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Sheth R, Parikh E, Olayeye K, Pfeifer K, Khanna D. The Effects of Ayahuasca on Psychological Disorders: A Systematic Literature Review. Cureus 2024; 16:e55574. [PMID: 38576633 PMCID: PMC10994171 DOI: 10.7759/cureus.55574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/01/2024] [Indexed: 04/06/2024] Open
Abstract
Ayahuasca is an original Amazonian brew made from the vines and leaves of Psychotroa viridis and Banisteriopsis caapi. Both P. viridis and B. caapi give this brew its unique psychedelic properties which have been revered over centuries. In recent years, ayahuasca has gained attention as a potential therapeutic tool for mental health disorders, including substance abuse and depression. The uniqueness of ayahuasca's therapeutic potential is that it is an amalgamation of its biochemical makeup and the ritual guided by a shaman, along with the interpretation of the participant of their experience. The boom of "ayahuasca tourism" has brought forth testimonies of feeling "cured" of depression, and substance abuse and an improvement in overall well-being. This systematic literature review focuses on summarizing the recently available research on the effectiveness of ayahuasca as a treatment for depression, anxiety, substance abuse, eating disorders, and post-traumatic stress disorder. It also focuses on understanding the effects it has on personality traits that play a significant role in the manifestation of the above-listed mental health conditions effects. Additionally, the review investigates the importance and role the ritual itself plays, often described as the "mystical experience". This systematic literature review aims to explore the current state of knowledge regarding the use of ayahuasca for numerous mental health conditions by analyzing medical research papers published no earlier than September 2017 to no later than May 2023 from Google Scholar and PubMed. A total of 43 articles met the criteria and were used for detailed analysis. This review will synthesize the findings of the studies, examining the potential therapeutic effects of ayahuasca on multiple mental health disorders, the significance of the "mystical experience," and the mechanisms of action underlying its effects. Through the review, ayahuasca proves to be a worthwhile therapeutic tool that if used in the right setting influences mind, body, and spirit. It is important to note that most studies used in this article relied on surveys and self-reporting proving to be a limitation as no clear standard has been achieved to test the efficacy of ayahuasca. The respect for the culture and origin needs to be retained as Western medicine dwells deeper into ayahuasca's benefits.
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Affiliation(s)
- Reena Sheth
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Esha Parikh
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Kunmilayo Olayeye
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Kylie Pfeifer
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
| | - Deepesh Khanna
- Foundational Sciences, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Clearwater, USA
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Wolfson P, Vaid G. Ketamine-assisted psychotherapy, psychedelic methodologies, and the impregnable value of the subjective-a new and evolving approach. Front Psychiatry 2024; 15:1209419. [PMID: 38362026 PMCID: PMC10867319 DOI: 10.3389/fpsyt.2024.1209419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
Psychiatry is in a growth phase in which several psychedelic medicines have entered its arena with great promise. Of these, presently, ketamine is the only medicine that may be legally prescribed. We hypothesize that at subanesthetic doses, ketamine produces a unique spectrum of altered states, ranging from psychoactive to deep ego-dissolving experiences, that are intrinsic to ketamine's therapeutic effects. When these experiences are embedded in a therapeutic relationship-a setting-that fosters an amplification of the recipient's subjective consciousness, personal growth, inner healing, greater clarity, and better relationships may well ensue. While much of the literature on ketamine labels its dissociative effects as 'side effects', alteration of consciousness is a component and unavoidable 'effect' of its therapeutic impact. From its inception in the clinical trials of the 1960s, ketamine was recognized for producing dissociative, psychedelic effects on consciousness in subjects as they emerged from ketamine-induced anesthesia. Unanticipated and unintegrated, these experiences of 'emergence phenomena' were felt to be disturbing. Accordingly, such experiences have been typically labeled as dissociative side effects. However, in a conducive set and settings, these experiences have been demonstrated to be of positive use in psychiatry and psychotherapy, providing a time-out from usual states of mind to facilitate a reshaping of self-experience along with symptomatic relief. In this way, ketamine-assisted psychotherapy (KAP) offers a new potential in psychiatry and psychotherapy that is powerfully valanced toward recognizing experience, individuality, and imagination. Essential to a successful therapeutic experience and outcome with KAP is close attention to the subjective experience, its expression by the recipient and integration of the ketamine experience as a healing opportunity.
