At various points over the past 20 years,
I've studied two fundamental
human experiences
that have taught me
an awful lot about emotion,
and that may hold the keys
to a revolution in psychiatry.
The first is how we experience music.
The second is how we experience
psychedelic drugs
such as LSD and magic mushrooms,
or, psilocybin,
which is the active component
in magic mushrooms.
You may be wondering what these two things
have in common outside of Woodstock.
After all, music is not
a physical substance.
It can be described as a limited set
of vibrations in the air
that can be detected by your ear.
Music may seem to have more to do
with aesthetics than with biology
or chemistry.
Psychedelic drugs on the other hand
are physical substances.
They are chemical compounds
that you can ingest
that directly interact
with brain chemistry
and change your experience of the world.
This change is temporary,
but the effects of this change
can alter the course of your life.
But let's face it:
psychedelics have the potential
to trigger unexpected
and potentially dangerous effects.
So what could these two very different
things possibly have in common?
I've found that music and psychedelics
can impact our well-being
in powerful and complementary ways.
Music can have a direct
impact on our emotions
with measurable impacts on the brain;
psychedelic drugs,
under the right circumstances,
may have therapeutic effects.
These effects can be manifest in patterns
that we can study
and document with brain scans.
And together and leveraged
in a purposeful fashion,
music and psychedelics may have
an even greater healing impact
on patients.
What's more, these effects can be manifest
in healthier and happier lives
and more integrated personalities.
I began my journey into the mental
health benefits of music
long before I ever intended
to make such a journey.
For roughly half of my life
I've been a musician,
having played in community orchestras,
community theaters,
wedding bands --
a salsa-merengue band.
I was a member of a string band
in Philadelphia for many years.
And for the better part
of my formative years,
I was the drummer
in a Weezer-Nirvana cover band
that morphed into a hardcore punk band.
(Laughter)
That's right.
Drummer in a punk band.
But it wasn't until I really began
my career in psychology and neuroscience
that I began to also appreciate
how widely and how deeply
we as a species,
both implicitly and explicitly,
use music as a tool to try
to regulate our emotions
and to heal.
And for some us, music keeps us going.
For others, music isn't quite enough.
For me, this led to some
fascinating questions.
I began to use music as a tool
to study emotion and memory in the brain.
My first scientific study was focused
on music-evoked nostalgia.
Nostalgia's a rich and bittersweet emotion
that is intimately tied up
with our autobiographical memories.
We can often encounter nostalgia
in unexpected places.
You may have had the experience
driving down the highway,
turning on the radio
or firing up your favorite music
recommendation service,
and you hear a song
you haven't heard in ages
and you get immediately
transported back in time
and dumped into this immersive memory --
something you haven't
thought about in ages
but was very meaningful to you --
maybe wedding day or senior prom
or the birth of your first child
or the death of a loved one.
Music can serve as a powerful context cue
for deeply meaningful and intensely vivid
nostalgic memories such as these.
Nostalgia in a sense is deeply woven
into our sense of self.
Who are we at our most authentic selves?
By connecting us
with our emotional histories,
nostalgia can help us
to stave off sadness, loneliness,
existential threat
and even the imminence of death
and the approaching horizon
of our lives as we age.
To try to get a better understanding
of how music may tap into nostalgia
and what that may be doing in the brain,
I began to work with computational
models of music cognition.
I applied these models
to interrogate brain activity
that was recorded
while people were listening
to nostalgia-evoking
and nonnostalgia-evoking music.
And importantly --
at least to a brain geek like me --
I found that nostalgia was able
to recruit a wide network of brain regions
involved in multiple levels
of difference cognitive processes.
Whereas nonnostalgic music
could recruit brain regions
such as Heschl's gyrus,
involved in basic auditory processing,
or Broca's area,
which involved in processing
grammar and syntax
not only in language but also in music,
nostalgia was able to recruit
these brain regions and more.
Brain regions such as the substantia nigra
involved in reward processing
or the anterior insula involved
in the visceral experience of emotion
or brain regions
in the inferior frontal gyrus
that are involved
in autobiographical memories.
Nostalgia was also able to recruit
a wide network of brain regions
in prefrontal, frontal, cingulate,
insular, parietal, occipital
and subcortical brain regions
that span nearly all
of our cognitive faculties.
This may explain why nostalgia
can have such an outsized impact on us.
But as powerful as it is in the moment,
the salve of music-evoked
nostalgia eventually fades.
Nostalgia may be more of a Band-Aid,
less of an antibiotic
and typically far from a surgical
intervention for our emotional health.
Music can draw out nostalgia
and music and nostalgia
can move our feelings,
but how do we make these feelings stick?
After studying the nostalgic brain,
I joined a team
at Johns Hopkins University
that was studying the effects
of psychedelic drugs,
and I quickly began to learn how deeply
a piece of music could impact a person
during a psychedelic experience.
I was previously vexed by the difficulty
in predicting precisely
what musical stimulus would evoke
precisely what response
within a given individual.
A song that evokes nostalgia in one person
could just as easily evoke disinterest
or disgust in another person.
I began to learn how deeply most music
seemed to impact most people
during psychedelic experiences.
Since at least the late '50s,
the value of using music to help people
to navigate psychedelic
experiences was clear.
We continue this tradition
in our modern research,
asking volunteers to listen to music
during the course
of a psychedelic therapy session,
and despite most people being
mostly naïve to the music that we play
before they get into the sessions,
after these sessions,
our volunteers practically
beg us for the playlists.
And some of them report
returning to the songs
that were most impactful to them
during their psychedelic experience
weeks, months and even many years
after the experience.
Somehow these songs
can turn into touchstones
that can rekindle the most powerful
and impactful and insightful experiences
that people encountered
during their psychedelic sessions.
