Healing Music for Treatment-Resistant Depression
The phrase "healing music" has been used rather liberally in the past, to describe songs that are slow, soft, or even a bit spiritual. Although there are some interpretative similarities with the use of music in treatments for resistant depression and esketamine, the phrase carries much more meaning in this case. Listeners need to understand this term is being used to describe music having a therapeutic function, and not just music that is perceived as nice or pleasant.
The research behind it
The music therapy literature, particularly the work that stems from the psychedelic-assisted therapies at Johns Hopkins, NYU, and Imperial College London, has begun to delineate various musical elements that facilitate therapy. These therapies define the role of music in therapy as an active component, not as background. The same applies to the Spravato® therapy.
While esketamine is not a psychedelic, it and psychedelics do share the property of increasing neural plasticity and the default mode network, and the music that has been shown to be positive in the context of psychedelic-assisted therapy also works in the context of a Spravato® session.
"Healing music isn't just music that feels good. It's music that creates the conditions for the therapeutic process to unfold."
Four Elements of Healing Music
Emotional arc
Healing music is dynamic. Healing music is not music that stays in one place; it is music that creates a resolution, releases built up tension, builds, and creates openness. Music that is highly calm, or music that is highly intense, do not follow this emotional arc.
Harmonic openness
Certain types of music can help relieve stress by maintaining a gentle, anticipatory state rather than a state of musical conflict. This can be found in music that contains open fifths, suspended chords, and modal scales. Many minimalist forms of classical music, jazz, and well thought out ambient music, among others, utilize this particular technique.
Music with no expectation
There is no ontological demand for action on the part of the listener. This doesn't mean you need to dance, sing along, or follow the beat. Healing music creates and occupies a space for the listener. Certain genres, or types of music, with a strong pulse, words, or a large dynamic range actually stress the body, and create a demand that can interfere with the healing process.
Timbral Healing
A body heals through resonance. This is why a lot of the music utilized in music therapy is strictly instrumental. A lot of string and piano music, as well as music made from woodwinds and other resonating instruments, have the ability to harmonically stimulate a body.
The role of the listener
It is helpful for the listener to have no demands and no expectations. The music is best able to assist healing when the listener is receptive to the music and lets it move them rather than analyzing it. In the therapeutic literature, this is referred to as "music evoked imagery," or music becoming the vehicle of inner fulfillment rather than being an object of focus. This is especially difficult for patients with treatment-resistant depression.
Depression causes anhedonia, which is a loss of the ability to feel pleasure and emotional resonance. It even can affect one's ability to connect to and find pleasure in music. In the beginning of each session, you might not be able to connect to the music, but you shouldn't beat yourself up about that. The inability to connect with music may actually be a part of the treatment that your therapist is working on.
Many clinic patients have reported that with treatment, they develop a different relationship with music and begin to feel more deeply the music that they were initially unable to feel. This inability to feel is a physical marker of the therapeutic progress you have made.
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Ready to build your healing playlist?
Our free curated playlists are built with these principles in mind — instrumental, emotionally open, and sequenced for the arc of a Spravato® session.
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The Listening to Spravato® Book
Genre guides, session playlists, and the science of music-assisted healing — by Justin Page