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Zaretsky TG, Jagodnik KM, Barsic R, Antonio JH, Bonanno PA, MacLeod C, Pierce C, Carney H, Morrison MT, Saylor C, Danias G, Lepow L, Yehuda R. The Psychedelic Future of Post-Traumatic Stress Disorder Treatment. Curr Neuropharmacol 2024; 22:636-735. [PMID: 38284341 PMCID: PMC10845102 DOI: 10.2174/1570159x22666231027111147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 01/30/2024] Open
Abstract
Post-traumatic stress disorder (PTSD) is a mental health condition that can occur following exposure to a traumatic experience. An estimated 12 million U.S. adults are presently affected by this disorder. Current treatments include psychological therapies (e.g., exposure-based interventions) and pharmacological treatments (e.g., selective serotonin reuptake inhibitors (SSRIs)). However, a significant proportion of patients receiving standard-of-care therapies for PTSD remain symptomatic, and new approaches for this and other trauma-related mental health conditions are greatly needed. Psychedelic compounds that alter cognition, perception, and mood are currently being examined for their efficacy in treating PTSD despite their current status as Drug Enforcement Administration (DEA)- scheduled substances. Initial clinical trials have demonstrated the potential value of psychedelicassisted therapy to treat PTSD and other psychiatric disorders. In this comprehensive review, we summarize the state of the science of PTSD clinical care, including current treatments and their shortcomings. We review clinical studies of psychedelic interventions to treat PTSD, trauma-related disorders, and common comorbidities. The classic psychedelics psilocybin, lysergic acid diethylamide (LSD), and N,N-dimethyltryptamine (DMT) and DMT-containing ayahuasca, as well as the entactogen 3,4-methylenedioxymethamphetamine (MDMA) and the dissociative anesthetic ketamine, are reviewed. For each drug, we present the history of use, psychological and somatic effects, pharmacology, and safety profile. The rationale and proposed mechanisms for use in treating PTSD and traumarelated disorders are discussed. This review concludes with an in-depth consideration of future directions for the psychiatric applications of psychedelics to maximize therapeutic benefit and minimize risk in individuals and communities impacted by trauma-related conditions.
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Affiliation(s)
- Tamar Glatman Zaretsky
- James J. Peters Veterans Affairs Medical Center, New York, NY, USA
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kathleen M. Jagodnik
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert Barsic
- James J. Peters Veterans Affairs Medical Center, New York, NY, USA
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Josimar Hernandez Antonio
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Philip A. Bonanno
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Carolyn MacLeod
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charlotte Pierce
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Hunter Carney
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Morgan T. Morrison
- James J. Peters Veterans Affairs Medical Center, New York, NY, USA
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles Saylor
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - George Danias
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lauren Lepow
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Yehuda
- James J. Peters Veterans Affairs Medical Center, New York, NY, USA
- The Center for Psychedelic Psychotherapy and Trauma Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Cruz L, Bienemann B, Palhano-Fontes F, Tófoli LF, Araújo DB, Mograbi DC. A quantitative textual analysis of the subjective effects of ayahuasca in naïve users with and without depression. Sci Rep 2023; 13:19635. [PMID: 37949934 PMCID: PMC10638373 DOI: 10.1038/s41598-023-44193-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/04/2023] [Indexed: 11/12/2023] Open
Abstract
Ayahuasca is a brew with psychoactive properties that has been used as an entheogen for centuries, with more recent studies suggesting it is a promising treatment for some clinical disorders. Although there is an emerging scientific literature on its effects, to the best of our knowledge no study has explored the self-reported experiences of first-time ayahuasca users with quantitative textual analysis tools. Accordingly, the current study aimed to analyze the subjective experience of naive individuals with depression and healthy controls after consuming ayahuasca. For this purpose, responses from a subsample of participants from a previous clinical trial to open-ended questions regarding their experience with ayahuasca underwent textual analysis. Data from nine patients with treatment-resistant depression and 20 healthy individuals were included, and quantitative textual analysis was performed using IRaMuTeQ 0.7 alpha 2 and R 3.1.2. The analysis identified five clusters: alterations in the state of consciousness, cognitive changes, somatic alterations, auditory experiences, and visual perceptual content. Additionally, findings suggest specific features of the experience of people with depression with ayahuasca, such as increased aversive bodily reactions. The results are consistent with previous findings indicating central axes of the psychedelic experience, and may inform therapeutic approaches using ayahuasca.
