How Music Affects Psychedelic & Ketamine Therapy: 41 Studies on How It Shapes Emotion, Imagery, Memory, and Surrender

Music is often treated as an atmospheric accessory in psychedelic and ketamine therapy: useful, pleasant, optional, or merely calming. Across a curated evidence base of 41 studies, reviews, mechanistic papers, clinical reports, playlist-design papers, ketamine-specific studies, ceremonial-music papers, and counterarguments, music repeatedly appears as an active session-shaping variable. The strongest evidence supports music's role in the acute treatment experience: intensifying and organizing emotion, shaping imagery and memory, supporting surrender, giving structure to fear and difficult material, contributing to meaning-making, and making ketamine treatment more tolerable. Ketamine-specific findings are clearest for tolerability, anxiety, and hemodynamic response; they do not yet prove that music independently improves antidepressant outcomes. The literature does not establish a universal playlist, a single superior genre, or music as a stand-alone treatment. It shows something more clinically useful: when psychoactive treatment loosens ordinary perception, body sense, time, emotional control, and autobiographical access, music becomes part of the treatment architecture. The research gap is no longer whether music matters. The research gap is how to select, sequence, personalize, report, and test music as a treatment variable rather than treating it as background sound.