Music Is Directive: Rethinking Non-Directive Psychedelic Practice

The Paradox in the Room 

Music begins shaping the session long before the medicine takes hold. A shift in harmony tightens the chest. A low drone draws awareness inward. Though often described as "supportive," sound rarely stays neutral. It moves the body, primes emotion, and directs attention. For some, that movement feels like guidance. For others, especially those with neurodivergent sensory systems, it can feel too much, too fast, or too intimate.

This creates a central paradox. Modern psychedelic therapy prizes non-directive practice and trusts the participant’s inner healing intelligence (Mithoefer et al., 2017; Richards, 2015). Yet music, which is the primary stimulus in most sessions, carries its own momentum. It cues, invites, and sometimes pushes. The task is not to pretend that music is neutral. The task is to work with its influence ethically, in ways attuned to each nervous system’s way of perceiving and consenting to sound.

Oregon’s psilocybin framework defines non-directive care as client-led. Facilitators may play music only with prior consent, and clients may request silence at any time (Oregon Health Authority, 2024, OAR 333-333-5200[6]). The rules state that music must be non-directive and supportive, though they offer scant criteria to define what those qualities mean in practice.

Non-Directive Ideals and Their Limits 

Non-directive models were developed to protect autonomy and soften the influence of suggestion. Early academic protocols emphasized inward focus, eyeshades, and therapist neutrality to reduce the therapist’s influence during moments of heightened sensitivity (Johnson, Richards, & Griffiths, 2008). Oregon’s program reflects these commitments by discouraging interpretation or steering interventions.

Neutrality, however, is fragile. Any element of the room can influence experience—the lighting, the facilitator’s posture, the artwork, or the first musical note that enters the space. For some, these cues feel like gentle support. For others, particularly those who sense shifts in stimulus more acutely, they can feel like demands. A sudden rhythmic change might signal urgency. A minor chord might register as danger.

No environment lands the same way twice because every nervous system arrives with its own history. Many neurodivergent participants show precise attunement to rhythm, tone, timbre, and pattern. They may also be more vulnerable to sensory or emotional overwhelm. For them, autonomy depends less on the absence of influence and more on the presence of predictability, clear options, and the ability to anticipate what comes next.

Under psychedelics, filters loosen, and the influence of music deepens. Facilitators can offer structure that supports agency: inviting pre-consent to themes or selections, offering hand signals or volume controls, and normalizing the request for silence. Kaelen and colleagues (2018) found that the participant’s relationship with the music predicted emotional depth and therapeutic outcome more strongly than drug intensity. Music shapes experience. The ethical work is to ensure it does so transparently and collaboratively.

How Music Directs the Psyche 

Neuroscience helps clarify why sound holds such authority under psychedelics. Standard top‑down control relaxes, giving greater weight to sensory input (Jerotić, Vuust, & Kringelbach, 2023). With filtering loosened, perception becomes immediate and vivid. Small shifts in tone color or rhythm can land with amplified force.

Under LSD, the brain devotes extra resources to timbre in language‑related regions, and many describe the music as having presence or sentience. The combination of neurobiology and subjective testimony illustrates why music often behaves like a co‑therapist (Kaelen et al., 2018). Heightened emotional salience, vivid sensory imagery, and synesthetic blending strengthen the guiding power of sound.

Kaelen’s imaging studies also showed increased connectivity between the parahippocampal region and visual cortex under LSD with music, perhaps enhancing autobiographical imagery. When expectations loosen, sound can frame the direction the psyche takes. A cinematic swell might evoke childhood memories, inner landscapes, or waves of nostalgia.

For neurodivergent listeners, amplification can be even more pronounced. Brains already tuned to detail or texture may register the world with an intensified signal. Under psychedelics, those channels widen further. A single overtone can feel luminous or piercing. Harmonic dissonance can read as physical pressure. Some experience music as immersive and grounding; others find it overwhelming. Both responses are valid interpretations of a high‑resolution environment.

This makes music both potent and risky as a therapeutic tool. Its directive power arises not only from its structure but from the listener’s perceptual wiring. What soothes one participant may unsettle another. Ethical facilitation turns this from a matter of control into a practice of attunement.