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Affiliation(s)
- Lucas Cruz
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Bheatrix Bienemann
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | | | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | - Dráulio B Araújo
- Brain Institute, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil.
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, PO Box 078, London, UK.
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Greń J, Tylš F, Lasocik M, Kiraly C. Back from the rabbit hole. Theoretical considerations and practical guidelines on psychedelic integration for mental health specialists. Front Psychol 2023; 14:1054692. [PMID: 37904908 PMCID: PMC10613493 DOI: 10.3389/fpsyg.2023.1054692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 08/25/2023] [Indexed: 11/01/2023] Open
Abstract
The growing interest in and prevalence of the use of psychedelics, as well as the potential benefits and negative consequences associated with psychedelic experiences, create a need for mental health specialists to be able to provide adequate and effective intervention regarding the content and consequences of these experiences, that is, psychedelic integration. At the same time, current graduate training in psychiatry, psychology, psychotherapy, counseling, etc., fails to adequately prepare professionals for such interventions. In order to fill this gap, an international, bottom-up project was established to attempt developing guidelines. This project was conducted by means of literature reviews as well as roundtable discussions among project participants, leading to a consensus on the guidelines' final scope and content. Drawing from the outcomes of this project, this article presents proposed comprehensive guidelines covering both theoretical and practical aspects of psychedelic integration, that are intended to serve as a resource for various mental health specialists who may encounter individuals in need of support considering their psychedelic experiences. These guidelines encompass clinician-friendly information on the effects of psychedelics, a definition of psychedelic integration, the general theoretical considerations linked to utilization of psychedelic experiences in clinical practice, a simple model organizing the course of psychedelic integration practice, as well as an overview of the current models of psychedelic integration, along with a selective presentation of basic and specific interventions derived from various psychotherapeutic approaches that can be employed in the practice of psychedelic integration.
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Affiliation(s)
- Jakub Greń
- Public Health Department, Institute of Psychiatry and Neurology, Warsaw, Poland
- Polish Psychedelic Society, Warsaw, Poland
| | - Filip Tylš
- Psyon - Psychedelic Clinic, Prague, Czechia
- 3rd Medical Faculty, Charles University in Prague, Prague, Czechia
- National Institute of Mental Health, Klecany, Czechia
- Czech Psychedelic Society, Prague, Czechia
| | - Michał Lasocik
- Polish Psychedelic Society, Warsaw, Poland
- Polish Society of Process Psychology, Warsaw, Poland
| | - Csaba Kiraly
- Multidiszciplináris Társaság a Pszichedelikumok Kutatásáért, Budapest, Hungary
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Gearin AK. Moving beyond a figurative psychedelic literacy: Metaphors of psychiatric symptoms in ayahuasca narratives. Soc Sci Med 2023; 334:116171. [PMID: 37639859 DOI: 10.1016/j.socscimed.2023.116171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/05/2023] [Accepted: 08/08/2023] [Indexed: 08/31/2023]
Abstract
Metaphors, analogies, and similes commonly appear in narratives of drinking the potent psychedelic "ayahuasca", presenting an intriguing transcultural pattern. Based upon survey and field research at an ayahuasca healing center in Pucallpa, Peru, the article investigates conceptual metaphors in narratives of ayahuasca experiences made by the visiting international guests. Bodily metaphors and visionary analogies frequently appear in narrative plots where they can express the reappraisal, overcoming, and sometimes emboldening of symptoms diagnosed by psychiatry. Moving beyond the literal-figurative divide, the article explores the intrinsic "metaphoricity" of psychedelic experiences and advocates for a literacy of conceptual metaphors regarding both clinical and non-clinical psychedelic narratives. Developing this literacy can broaden approaches in psychedelic psychiatry that analyze and treat syndromes and disorders, while also being applicable to social science and humanities research that examine psychoactive drug use beyond medical frameworks.
