Set and Setting: Is It Controlled?

In this episode of the Psychedelic Medicine Podcast, Frederick Barrett joins to discuss setting and the research into how this variable can affect psychedelic experiences. Fred is an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine where he is also the associate center director of the Center for Psychedelic and Consciousness Research. He has been conducting research at Johns Hopkins since 2013 and is currently leading a number of ongoing studies to better understand the psychological, biological, and neurological mechanisms underlying therapeutic efficacy of psychedelics.

In this discussion, Fred unpacks his recent article “Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature” which appeared in the February 2022 edition of Current Topics in Behavioral Neurosciences. For this study, Dr. Barrett and colleagues gathered as many studies as they could find which dealt with the topic of the role of setting in psychedelic experiences. While they found over 1,000 articles which discussed the topic in some capacity, the researchers eventually narrowed the selection down to just 43 articles which provided empirical data on this variable.

Fred mentions that while ideas of set and setting loom large in psychedelic discussions, this is actually a topic which has received comparably less attention in research contexts. This is beginning to change, however, as researchers have become more certain in the overall efficacy of psychedelic therapies for treating a variety of conditions and are now turning to more specialized investigations, such as looking more closely into the impacts caused by various tweaks to the setting of psychedelic therapies.

When it comes to the state of current research on setting, Dr. Barrett reports that music is by far the most studied variable. He discusses different approaches which psychedelic therapists have taken in investigating this topic, with research investigating familiar vs unfamiliar music, or having music vs not having music in a session. He also shares research about expert meditators and how these subjects responded differently to music while under the influence of psychedelics when compared to typical patients. 

Another variable which Fred discusses is the element of ritual, which is especially prominent in more traditional contexts of psychedelic use. This variable is also interesting because it interacts with participants' expectations, blurring the distinction between set and setting as distinct categories. In closing, Dr. Barrett shares some of his own thoughts about the blurriness of set and setting, suggesting that our understanding of these categories may evolve as empirical research further investigates the roles they play in guiding psychedelic experiences.

In this episode:

• The relationship between ritual and set and setting
• The difficulties of rigorously studying all the variables of setting in the context of psychedelic experiences
• The different aspects of setting in traditional, ritualistic contexts for psychedelic experiences versus the context of modern psychedelic therapy
• Music as an important aspect of setting during psychedelic journeys
• The blurry distinction between set and setting

Quotes:

“Out of all of this literature, the one thing that became clear to us was that everybody talks about set and setting, and many papers affirm set and setting are important, but very few actually empirically test an element of set and setting.” [6:49]

“One of the elements of set and setting in general that we found to be addressed across a number of different studies was the question of specific ritual or ceremonial settings.” [15:04]

“Music seems to play an overwhelming role in shaping—and some people think driving—their psychedelic experience.” [22:25]

“Set and setting are both mutable. Your experience at one point in a session, I would argue, is going to influence, or at least has the opportunity to influence the things that happen next.” [41:03]

Links:

Dr. Barrett’s paper: Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes

Johns Hopkins Center for Psychedelic & Consciousness Research

Fred on Twitter

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