WEBVTT 00:00:01.277 --> 00:00:03.950 At various points over the past 20 years, 00:00:03.974 --> 00:00:07.745 I've studied two fundamental human experiences 00:00:07.769 --> 00:00:10.031 that have taught me an awful lot about emotion 00:00:10.055 --> 00:00:13.951 and that may hold the keys to a revolution in psychiatry. 00:00:13.975 --> 00:00:16.026 The first is how we experience music. 00:00:16.345 --> 00:00:19.256 The second is how we experience psychedelic drugs 00:00:19.280 --> 00:00:21.985 such as LSD and magic mushrooms, 00:00:22.009 --> 00:00:23.241 or psilocybin, 00:00:23.265 --> 00:00:25.578 which is the active component in magic mushrooms. NOTE Paragraph 00:00:26.086 --> 00:00:29.835 You may be wondering what these two things have in common outside of Woodstock. 00:00:29.859 --> 00:00:33.685 After all, music is not a physical substance. 00:00:33.709 --> 00:00:37.177 It can be described as a limited set of vibrations in the air 00:00:37.201 --> 00:00:38.858 that can be detected by your ear. 00:00:39.318 --> 00:00:42.671 And music may seem to have more to do with aesthetics than with biology 00:00:42.695 --> 00:00:43.913 or chemistry. 00:00:44.401 --> 00:00:47.317 Psychedelic drugs, on the other hand, are physical substances. 00:00:47.341 --> 00:00:49.667 They are chemical compounds that you can ingest 00:00:49.691 --> 00:00:52.196 that directly interact with brain chemistry 00:00:52.220 --> 00:00:54.145 and change your experience of the world. 00:00:54.752 --> 00:00:56.921 This change is temporary, 00:00:56.945 --> 00:01:00.011 but the effects of this change can alter the course of your life. 00:01:00.562 --> 00:01:01.712 But let's face it: 00:01:01.736 --> 00:01:03.253 psychedelics have the potential 00:01:03.277 --> 00:01:06.293 to trigger unexpected and potentially dangerous effects. 00:01:06.317 --> 00:01:09.693 So what could these two very different things possibly have in common? NOTE Paragraph 00:01:11.398 --> 00:01:15.557 I've found that music and psychedelics can impact our well-being 00:01:15.581 --> 00:01:17.940 in powerful and complementary ways. 00:01:18.707 --> 00:01:21.181 Music can have a direct impact on our emotions, 00:01:21.205 --> 00:01:23.129 with measurable impacts in the brain; 00:01:23.153 --> 00:01:26.060 psychedelic drugs, under the right circumstances, 00:01:26.084 --> 00:01:28.042 may have therapeutic effects. 00:01:28.066 --> 00:01:30.437 These effects can be manifest in patterns 00:01:30.461 --> 00:01:33.259 that we can study and document with brain scans. 00:01:33.770 --> 00:01:36.723 And together, and leveraged in a purposeful fashion, 00:01:36.747 --> 00:01:39.687 music and psychedelics may have an even greater healing impact 00:01:39.711 --> 00:01:40.949 on patients. 00:01:40.973 --> 00:01:45.363 What's more, these effects can be manifest in healthier and happier lives 00:01:45.387 --> 00:01:47.228 and more integrated personalities. NOTE Paragraph 00:01:47.989 --> 00:01:50.752 I began my journey into the mental health benefits of music 00:01:50.776 --> 00:01:53.264 long before I ever intended to make such a journey. 00:01:53.804 --> 00:01:56.193 For roughly half of my life, I've been a musician, 00:01:56.217 --> 00:01:58.069 having played in community orchestras, 00:01:58.093 --> 00:01:59.679 community theaters, 00:01:59.703 --> 00:02:01.535 wedding bands, a salsa-merengue band. 00:02:01.559 --> 00:02:05.968 I was a member of a string band in Philadelphia for many years. 00:02:05.992 --> 00:02:08.353 And for the better part of my formative years, 00:02:08.377 --> 00:02:11.605 I was the drummer in a Weezer-Nirvana cover band 00:02:11.629 --> 00:02:13.739 that morphed into a hardcore punk band. NOTE Paragraph 00:02:13.763 --> 00:02:14.971 (Laughter) NOTE Paragraph 00:02:14.995 --> 00:02:16.146 That's right. 