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Affiliation(s)
- Alex K Gearin
- Medical Ethics and Humanities Unit, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; Centre for Medical Ethics and Law, Faculty of Law and LKS Faculty of Medicine, The University of Hong Kong, Hong Kong.
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Simonsson O, Stenfors CUD, Goldberg SB, Hendricks PS, Osika W. Altered states of leadership: mindfulness meditation, psychedelic use, and leadership development. Front Psychol 2023; 14:1151626. [PMID: 37476092 PMCID: PMC10354271 DOI: 10.3389/fpsyg.2023.1151626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/15/2023] [Indexed: 07/22/2023] Open
Abstract
Background Previous research suggests that mindfulness meditation and psychedelic substances show promise as mental health interventions, but relatively little remains known about their potential impact on leadership outcomes. Aims This study aimed to investigate if and how mindfulness meditation and psychedelic use may impact leadership among respondents with a management position as their primary role at work. Methods Using samples representative of the US and UK adult populations with regard to sex, age, and ethnicity, this study used quantitative and qualitative methods to examine if and how mindfulness meditation and psychedelic use may impact leadership. Results Among respondents with a management position as their primary role at work (n = 3,150), 1,373 reported having tried mindfulness meditation and 559 reported having tried psychedelics. In covariate-adjusted regression analyses, both lifetime number of hours of mindfulness meditation practice and greater psychological insight during respondents' most intense psychedelic experience were associated with describing a positive impact on leadership (ORs = 2.33, 3.49; ps < 0.001), while qualitative analyses revealed nuances in the type of impacts mindfulness meditation and psychedelic use had on leadership. There were several subthemes (e.g., focus, creativity, patience, empathy, compassion) that were frequently reported with both mindfulness meditation and psychedelic use. There were also unique subthemes that were more commonly reported with mindfulness meditation (e.g., improved sleep, stress reduction, calming effects) and psychedelic use (e.g., greater self-understanding, less hierarchical attitudes toward colleagues, positive changes in interpersonal attitudes and behaviors), respectively. Conclusion Although causality cannot be inferred due to the research design, the findings in this study suggest potential complementary effects of mindfulness meditation and psychedelic use on leadership, which could inspire new approaches in leadership development.
