Episode 60 – Why Music Is More Than Background Noise in Ketamine Therapy (Soundbites from the Vault)
Steve Gelberg, author of Tuning In, shares why music is a therapeutic tool in ketamine sessions, how it works, and what providers should actually be playing.
We're taking it a little easy in July, and in the spirit of that, we're launching something new: Soundbites from the Vault. These are shorter, standalone segments from earlier episodes that we think are worth revisiting, easy to digest, and immediately relevant to your practice.
For our first soundbite, we're revisiting one of our favorite conversations from Episode 32 with Steve Gelberg, author of Tuning In: Experiencing Music in Psychedelic States.
Steve spent years researching the intersection of music and psychedelic-assisted therapy, and what he shares here has direct practical implications for how you're running your ketamine sessions.
This segment gets into something most providers haven't thought deeply about: music isn't just filling the silence. It's doing active therapeutic work, from calming a patient's first fear response as ketamine comes on, to opening access to the subconscious material that makes treatment meaningful.
Steve also covers the practical side, including what types of music to use, why lyrics are generally a problem, and how to think about the classical versus ambient debate without getting dogmatic about it.
If you've been using the same playlist since you opened, this one is worth 15 minutes of your time.
What You'll Learn in This Episode:
Why music and psychedelics share a unique therapeutic synergy rooted in how both interact with emotional and subconscious experience
How the right music can calm the ego's fear response during the onset of a ketamine session and support deeper therapeutic outcomes
Why lyrics are generally avoided during psychedelic-assisted therapy and what instrumental genres tend to work best
The case for neoclassical music as a middle ground between classical and ambient for ketamine sessions
How to think about patient-chosen music versus therapist-curated playlists, and why avoiding dogma matters more than finding the perfect answer
Key Takeaways:
Music is not background noise in ketamine therapy. It is doing active clinical work by reducing fear at onset, lowering ego defenses, and creating conditions for deeper therapeutic access.
The shared quality between music and psychedelics is their ability to bypass the protective structures we build around emotion. Together, their effect is greater than either alone.
Instrumental music is strongly preferred. Lyrics engage the cognitive mind and pull patients out of the open, non-directive state that makes ketamine therapy effective.
Neoclassical music offers the tonal richness of classical instruments with the open, relaxing quality of ambient, making it a practical choice for providers navigating the classical versus ambient debate.
There is no single correct playlist. Steve's strongest recommendation is to stay flexible, stay curious, and resist any approach that presents music selection as a fixed protocol.
Listen to the episode on Apple Podcasts, Spotify, Overcast, or on your favorite podcast platform. Watch the discussion on YouTube here.
Episode 60 show notes:
00:00:00 - Teaser: "The right kind of music…”
00:00:33 Episode Introduction and Soundbites from the Vault Launch
00:01:32 The Shared Ontology of Music and Psychedelics
00:03:37 How Psychedelics Open the Emotional Sphere of Consciousness
00:04:41 The Unique Therapeutic Synergy Between Music and Ketamine
00:05:08 What Music Is Actually Doing at the Onset of a Ketamine Session
00:05:55 How Music Helps Surface the Root of Depression, Phobias, and Trauma
00:07:01 Music as an Ancient and Primal Human Tool: Lullabies and Soothing
00:08:25 The Case for Healing Female Voices in Psychedelic-Assisted Therapy
00:09:41 How to Choose Music for Ketamine Sessions: A Provider's Guide
00:10:23 The Classical vs. Ambient Debate: Origins and Context
00:11:36 Why Lyrics Are Generally Avoided During Ketamine Therapy
00:12:39 Neoclassical Music: The Best of Both Classical and Ambient
00:13:39 Avoiding Agitating or Overly Dramatic Music in Sessions
00:14:11 Patient-Chosen vs. Therapist-Curated Playlists
00:15:12 Why There Should Be No Dogma Around Music Selection
00:15:48 Episode Ending and Resources
Thanks for Listening
Resources & Links From This Episode
👉 Disclosure: Some of the links in these show notes are affiliate links. If you choose to make a purchase through them, we may earn a small commission at no additional cost to you. Thanks for supporting the podcast!