Persistent Demand for Autonomy and Religious Trauma 

For clients with histories that tie autonomy to injury, the stakes of influence grow sharper. Research on Pathological Demand Avoidance (PDA)—often reframed as Persistent Demand for Autonomy—describes an intense physiological or emotional resistance to external control when it is perceived (Green et al., 2018). In psychedelic contexts, this can show up as withdrawal, defiance, or shutdown when facilitators, or the music itself, feel too directive. Over‑structured playlists or imposed emotional arcs may be interpreted as pressure rather than support.

Religious trauma adds further layers. Many neurodivergent individuals, whose moral and sensory sensitivities clash with rigid systems, carry wounds from coercive or shaming religious environments. Clinical playlists that rely on sacred choral music, such as those used at Johns Hopkins (2020), can evoke profound beauty for some and profound distress for others. Old memories or feelings attached to authority, judgment, or betrayal can resurface quickly.

For some, religious‑affiliated music later becomes a vehicle for integration or forgiveness. Yet such healing depends on informed consent and agency. Facilitators can help by discussing musical elements that may feel charged, offering examples in advance, and affirming each participant’s right to skip or substitute any track. Trust grows when boundaries are respected.

Qualities of Directive and Non‑Directive Sound 

Directive sound typically signals movement or meaning. It may involve strong rhythmic drive, harmonic tension and release, lyrical content, or culturally coded emotional cues such as cinematic strings or sacred choral motifs (Kaelen, 2022). These elements can evoke powerful imagery or feeling. They can also overwhelm.

Less‑directive sound emphasizes openness. Sustained tones, drones, minimal harmonic motion, slow‑evolving textures, and the absence of lyrics allow for personal interpretation. Nature‑based or ambient soundscapes often widen psychological space rather than narrowing it. Gradual transitions and predictable structures support participants who rely on sensory stability.

Neither approach is inherently superior—Fit, timing, and transparent communication matter most. During peak or fragile phases, sparse or minimal sound may help preserve autonomy. In integrative or cathartic phases, more expressive forms may support emotional articulation. A clear conversation in preparation helps clients understand how musical qualities may shape their experience.

The Ethics of Influence 

When music behaves like a co‑therapist, it carries ethical weight. Direction becomes a question of power. Over‑directive playlists can impose an emotional script, shaping the process more than reflecting it. Nader (2025) argues that music may act as a confounding variable, introducing external emotional content that displaces the material the session seeks to access. Even well‑curated playlists can shift inner work toward a guided performance rather than an authentic encounter with self.

Himmerich and Heiderscheit (2024) detail adverse reactions associated with therapeutic music: resurfaced trauma, negative emotions, distress, overstimulation, and symptom worsening. These reactions can stem from the music itself, the way it is applied, the therapeutic relationship, the listener’s associations, or the broader context of the room.

For neurodivergent participants, this question of influence extends into the sensory realm. A system that processes sound intensively has a weaker buffer against surprise. Sudden modulations, sacred choral voices, or particular vocal timbres can register as breaches. Transparency and consent become forms of accommodation. Participants deserve to know how to signal when the music goes too far.

Ethical facilitation centers this agency from the beginning: collaborating on volume and pacing, inviting feedback before sessions start, and normalizing adjustments mid‑journey. Silence also counts as a sound choice. A low drone or the pause between tracks may offer more safety than any melody. Sometimes the most therapeutic intervention is quiet, allowing space for the psyche to speak.

Nader challenges the assumption that music is inherently therapeutic. From a “psychedelic minimalism” perspective, emotional neutrality supports unmediated engagement with the self. Emotionally charged or autobiographically meaningful music risks overpowering the process by substituting an external script for internal exploration. A minimalist or silent setting may better preserve authenticity for some clients.

Silence becomes an active form of non‑directive support. The deeper principle is that consent is moment‑to‑moment. Influence is always present. What matters is how consciously it is negotiated. When facilitators treat music as a dialogue, they support each nervous system in staying in relationship with sound rather than being carried by it.