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Affiliation(s)
- Otto Simonsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Sociology, University of Oxford, Oxford, United Kingdom
| | | | - Simon B. Goldberg
- Department of Counseling Psychology, University of Wisconsin–Madison, Madison, WI, United States
| | - Peter S. Hendricks
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Walter Osika
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Kähönen J. Psychedelic unselfing: self-transcendence and change of values in psychedelic experiences. Front Psychol 2023; 14:1104627. [PMID: 37388660 PMCID: PMC10300451 DOI: 10.3389/fpsyg.2023.1104627] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 03/31/2023] [Indexed: 07/01/2023] Open
Abstract
Psychedelic experiences have been shown to both facilitate (re)connection to one's values and change values, including enhancing aesthetic appreciation, promoting pro-environmental attitudes, and encouraging prosocial behavior. This article presents an empirically informed framework of philosophical psychology to understand how self-transcendence relates to psychedelic value changes. Most of the observed psychedelic value changes are toward the self-transcendent values of Schwartz's value theory. As psychedelics also reliably cause various self-transcendent experiences (STEs), a parsimonious hypothesis is that STEs change values toward self-transcendent values. I argue that STEs indeed can lead to value changes, and discuss the morally relevant process of self-transcendence through Iris Murdoch's concept of "unselfing". I argue that overt egocentric concerns easily bias one's valuations. Unselfing reduces egocentric attributions of salience and enhances non-egocentric attention to the world, widening one's perspective and shifting evaluation toward self-transcendent modes. Values are inherently tied to various evaluative contexts, and unselfing can attune the individual to evaluative contexts and accompanying values beyond the self. Understood this way, psychedelics can provide temporarily enhanced access to self-transcendent values and function as sources of aspiration and value change. However, contextual factors can complicate whether STEs lead to long-term changes in values. The framework is supported by various research strands establishing empirical and conceptual connections between long-term differences in egocentricity, STEs, and self-transcendent values. Furthermore, the link between unselfing and value changes is supported by phenomenological and theoretical analysis of psychedelic experiences, as well as empirical findings on their long-term effects. This article furthers understanding of psychedelic value changes and contributes to discussions on whether value changes are justified, whether they result from cultural context, and whether psychedelics could function as tools of moral neuroenhancement.
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Apud I, Scuro J, Carrera I, Oliveri A. Ayahuasca Ritual, Personality and Sociality: Observational Research Conducted in a Substance Use Disorder Rehabilitation Center in Uruguay. J Psychoactive Drugs 2023; 55:141-150. [PMID: 35506737 DOI: 10.1080/02791072.2022.2053004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 12/13/2021] [Accepted: 01/10/2022] [Indexed: 10/18/2022]
Abstract
The current article presents a mixed qualitative-quantitative observational study of the effect of ayahuasca ritual on subjective experiences and personality traits on participants of a center specialized in the treatment of substance use disorder in Uruguay. When comparing the psychological traits of ayahuasca participants to a control group, quantitative results using the Zuckerman-Kuhlman-Aluja Personality Questionnaire showed statistically significant higher scores in Impulsive Sensation Seeking, Boredom Susceptibility, and Social Warmth scales. Qualitative analysis of ayahuasca experiences resulted in five main categories: emotional experiences (including social emotions such as love and empathy), corporal experiences, spiritual/transcendental experiences, personal experiences, and visions. Last, qualitative descriptions provide support for the importance of social interactions in the phenomenological manifestations of the psychedelic experience. Both quantitative and qualitative results suggest that the combination of social interactions and the pharmacological action of ayahuasca could facilitate the manifestation of social emotions during the ritual, and may contribute to the long-term increase of empathic and social aspects of personality.
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Affiliation(s)
- Ismael Apud
- Institute of Foundations and Methods in Psychology, Faculty of Psychology, Universidad de la República, Montevideo, Uruguay
| | - Juan Scuro
- Department of Social Anthropology, Faculty of Humanities and Educational Sciences, Universidad de la República, Montevideo, Uruguay
| | - Ignacio Carrera
- Department of Organic Chemistry, Faculty of Chemistry, Universidad de la República, Montevideo, Uruguay
| | - Andrés Oliveri
- Institute of Foundations and Methods in Psychology, Faculty of Psychology, Universidad de la República, Montevideo, Uruguay
