WEBVTT

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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 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

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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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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

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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 on the brain;

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psychedelic drugs,

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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 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,

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a salsa-meringue 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

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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 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-invoked 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
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 --

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at least to a brainiac 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 difference 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 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 can 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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of 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 nob 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 longlasting.

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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 increased 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 effective stimuli,

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specifically 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 to alter the entire brain

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for a period of time,

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and that may lead to a change
in neurocircuitry

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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 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 not being researched
for a wide range of medical indications.

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There's a 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-resistent depression

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and the depression and anxiety

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that accompany
a late-stage cancer diagnosis.

99:59:59.999 --> 99:59:59.999
There's also eveidence 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, opioid-use disorder

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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

99:59:59.999 --> 99:59:59.999
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
neuro 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

99:59:59.999 --> 99:59:59.999
is what's necessary to really help
people to develop the resources

99:59:59.999 --> 99:59:59.999
that they need to begin to recover
from years of depression and substane 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

99:59:59.999 --> 99:59:59.999
or birth defects after
being exposed to these drugs

99:59:59.999 --> 99:59:59.999
or fears that people are going
to lose their minds

99:59:59.999 --> 99:59:59.999
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.

99:59:59.999 --> 99:59:59.999
They're powerful compounds

99:59:59.999 --> 99:59:59.999
that need to be administered
under carefully controlled circumstances,

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and there are almost certainly
people in this world

99:59:59.999 --> 99:59:59.999
for whom psychedelics
are incredibly dangerous.

99:59:59.999 --> 99:59:59.999
But ...

99:59:59.999 --> 99:59:59.999
antibiotics administered to the wrong
person or the wrong conditions

99:59:59.999 --> 99:59:59.999
can be incredibly dangerous,

99:59:59.999 --> 99:59:59.999
if not worse.

99:59:59.999 --> 99:59:59.999
But administered to the right person
under the right conditions,

99:59:59.999 --> 99:59:59.999
antibiotics save lives.

99:59:59.999 --> 99:59:59.999
Administered to the right people
under the right conditions,

99:59:59.999 --> 99:59:59.999
psychedelic drugs may save lives.

99:59:59.999 --> 99:59:59.999
It can often feel like it's impossible

99:59:59.999 --> 99:59:59.999
to heal our hearts and our minds

99:59:59.999 --> 99:59:59.999
and to grow.

99:59:59.999 --> 99:59:59.999
But I truly believe that we all have
the resources within ourselves

99:59:59.999 --> 99:59:59.999
to do just that.

99:59:59.999 --> 99:59:59.999
The challenge is often identifying
and connecting with those resources.

99:59:59.999 --> 99:59:59.999
And it may be the psychedelics
and music can help people

99:59:59.999 --> 99:59:59.999
to do just that.

99:59:59.999 --> 99:59:59.999
Together, psychedelics and music
may be able to open our minds to change

99:59:59.999 --> 99:59:59.999
and direct that change,

99:59:59.999 --> 99:59:59.999
reconnect us with our most
authentic selves

99:59:59.999 --> 99:59:59.999
and allow us access to the things

99:59:59.999 --> 99:59:59.999
that really allow us to make
meaning in this world

99:59:59.999 --> 99:59:59.999
and reconnect

99:59:59.999 --> 99:59:59.999
with our most authentic selves.

99:59:59.999 --> 99:59:59.999
Thank you.

99:59:59.999 --> 99:59:59.999
(Applause)