00:02:16.170 --> 00:02:17.519 Drummer in a punk band. NOTE Paragraph 00:02:17.543 --> 00:02:22.091 But it wasn't until I really began my career in psychology and neuroscience 00:02:22.115 --> 00:02:27.495 that I began to also appreciate how widely and how deeply we as a species, 00:02:27.519 --> 00:02:29.906 both implicitly and explicitly, 00:02:29.930 --> 00:02:32.829 use music as a tool to try to regulate our emotions 00:02:32.853 --> 00:02:34.316 and to heal. 00:02:34.340 --> 00:02:36.860 And for some of us, music keeps us going. 00:02:36.884 --> 00:02:39.186 For others, music isn't quite enough. 00:02:39.843 --> 00:02:42.110 For me, this led to some fascinating questions. 00:02:42.134 --> 00:02:45.537 I began to use music as a tool to study emotion and memory in the brain. NOTE Paragraph 00:02:45.939 --> 00:02:49.511 My first scientific study was focused on music-evoked nostalgia. 00:02:49.535 --> 00:02:52.436 Nostalgia's a rich and bittersweet emotion 00:02:52.460 --> 00:02:55.384 that is intimately tied up with our autobiographical memories. 00:02:55.974 --> 00:02:59.512 We can often encounter nostalgia in unexpected places. 00:02:59.536 --> 00:03:02.736 You may have had the experience of driving down the highway, 00:03:02.760 --> 00:03:03.926 turning on the radio 00:03:03.950 --> 00:03:06.672 or firing up your favorite music recommendation service, 00:03:06.696 --> 00:03:09.038 and you hear a song you haven't heard in ages, 00:03:09.062 --> 00:03:11.307 and you get immediately transported back in time 00:03:11.331 --> 00:03:13.808 and dumped into this immersive memory -- 00:03:13.832 --> 00:03:15.833 something you haven't thought about in ages 00:03:15.857 --> 00:03:17.474 but was very meaningful to you -- 00:03:17.498 --> 00:03:19.261 maybe wedding day or senior prom 00:03:19.285 --> 00:03:20.810 or the birth of your first child 00:03:20.834 --> 00:03:22.349 or the death of a loved one. 00:03:22.681 --> 00:03:25.600 Music can serve as a powerful context cue 00:03:25.624 --> 00:03:31.102 for deeply meaningful and intensely vivid nostalgic memories such as these. NOTE Paragraph 00:03:32.192 --> 00:03:35.826 Nostalgia, in a sense, is deeply woven into our sense of self. 00:03:37.148 --> 00:03:39.280 Who are we at our most authentic selves? 00:03:39.304 --> 00:03:41.448 By connecting us with our emotional histories, 00:03:41.472 --> 00:03:44.528 nostalgia can help us to stave off sadness, loneliness, 00:03:44.552 --> 00:03:45.948 existential threat 00:03:45.972 --> 00:03:47.450 and even the imminence of death 00:03:47.474 --> 00:03:49.868 and the approaching horizon of our lives as we age. NOTE Paragraph 00:03:51.090 --> 00:03:54.960 To try to get a better understanding of how music may tap into nostalgia 00:03:54.984 --> 00:03:57.333 and what that may be doing in the brain, 00:03:57.357 --> 00:04:00.844 I began to work with computational models of music cognition. 00:04:00.868 --> 00:04:04.043 I applied these models to interrogate brain activity 00:04:04.067 --> 00:04:07.019 that was recorded while people were listening 00:04:07.043 --> 00:04:10.753 to nostalgia-evoking and nonnostalgia-evoking music. 00:04:10.777 --> 00:04:13.818 And importantly, at least to a brain geek like me, 00:04:13.842 --> 00:04:17.516 I found that nostalgia was able to recruit a wide network of brain regions 00:04:17.540 --> 00:04:20.706 involved in multiple levels of different cognitive processes. 