Of course I had to know
what was going on here.
I began to deploy
my batteries of questionnaires
and my carefully crafted experiments
and my big, fancy MRI machines
to try to determine
just what could be happening
during these experiences
that could explain the depth
of impact that people were encountering.
At a basic psychological level,
my colleagues and I determined that,
for instance, LSD can increase
positive emotions
that are uniquely encountered
during music listening.
This may have relevance just by itself
for healthy individuals
as well as people suffering from mood
and substance-use disorders.
But what was happening in the brain?
Earlier we learned that the entire brain
listens to nostalgic music.
When applying computational models
of music cognition
to interrogate brain activity
that was recorded during music listening
under the effects of LSD,
we found that the entire brain
was listening to music
and psychedelics were turning up the gain.
Where nostalgia could recruit
brain regions involved in language,
memory and emotion,
psychedelics were recruiting
these brain regions
at least twice as strongly.
Brain regions such as the thalamus
that's involved in basic
sensory processing
or the medial prefrontal cortex
and the posterior singular cortex,
which can be involved in memory
and emotion and mental imagery.
These brain regions were recruited
up to four times as strongly
during the effects of LSD
than without LSD.
Psychedelics turn the nob up to 11.
Sensory information is more
richly experienced in the brain;
emotions, memories
and mental imagery are supercharged,
and it may be the wholesale
and strong recruitment
of a wide range of brain regions
during these experiences
that is the necessary key
to unlocking change
that sets these drugs
and these experiences apart from others.
And the effects can be long-lasting.
In a study of healthy individuals,
I demonstrated that a single
high dose of psilocybin
could reduce negative affect in volunteers
for at least a week after psilocybin,
and increased positive affect
for at least a month after a single
high dose of psilocybin.
The reduction in negative affect
that we observed after
psilocybin administration
was accompanied by a reduction
one week after psilocybin
in the response of a primitive
brain region called the amygdala
to emotional stimuli.
In a separate study in patients
with major depressive disorder,
not only did we observe a substantial
decrease in depression severity
in most of our patients
after two doses of psilocybin,
but we also observed a reduction
in the amygdala response
to negative affective stimuli,
specifically one week after psilocybin.
This reduction in amygdala response
was associated with an enduring
reduction in depression severity
for at least three months
after psilocybin administration,
but frankly, we're still counting.
So what does this all mean?
It means that music
and psychedelics may be able
to alter the entire brain
for a period of time,
and that may lead to a change
in neurocircuitry
that may be stuck in patterns
of negative emotional bias.
This may be able to give people
a period of relief
from the grip and the claws
of negative emotion.
And that may be just enough to give
someone access to new perspectives
on their selves and their lives
and begin on the road to healing
from years of depression.
These drugs are early
in stages of research,
but they're now being researched
for a wide range of medical indications.
There's evidence growing
that psychedelics may be effective
in helping to treat mood disorders
such as major depressive disorder,
treatment-resistant depression
and the depression and anxiety
that accompany a late-stage
cancer diagnosis.
There's also eveidence accumulating
that psychedelics may be effective
in helping to treat a wide range
of substance-use disorders,
including smoking, drinking
and cocaine use.
Additional studies
are either being planned
or are already underway
to determine whether psychedelics
may be effective in treating
an even wider range
of intractable disorders
such as OCD, PTSD,
opioid-use disorder
and anorexia.
At this point it might be reasonable
to take a step back
and say, "Are psychedelics
being sold as a panacea?"
And if so, we should
be rightfully skeptical.
Why should we expect such a small family
of compounds to be so effective
in treating such a wide range
of disparate disorders?
Here's a perspective we might consider.
Some of these disorders
share a common thread.
At some level,
mood disorders and substance-use disorders
involve negative affect
and a disconnection
from our most authentic selves.
Psychedelics may break that mold.
Psychedelics and music
may represent a one-two punch
that can operate on psychological
neural processes such as negative affect
that cut across and contribute
to multiple disorders.
It may be that targeting
such transdiagnostic processes
is what's necessary to really help people
to develop the resources
that they need to begin to recover
from years of depression
and substance use.
They say you never get a second chance
to make a first impression,
and that may be true
for psychedelic drugs.
After all, no matter
how much data come out
for the potential of therapeutic
effects of these drugs,
there are still some who are stuck
on the stigma from the '60s and '70s:
myths of the wildly addictive
properties of these drugs
or myths of genetic abnormalities
or birth defects after
being exposed to these drugs
or fears that people
are going to lose their minds
and go insane --
or maybe even most pervasive
is the sense that these effects
are necessarily real
and that they're a necessary outcome
of having been exposed to these compounds.
It may be time to change
our thinking on that point.
No one should expect psychedelic
drugs to work for everyone.
No one should expect psychedelic
drugs to work for everything.
They're powerful compounds
that need to be administered
under carefully controlled circumstances.
And there are almost certainly
people in this world
for whom psychedelics
are incredibly dangerous.
But ...
antibiotics administered to the wrong
person under the wrong conditions
can be incredibly dangerous,
if not worse.
But administered to the right person
under the right conditions,
antibiotics save lives.
Administered to the right people
under the right conditions,
psychedelic drugs may save lives.
It can often feel like it's impossible
to heal our hearts and our minds
and to grow,
but I truly believe that we all have
the resources within ourselves
to do just that.
The challenge is often identifying
and connecting with those resources,
and it may be that psychedelics
and music can help people
to do just that.
Together, psychedelics and music
may be able to open our minds to change
and direct that change,
reconnect us with our most
authentic selves
and allow us access to the things
that really allow us to make
meaning in this world
and reconnect
with our most authentic selves.
Thank you.
(Applause)