Connect with Steve Gelberg at:
Steve’s book: Tuning In: Experiencing Music in Psychedelic States
Selected Links From the Episode:
Enjoyed this soundbite? Listen to the full conversation with Steve Gelberg from Episode 32.
Steve's neoclassical playlist, a blend of classical and ambient curated for psychedelic-assisted therapy: Neo-Classical for Psychonauts on Spotify.
Browse all of Steve's curated playlists referenced in Episode 32.
Professional Education Disclaimer: This content is intended exclusively for licensed healthcare professionals and should not be used by patients for self-treatment or self-education. The information presented reflects individual provider experiences and should not replace clinical judgment, professional training, or comprehensive research. Healthcare providers must conduct their own due diligence, consult current literature, and evaluate treatment approaches within their specific practice context and regulatory environment. This educational content does not constitute medical advice for specific patients or clinical situations - treatment decisions should always be based on individual patient assessment and adherence to professional medical standards.
Frequently Asked Questions
Why does music matter during a ketamine therapy session beyond keeping patients comfortable?
According to Steve, music plays a much more active therapeutic role than most providers may realize. When ketamine begins to take effect, patients can experience a fear or disorientation response as the ego encounters unfamiliar states. Steve's view is that the right music can help calm that initial anxiety and allow the patient to move into the experience rather than resist it. Beyond that first hurdle, he suggests music may also help lower the ego's defensive structures over the course of the session, potentially making it easier for patients to access the emotional and subconscious material that drives meaningful therapeutic outcomes. In his framing, it's less about comfort and more about creating the conditions for the work to actually happen.
Should I avoid music with lyrics during ketamine infusions?
Instrumental music is generally recommended for ketamine and psychedelic-assisted therapy sessions. The thinking is that lyrics engage the cognitive and rational mind, which can pull patients out of the open, non-directed state that supports deeper therapeutic experience. Even lyrics that seem neutral or positive can introduce a thinking quality that works against the letting-go process. That said, Steve is careful to avoid being prescriptive about this. Instrumental options including classical, ambient, world music with foreign language vocals, and neoclassical are widely used and worth exploring, but as with most things in this space, patient response is subjective and what works in one session may not work in another. The stronger principle here is to stay attuned to your patient rather than following any fixed rule.
What type of music works best for ketamine therapy sessions: classical or ambient?
Steve describes this as an ongoing debate in the field, and one he doesn't think has a definitive answer. Classical music offers emotional direction and tonal richness that can help guide certain experiences, while ambient music provides a more open, non-directive quality that gives patients more room to go where they need to go. Neoclassical music, which uses western classical instruments in a more relaxed ambient style, has emerged as a middle ground that Steve finds compelling because it draws on the best of both. His broader point is that providers should develop their own sense of what works through listening and clinical experience, rather than treating any single genre as the correct choice.
Should patients be allowed to choose their own music for ketamine sessions?
Steve acknowledges this is a question the field hasn't fully settled. Allowing patients to bring their own music can feel personal and supportive, but it also carries some risk if their preferred music is agitating, emotionally demanding, or lyrically distracting. His general sense is that most practitioners do well to maintain their own curated playlists as a foundation, while staying open to patient input within reason. The one area where he does offer clearer guidance is around avoiding music that is dissonant or likely to activate the thinking mind, regardless of who selected it. Beyond that, he leans toward flexibility and away from any approach that presents music selection as a fixed protocol.
How does music relate to the therapeutic process in ketamine therapy?
One of the more interesting ideas Steve shares is that music and psychedelics including ketamine actually share a common quality: both have the capacity to bypass the protective and defensive structures we build around our emotional lives. Music, when truly listened to, can go to very deep emotional places on its own. Ketamine opens similar doors by quieting the ego's usual gatekeeping. When the two work together, Steve suggests the synergy may amplify access to suppressed emotional material and subconscious content that is often at the root of conditions like depression, anxiety, and trauma. It's a useful reframe for providers who may have thought of the playlist as an afterthought rather than part of the therapeutic protocol itself.