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Michael P, Luke D, Robinson O. An encounter with the self: A thematic and content analysis of the DMT experience from a naturalistic field study. Front Psychol 2023; 14:1083356. [PMID: 37051610 PMCID: PMC10083325 DOI: 10.3389/fpsyg.2023.1083356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/22/2023] [Indexed: 03/28/2023] Open
Abstract
IntroductionN,N-Dimethyltryptamine (DMT) is an endogenous serotonergic psychedelic capable of producing radical shifts in an experience that have significant implications for consciousness and its neural correlates, especially given the “disconnected consciousness” suggested by the “breakthrough” DMT state. Its increasing usage and clinical trial indicate the growing importance of a thorough elucidation of the experience's qualitative content, over and above the phenomenological structure. This is particularly in light of the intensely pervasive effects of DMT occasions in all dimensions of the self, which are often ontologically challenging yet potentially transformative.MethodsThis is the second report on the first naturalistic field study of DMT use exploring its qualitative analysis. Screened, healthy, anonymized, and experienced DMT users were observed during their non-clinical use of the drug at home (40–75-mg inhaled). In-depth semi-structured interviews, inspired by the micro-phenomenological technique, were employed immediately after their experience. This study reports on the thematic and content analysis of one major domain of the breakthrough experiences elicited, the “self”; where analyses of the “other” were previously reported. A total of 36 post-DMT experience interviews with mostly Caucasian (83%) men (eight women) of a mean of 37 years were predominantly inductively coded.ResultsInvariably, profound and highly intense experiences occurred. The first overarching category comprised the onset of effects, encompassing super-ordinate themes including sensory, emotion and body, and space-time shifts; the second category comprised bodily effects, encompassing themes including pleasurable, neutral/both, and uncomfortable; the third category comprised the sensorial effects, encompassing open-eye, visual, and cross-modal and other; the fourth comprised the psychological effects, encompassing memory and language, awareness and sense of self, and time distortions; and the fifth comprised the emotional effects, encompassing positive, neither/both, and challenging experiences. Many further subthemes also illuminate the rich content of the DMT experience.DiscussionThe present study provides a systematic and nuanced analysis of the content of the breakthrough DMT state pertaining to one's personal and self-referential experiences of the body, senses, psychology, and emotions. The resonances both with previous DMT studies and other types of extraordinary experiences, such as the alien abduction, shamanic and near-death experiences, are also elaborated upon. Putative neural mechanisms and their promise as a psychotherapeutic agent, especially owing to deep emotional impact, are discussed.
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Affiliation(s)
- Pascal Michael
- Centre for Mental Health, School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
| | - David Luke
- Centre for Mental Health, School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
- Department of Brain Sciences, Faculty of Medicine, Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Oliver Robinson
- Centre for Mental Health, School of Human Sciences, Old Royal Naval College, University of Greenwich, London, United Kingdom
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Kawakami A, Suzuki M. Ayahuasca in Western society and the metacognitive counselling approach. COUNSELLING & PSYCHOTHERAPY RESEARCH 2023. [DOI: 10.1002/capr.12628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Atsuko Kawakami
- Division of Sociology, School of Behavioral Sciences Tarleton State University Stephenville Texas USA
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Ponomarenko P, Seragnoli F, Calder A, Oehen P, Hasler G. Can psychedelics enhance group psychotherapy? A discussion on the therapeutic factors. J Psychopharmacol 2023:2698811231155117. [PMID: 36855289 DOI: 10.1177/02698811231155117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
BACKGROUND Despite the growth of psychedelic research, psychedelic-assisted group psychotherapy (PAGP) has received little attention in comparison to individual psychedelic-assisted psychotherapy models. METHODS In this article, we aim to discuss the therapeutic potential of PAGP, as well as outline existing models and the challenges of this approach. Using Irvin Yalom's 11 therapeutic factors of group therapy as a basic framework, we analyse current literature from clinical studies and neurobiological research relative to the topic of PAGP. RESULTS We argue that combining psychedelic substances and group psychotherapy may prove beneficial for increasing group connectedness and interpersonal learning, potentially enhancing prosocial behaviour with direct opportunities to practice newly acquired knowledge about previously maladaptive behavioural patterns. Challenges regarding this approach include a more rigid therapy structure and potential loss of openness from patients, which may be ameliorated by adequate therapeutic training. CONCLUSION We hope for this article to support clinical research on PAGP by presenting a therapeutic framework and outlining its mechanisms and challenges.