00:04:20.730 --> 00:04:24.111 Whereas nonnostalgic music could recruit brain regions 00:04:24.135 --> 00:04:25.413 such as Heschl's gyrus, 00:04:25.437 --> 00:04:27.633 involved in basic auditory processing, 00:04:27.657 --> 00:04:28.976 or Broca's area, 00:04:29.000 --> 00:04:31.388 which is involved in processing grammar and syntax 00:04:31.412 --> 00:04:33.762 not only in language but also in music, 00:04:33.786 --> 00:04:36.665 nostalgia was able to recruit these brain regions and more. 00:04:36.689 --> 00:04:40.217 Brain regions such as the substantia nigra involved in reward processing 00:04:40.241 --> 00:04:43.607 or the anterior insula involved in the visceral experience of emotion 00:04:43.631 --> 00:04:46.605 or brain regions in the inferior frontal gyrus 00:04:46.629 --> 00:04:48.943 that are involved in autobiographical memories. 00:04:48.967 --> 00:04:52.063 Nostalgia was also able to recruit a wide network of brain regions 00:04:52.087 --> 00:04:55.499 in prefrontal, frontal, cingulate, insular, parietal, occipital 00:04:55.523 --> 00:04:57.025 and subcortical brain regions 00:04:57.049 --> 00:04:59.507 that span nearly all of our cognitive faculties. 00:04:59.531 --> 00:05:03.145 This may explain why nostalgia can have such an outsized impact on us. NOTE Paragraph 00:05:03.523 --> 00:05:05.389 But as powerful as it is in the moment, 00:05:05.413 --> 00:05:08.547 the salve of music-evoked nostalgia eventually fades. 00:05:09.204 --> 00:05:11.657 Nostalgia may be more of a Band-Aid, 00:05:11.681 --> 00:05:13.197 less of an antibiotic 00:05:13.221 --> 00:05:16.728 and typically far from a surgical intervention for our emotional health. 00:05:17.731 --> 00:05:19.642 Music can draw out nostalgia 00:05:19.666 --> 00:05:21.810 and music and nostalgia can move our feelings, 00:05:21.834 --> 00:05:23.788 but how do we make these feelings stick? NOTE Paragraph 00:05:24.608 --> 00:05:26.331 After studying the nostalgic brain, 00:05:26.355 --> 00:05:28.455 I joined a team at Johns Hopkins University 00:05:28.479 --> 00:05:30.947 that was studying the effects of psychedelic drugs, 00:05:30.971 --> 00:05:34.708 and I quickly began to learn how deeply a piece of music could impact a person 00:05:34.732 --> 00:05:36.279 during a psychedelic experience. 00:05:36.303 --> 00:05:39.383 I was previously vexed by the difficulty in predicting precisely 00:05:39.407 --> 00:05:42.381 what musical stimulus would evoke precisely what response 00:05:42.405 --> 00:05:43.783 within a given individual. 00:05:43.807 --> 00:05:47.618 A song that evokes nostalgia in one person could just as easily evoke disinterest 00:05:47.642 --> 00:05:49.061 or disgust in another person. 00:05:49.085 --> 00:05:54.211 I began to learn how deeply most music seemed to impact most people 00:05:54.235 --> 00:05:55.934 during psychedelic experiences. NOTE Paragraph 00:05:56.547 --> 00:05:58.365 Since at least the late '50s, 00:05:58.389 --> 00:06:00.500 the value of using music to help people 00:06:00.524 --> 00:06:03.288 to navigate psychedelic experiences was clear. 00:06:03.312 --> 00:06:05.882 We continue this tradition in our modern research, 00:06:05.906 --> 00:06:08.106 asking volunteers to listen to music 00:06:08.130 --> 00:06:10.630 during the course of a psychedelic therapy session, 00:06:10.654 --> 00:06:14.608 and despite most people being mostly naive to the music that we play 00:06:14.632 --> 00:06:16.692 before they get into the sessions, 00:06:16.716 --> 00:06:17.882 after these sessions, 00:06:17.906 --> 00:06:20.550 our volunteers practically beg us for the playlists. 00:06:20.574 --> 00:06:23.723 And some of them report returning to the songs 00:06:23.747 --> 00:06:26.939 that were most impactful to them during their psychedelic experience 00:06:26.963 --> 00:06:29.623 weeks, months and even many years after the experience. 