Where the Field Can Grow 

The integrity of psychedelic care depends on acknowledging music’s influence. The question is whether that influence can become transparent, collaborative, and responsive to diverse nervous systems.

Evidence already shows that peak‑period music differs from pre‑peak music: peak pieces tend to have predictable phrasing, continuous motion, and lower perceptual brightness, while pre‑peak music is more varied and diffuse (Barrett et al., 2017). Guided‑Imagery‑and‑Music frameworks map musical intensity to the phases of a psychedelic session and offer a scaffolding for thoughtful design (Messell et al., 2022). Future research could build on these foundations by testing low‑directive, adaptive, or client‑responsive systems and co‑created soundscapes, and by examining how predictability of tone, rhythm, or timbre supports safety for listeners with diverse sensory profiles.

Music will always carry influence. The task is to intentionally work with that influence. Ethical facilitation rests on transparency, responsiveness, and humility. When facilitators listen consciously, music becomes less about guiding and more about accompanying. Whether through silence, a sustained tone, or a carefully chosen piece, sound can invite authenticity rather than prescribe meaning.

References

Green, J., Absoud, M., Grahame, V., Malik, O., Simonoff, E., & Baird, G. (2018). Pathological Demand Avoidance: Symptoms but not a syndrome. The Lancet Child & Adolescent Health, 2(6), 455–464. https://doi.org/10.1016/S2352-4642(18)30044-0

Himmerich, H., & Heiderscheit, A. (2024). The challenges and opportunities related to the therapeutic use of music in psychiatry. Expert Review of Neurotherapeutics, 24(7), 615-618. https://doi.org/10.1080/14737175.2024.2359429

Hopkins Medicine. (2020). Psilocybin playlist used in Johns Hopkins clinical studies [Spotify playlist]. Center for Psychedelic and Consciousness Research, Johns Hopkins Medicine. https://open.spotify.com/playlist/5KWf8H2pM0tlVd7niMtqeU

Jerotić, K., Vuust, P., & Kringelbach, M. L. (2023). Psychedelia: The interplay of music and psychedelics. Annals of the New York Academy of Sciences, 1531(1), 12–28. https://doi.org/10.1111/nyas.15082

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Kaelen, M. (2022). Music for Psychedelic Therapy – Mendel Kaelen, Founder and CEO of Wavepaths [Podcast interview with Brom Rector, Human 3 with Brom and Sam]. https://www.youtube.com/watch?v=xcHe8LZ99uk

Kaelen, M., Giribaldi, B., Raine, J., Evans, L., Timmerman, C., Rodriguez, N., Roseman, L., Feilding, A., Nutt, D., & Carhart-Harris, R. (2018). The hidden therapist: Evidence for a central role of music in psychedelic therapy. Psychopharmacology, 235, 505–519. https://doi.org/10.1007/s00213-017-4820-5

Messell, C., Summer, L., Bonde, L., Beck, B., & Stenbæk, D. (2022). Music programming for psilocybin-assisted therapy: Guided imagery and music-informed perspectives. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.873455

Mithoefer, M., Mithoefer, A., Jerome, L., Ruse, J., Doblin, R., Gibson, E., Ot’alora, M., Sola, E. (2017). A manual for MDMA-assisted psychotherapy in the treatment of posttraumatic stress disorder. Multidisciplinary Association for Psychedelic Studies (MAPS). https://maps.org/2014/01/27/a-manual-for-mdma-assisted-therapy-in-the-treatment-of-ptsd/

Nader, S. (2025). Psychedelic minimalism: the case against music in psychedelic therapy settings. Frontiers in Psychiatry, 16. https://doi.org/10.3389/fpsyt.2025.1652568

Oregon Health Authority. (2024). Oregon Administrative Rules, Chapter 333, Division 333: Psilocybin Services (OAR 333-333-5200). Retrieved from https://secure.sos.state.or.us/oard/displayDivisionRules.action?selectedDivision=7102

Richards, W. A. (2015). Sacred knowledge: Psychedelics and religious experiences. Columbia University Press.https://tinyurl.com/Sacred-Knowledge