Most playlists are created by an algorithm. Ours are built by an expert, and then evaluated by a substantial amount of science that most commercial music doesn't see. This is how we take an idea for a Listening to Spravato playlist and develop it into a clinically-oriented collection of music ready for use during your treatment.

Each Playlist Starts With Justin

Each playlist begins with Justin Page sitting in his treatment chair. As a Spravato patient himself, Justin is able to access the music in his sessions as someone along for the ride during an esketamine session, as opposed to a producer or curator of a playlist. The first version of every playlist is drawn from the music that resonated the most for Justin during his sessions. It's not a hypothetical process. It's a first-hand, done-it-myself process.

Justin notes how certain tracks generate his sense of safety and his sense of time. He also thinks about how the music interacts with the treatment. Only tracks that pass this first test continue to the next stage.

Testing With and Without Spravato

After a draft version of a playlist is created, it is subjected to two separate evaluations: one with and one without Spravato treatment.

Maybe a song is beautiful in a typical listening context, but in an esketamine session, it could be jarring, overstimulating, or emotionally intrusive. Music has tempo, timbre, and lyrical content, and in an esketamine session, these get amplified. A song in the background of your commute with a barely noticeable shift in dynamics can actually be a big disruption in an esketamine session when you're in a peak state of dissociation. By trying to listen to the same song in both the normal state and the esketamine state, Justin can find out how the song interacts with the medicine. This is one of the many important, yet underestimated, steps of therapeutic music for psychedelic-assisted therapy.

After Personal Testing, Promising Playlists Move to the fMRI Volunteer Studies

Personal testing helps guide the team to the following phase of the evaluation, which includes 15 to 20 fMRI volunteers. Each volunteer is placed in an fMRI machine to observe the brain during each individual track of the playlist. This is done to study the brain instead of just relying on volunteers saying they "felt calm."

Each song is studied to see how it interacts with the brain. Variations in the participants' anxiety levels are studied, as well as variations in their interoceptive levels. Participants are also studied to see if the sounds and the track help support the therapeutic process or if the sounds and track are detrimental to the process. If the track is supportive to the therapeutic state, it is kept. If the track is detrimental to the therapeutic state, it is removed.

Waveform Monitoring: The Geometry of Calm

An innovative aspect of the Listening to Spravato protocol is oscilloscope-based waveform monitoring. Lead researchers assessed the geometry of a track's audio waveforms on an oscilloscope. Of course, this process examines frequency response and EQ. However, such analysis is also concerned with the shape of sound over time.

Through testing, it was found that geometrically stable, smooth waveforms indicated and measured a physical decrease in anxiety. Irregular, jagged, or highly compressed waveforms — no matter how pleasing the sound — may subtly engage the nervous system's threat-detection mechanism. Stable waveforms appear to provide a physical anxiety reduction signal to the nervous system. For these reasons, the Listening to Spravato playlists avoid heavily compressed pop production and low-end dense sound.

Phase-Aligned Architecture

The last structural element to the protocol is the clarity of each playlist's three distinct phases of an esketamine session.

The first is the initial onset phase, which lasts for 20 to 30 minutes as the medicine begins to take effect. During this phase, the goal is to provide music that is slow, easy, and predictable to the nervous system in order to help the nervous system slow down.

During the peak phase, music can be more immersive and extensive, but should not contain sudden changes in dynamics or lyrics that can root listeners in normal reality. The frequencies selected are meant to help the listener remain aware while being open to new things.

During the integration phase, as the medicine starts to wear off, music begins to express a gentle pulse and a more advanced harmony. This phase eases the listener back and helps the listener remember what happened in the therapeutic session. Each playlist has tracks that align to particular phases. The sequencing of music is planned. Everything has a reason.

Accessible Music That Works in Conjunction With the Medicine

Because we feel therapeutic music should be tested in the same way as any other clinical tool, we have developed this Listening to Spravato testing and validation protocol. Many clinics today choose music by just having someone's favorite album or ambient music that they find online. We feel strongly that the breadth and power of this therapy deserve more than that.

We have combined our lived experience, personal testing, fMRI data, musical phase sequencing, and analysis of waves by an oscilloscope. All of our playlists are available on different streaming services so that you can listen to them for free.