00:06:29.647 --> 00:06:34.378 Somehow, these songs can turn into touchstones 00:06:34.402 --> 00:06:39.780 that can rekindle the most powerful and impactful and insightful experiences 00:06:39.804 --> 00:06:42.669 that people encountered during their psychedelic sessions. NOTE Paragraph 00:06:43.643 --> 00:06:45.945 Of course, I had to know what was going on here. 00:06:45.969 --> 00:06:48.209 I began to deploy my batteries of questionnaires 00:06:48.233 --> 00:06:49.949 and my carefully crafted experiments 00:06:49.973 --> 00:06:51.445 and my big, fancy MRI machines 00:06:51.469 --> 00:06:54.228 to try to determine just what could be happening 00:06:54.252 --> 00:06:55.546 during these experiences 00:06:55.570 --> 00:07:00.495 that could explain the depth of impact that people were encountering. 00:07:01.207 --> 00:07:02.720 At a basic psychological level, 00:07:02.744 --> 00:07:04.470 my colleagues and I determined that, 00:07:04.494 --> 00:07:07.175 for instance, LSD can increase positive emotions 00:07:07.199 --> 00:07:09.677 that are uniquely encountered during music listening. 00:07:09.701 --> 00:07:13.527 This may have relevance just by itself for healthy individuals 00:07:13.551 --> 00:07:16.761 as well as people suffering from mood and substance-use disorders. 00:07:16.785 --> 00:07:18.583 But what was happening in the brain? NOTE Paragraph 00:07:20.044 --> 00:07:23.917 Earlier we learned that the entire brain listens to nostalgic music. 00:07:24.859 --> 00:07:27.951 When applying computational models of music cognition 00:07:27.975 --> 00:07:31.846 to interrogate brain activity that was recorded during music listening 00:07:31.870 --> 00:07:33.717 under the effects of LSD, 00:07:33.741 --> 00:07:38.262 we found that the entire brain was listening to music 00:07:38.286 --> 00:07:40.465 and psychedelics were turning up the gain. 00:07:41.538 --> 00:07:44.945 Where nostalgia could recruit brain regions involved in language, 00:07:44.969 --> 00:07:46.124 memory and emotion, 00:07:46.148 --> 00:07:48.450 psychedelics were recruiting these brain regions 00:07:48.474 --> 00:07:49.760 at least twice as strongly. 00:07:49.784 --> 00:07:51.926 Brain regions such as the thalamus, 00:07:51.950 --> 00:07:53.950 that's involved in basic sensory processing 00:07:53.974 --> 00:07:55.486 or the medial prefrontal cortex 00:07:55.510 --> 00:07:57.130 and the posterior singular cortex, 00:07:57.154 --> 00:08:00.126 which can be involved in memory and emotion and mental imagery. 00:08:00.150 --> 00:08:03.321 These brain regions were recruited up to four times as strongly 00:08:03.345 --> 00:08:05.865 during the effects of LSD than without LSD. 00:08:07.274 --> 00:08:10.122 Psychedelics turn the knob up to 11. 00:08:10.850 --> 00:08:13.861 Sensory information is more richly experienced in the brain; 00:08:13.885 --> 00:08:17.220 emotions, memories and mental imagery are supercharged, 00:08:17.244 --> 00:08:19.893 and it may be the wholesale and strong recruitment 00:08:19.917 --> 00:08:24.139 of a wide range of brain regions during these experiences 00:08:24.163 --> 00:08:26.353 that is the necessary key to unlocking change 00:08:26.377 --> 00:08:29.924 that sets these drugs and these experiences apart from others. NOTE Paragraph 00:08:30.666 --> 00:08:32.632 And the effects can be long-lasting. 00:08:33.477 --> 00:08:35.098 In a study of healthy individuals, 00:08:35.122 --> 00:08:37.552 I demonstrated that a single high dose of psilocybin 00:08:37.576 --> 00:08:41.516 could reduce negative affect in volunteers for at least a week after psilocybin, 00:08:41.540 --> 00:08:43.064 and increase positive affect 00:08:43.088 --> 00:08:46.428 for at least a month after a single high dose of psilocybin. 00:08:46.735 --> 00:08:48.298 The reduction in negative affect 00:08:48.322 --> 00:08:50.798 that we observed after psilocybin administration 00:08:50.822 --> 00:08:54.208 was accompanied by a reduction, one week after psilocybin, 00:08:54.232 --> 00:08:57.186 in the response of a primitive brain region called the amygdala 00:08:57.210 --> 00:08:58.778 to emotional stimuli. 