelics may break that mold.
  243. Psychedelics and music
    may represent a one-two punch
  244. that can operate on psychological
    neural processes such as negative affect
  245. that cut across and contribute
    to multiple disorders.
  246. It may be that targeting
    such transdiagnostic processes
  247. is what's necessary to really help people
  248. to develop the resources
    that they need to begin to recover
  249. from years of depression
    and substance use.
  250. They say you never get a second chance
    to make a first impression,

  251. and that may be true
    for psychedelic drugs.
  252. After all, no matter
    how much data come out
  253. for the potential of therapeutic
    effects of these drugs,
  254. there are still some who are stuck
    on the stigma from the '60s and '70s:
  255. myths of the wildly addictive
    properties of these drugs
  256. or myths of genetic abnormalities
  257. or birth defects after
    being exposed to these drugs,
  258. or fears that people
    are going to lose their minds
  259. and go insane --
  260. or maybe even most pervasive
  261. is the sense that these effects
    are necessarily real
  262. and that they're a necessary outcome
    of having been exposed to these compounds.
  263. It may be time to change
    our thinking on that point.
  264. No one should expect psychedelic
    drugs to work for everyone.

  265. No one should expect psychedelic
    drugs to work for everything.
  266. They're powerful compounds
  267. that need to be administered
    under carefully controlled circumstances.
  268. And there are almost certainly
    people in this world
  269. for whom psychedelics
    are incredibly dangerous.
  270. But ...
  271. antibiotics administered to the wrong
    person under the wrong conditions
  272. can be incredibly dangerous, if not worse.
  273. But administered to the right person
    under the right conditions,
  274. antibiotics save lives.
  275. Administered to the right people
    under the right conditions,
  276. psychedelic drugs may save lives.
  277. It can often feel like it's impossible
    to heal our hearts and our minds

  278. and to grow,
  279. but I truly believe that we all have
    the resources within ourselves
  280. to do just that.
  281. The challenge is often identifying
    and connecting with those resources,
  282. and it may be that psychedelics
    and music can help people
  283. to do just that.
  284. Together, psychedelics and music
    may be able to open our minds to change
  285. and direct that change,
  286. reconnect us with our most
    authentic selves
  287. and allow us access to the things
  288. that really allow us to make
    meaning in this world
  289. and reconnect
  290. with our most authentic selves.
  291. Thank you.

  292. (Applause)