00:08:58.802 --> 00:09:03.092 In a separate study in patients with major depressive disorder, 00:09:03.116 --> 00:09:07.426 not only did we observe a substantial decrease in depression severity 00:09:07.450 --> 00:09:10.753 in most of our patients after two doses of psilocybin, 00:09:10.777 --> 00:09:14.900 but we also observed a reduction in the amygdala response 00:09:14.924 --> 00:09:18.309 to negative affective stimuli, specifically, 00:09:18.333 --> 00:09:19.751 one week after psilocybin. 00:09:20.212 --> 00:09:22.020 This reduction in amygdala response 00:09:22.044 --> 00:09:25.412 was associated with an enduring reduction in depression severity 00:09:25.436 --> 00:09:28.151 for at least three months after psilocybin administration, 00:09:28.175 --> 00:09:29.978 but frankly, we're still counting. NOTE Paragraph 00:09:31.073 --> 00:09:32.641 So what does this all mean? 00:09:33.562 --> 00:09:38.056 It means that music and psychedelics may be able 00:09:38.080 --> 00:09:41.693 to alter the entire brain for a period of time, 00:09:41.717 --> 00:09:45.910 and that may lead to a change in neural circuitry 00:09:45.934 --> 00:09:49.490 that may be stuck in patterns of negative emotional bias. 00:09:49.514 --> 00:09:52.945 This may be able to give people a period of relief 00:09:52.969 --> 00:09:55.503 from the grip and the claws of negative emotion. 00:09:56.675 --> 00:10:00.413 And that may be just enough to give someone access to new perspectives 00:10:00.437 --> 00:10:01.914 on their selves and their lives 00:10:01.938 --> 00:10:04.673 and begin on the road to healing from years of depression. NOTE Paragraph 00:10:06.428 --> 00:10:09.069 These drugs are early in stages of research, 00:10:09.093 --> 00:10:13.616 but they're now being researched for a wide range of medical indications. 00:10:13.640 --> 00:10:14.790 There's evidence growing 00:10:14.814 --> 00:10:18.131 that psychedelics may be effective in helping to treat mood disorders 00:10:18.155 --> 00:10:19.845 such as major depressive disorder, 00:10:19.869 --> 00:10:21.298 treatment-resistant depression 00:10:21.322 --> 00:10:22.757 and the depression and anxiety 00:10:22.781 --> 00:10:24.910 that accompany a late-stage cancer diagnosis. 00:10:24.934 --> 00:10:28.294 There's also evidence accumulating that psychedelics may be effective 00:10:28.318 --> 00:10:31.262 in helping to treat a wide range of substance-use disorders, 00:10:31.286 --> 00:10:33.373 including smoking, drinking and cocaine use. 00:10:33.397 --> 00:10:35.462 Additional studies are either being planned 00:10:35.486 --> 00:10:37.271 or are already underway 00:10:37.295 --> 00:10:40.200 to determine whether psychedelics may be effective in treating 00:10:40.224 --> 00:10:42.366 an even wider range of intractable disorders 00:10:42.390 --> 00:10:45.035 such as OCD, PTSD, 00:10:45.059 --> 00:10:46.961 opioid-use disorder and anorexia. NOTE Paragraph 00:10:48.368 --> 00:10:50.989 At this point it might be reasonable to take a step back 00:10:51.013 --> 00:10:54.043 and say, "Are psychedelics being sold as a panacea?" 00:10:54.067 --> 00:10:56.466 And if so, we should be rightfully skeptical. 00:10:56.490 --> 00:11:00.419 Why should we expect such a small family of compounds to be so effective 00:11:00.443 --> 00:11:03.307 in treating such a wide range of disparate disorders? 00:11:05.310 --> 00:11:07.476 Here's a perspective we might consider. 00:11:08.714 --> 00:11:11.294 Some of these disorders share a common thread. 00:11:12.459 --> 00:11:14.602 At some level, 00:11:14.626 --> 00:11:17.888 mood disorders and substance-use disorders involve negative affect 00:11:17.912 --> 00:11:20.323 and a disconnection from our most authentic selves. 00:11:21.653 --> 00:11:23.903 Psychedelics may break that mold. 00:11:24.923 --> 00:11:28.142 Psychedelics and music may represent a one-two punch 00:11:28.166 --> 00:11:32.541 that can operate on psychological neural processes such as negative affect 00:11:32.565 --> 00:11:35.318 that cut across and contribute to multiple disorders. 00:11:35.342 --> 00:11:39.533 It may be that targeting such transdiagnostic processes 00:11:39.557 --> 00:11:43.001 is what's necessary to really help people 00:11:43.025 --> 00:11:46.682 to develop the resources that they need to begin to recover 00:11:46.706 --> 00:11:49.302 from years of depression and substance use. NOTE Paragraph 00:11:50.394 --> 00:11:53.491 They say you never get a second chance to make a first impression, 00:11:53.515 --> 00:11:55.516 and that may be true for psychedelic drugs. 00:11:55.540 --> 00:11:58.379 After all, no matter how much data come out 00:11:58.403 --> 00:12:01.703 for the potential of therapeutic effects of these drugs, 00:12:01.727 --> 00:12:05.431 there are still some who are stuck on the stigma from the '60s and '70s: 00:12:05.455 --> 00:12:08.028 myths of the wildly addictive properties of these drugs 00:12:08.052 --> 00:12:09.783 or myths of genetic abnormalities 00:12:09.807 --> 00:12:12.285 or birth defects after being exposed to these drugs, 00:12:12.309 --> 00:12:14.766 or fears that people are going to lose their minds 00:12:14.790 --> 00:12:15.940 and go insane -- 00:12:15.964 --> 00:12:17.320 or maybe even most pervasive 00:12:17.344 --> 00:12:20.019 is the sense that these effects are necessarily real 00:12:20.043 --> 00:12:24.565 and that they're a necessary outcome of having been exposed to these compounds. 00:12:25.499 --> 00:12:28.447 It may be time to change our thinking on that point. NOTE Paragraph 00:12:29.547 --> 00:12:32.573 No one should expect psychedelic drugs to work for everyone. 00:12:32.597 --> 00:12:35.605 No one should expect psychedelic drugs to work for everything. 00:12:35.629 --> 00:12:37.027 They're powerful compounds 00:12:37.051 --> 00:12:41.557 that need to be administered under carefully controlled circumstances. 00:12:42.323 --> 00:12:44.705 And there are almost certainly people in this world 00:12:44.729 --> 00:12:46.935 for whom psychedelics are incredibly dangerous. 00:12:48.014 --> 00:12:49.164 But ... 00:12:49.719 --> 00:12:53.713 antibiotics administered to the wrong person under the wrong conditions 00:12:53.737 --> 00:12:55.959 can be incredibly dangerous, if not worse. 00:12:56.763 --> 00:12:59.764 But administered to the right person under the right conditions, 00:12:59.788 --> 00:13:01.135 antibiotics save lives. 00:13:02.353 --> 00:13:05.652 Administered to the right people under the right conditions, 00:13:05.676 --> 00:13:08.195 psychedelic drugs may save lives. NOTE Paragraph 00:13:11.066 --> 00:13:16.067 It can often feel like it's impossible to heal our hearts and our minds 00:13:16.091 --> 00:13:17.250 and to grow, 00:13:17.274 --> 00:13:20.598 but I truly believe that we all have the resources within ourselves 00:13:20.622 --> 00:13:21.773 to do just that. 00:13:21.797 --> 00:13:26.379 The challenge is often identifying and connecting with those resources, 00:13:26.403 --> 00:13:29.376 and it may be that psychedelics and music can help people 00:13:29.400 --> 00:13:30.550 to do just that. 00:13:32.030 --> 00:13:36.689 Together, psychedelics and music may be able to open our minds to change 00:13:36.713 --> 00:13:38.379 and direct that change, 00:13:38.403 --> 00:13:41.833 reconnect us with our most authentic selves 00:13:41.857 --> 00:13:44.407 and allow us access to the things 00:13:44.431 --> 00:13:47.170 that really allow us to make meaning in this world 00:13:47.194 --> 00:13:48.737 and reconnect 00:13:48.761 --> 00:13:50.452 with our most authentic selves. NOTE Paragraph 00:13:51.170 --> 00:13:52.320 Thank you. NOTE Paragraph 00:13:52.344 --> 00:13:56.571 (Applause)