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Affiliation(s)
| | | | - Abigail Calder
- Department of Medicine, University of Freiburg, Villars-sur-Glâne, Switzerland
| | - Peter Oehen
- Private Practice for Psychiatry and Psychotherapy, Biberist, Switzerland
| | - Gregor Hasler
- Department of Medicine, University of Freiburg, Villars-sur-Glâne, Switzerland
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George DR, Hanson R, Wilkinson D, Garcia-Romeu A. Ancient Roots of Today's Emerging Renaissance in Psychedelic Medicine. Cult Med Psychiatry 2022; 46:890-903. [PMID: 34476719 PMCID: PMC8412860 DOI: 10.1007/s11013-021-09749-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 01/30/2023]
Abstract
An international ban on psychedelics initiated by the United Nations' Convention on Psychotropic Substances in 1971 restricted the clinical use of these ancient psychoactive substances. Yet, in an era marked by rising mental health concerns and a growing "Deaths of Despair" epidemic (i.e., excess mortality and morbidity from suicide, drug overdose, and alcoholism), the structured psychedelic use that has long been a part of ritual healing experiences for human societies is slowly regaining credibility in Western medicine for its potential to treat various mental health conditions. We use a historical lens to examine the use of psychedelic therapies over time, translate ancient lessons to contemporary clinical and research practice, and interrogate the practical and ethical questions researchers must grapple with before they can enter mainstream medicine. Given the COVID-19 pandemic and its contributions to the global mental health burden, we also reflect on how psychedelic therapy might serve as a tool for medicine in the aftermath of collective trauma. Ultimately, it is argued that a "psychedelic renaissance" anchored in the lessons of antiquity can potentially help shift healthcare systems-and perhaps the broader society-towards practices that are more humane, attentive to underlying causes of distress, and supportive of human flourishing.
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Affiliation(s)
- Daniel R George
- Department of Humanities, Penn State Milton S Hershey Medical Center, Penn State College of Medicine, Hershey, PA, 17033, USA.
| | - Ryan Hanson
- Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Albert Garcia-Romeu
- Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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14
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Tvorun-Dunn M. Acid liberalism: Silicon Valley's enlightened technocrats, and the legalization of psychedelics. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2022; 110:103890. [PMID: 36279734 DOI: 10.1016/j.drugpo.2022.103890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 12/12/2022]
Abstract
The history of psychedelia within the New Left counterculture often implies a cultural alignment between psychedelics and progressive values or the promise of radical communitarian social reform. In contrast to these potentials, this paper examines Silicon Valley's engagement with psychedelics, a community which has demonstrated considerable financial and personal interests in these drugs despite promoting and advancing consistently neoliberal ends. This article studies Silicon Valley's culture of psychedelic drug use through extensive analysis of published interviews by tech industrialists, news reports, and recent studies on the tech industry's proliferation of mystical and utopian rhetoric. This work finds that psychedelics and their associated practices are given unconventional mystical meanings by some high-profile tech entrepreneurs, and that these meanings are integrated into belief systems and philosophies which are explicitly anti-democratic, individualist, and essentialist. It is argued that these mystical ideas are supported by a venture capital community which profits from the expression of disruptive utopian beliefs. These beliefs, when held by the extremely wealthy, have effects on legalization policy and the ways which psychedelics are commercialized within a legal marketplace. As Silicon Valley has put considerable resources into funding research and advocacy for psychedelics, I argue that the legalization of psychedelics will likely be operationalized to generate a near-monopoly on the market and promote further inequality in the United States that is reflective of both neoliberalism, and the essentialist beliefs of Silicon Valley functionaries.
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Affiliation(s)
- Maxim Tvorun-Dunn
- University of Tokyo, Department of Interdisciplinary Cultural Studies, Tokyo, Japan.
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15
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Hartogsohn I. Modalities of the psychedelic experience: Microclimates of set and setting in hallucinogen research and culture. Transcult Psychiatry 2022; 59:579-591. [PMID: 35818775 DOI: 10.1177/13634615221100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mid-20th-century American research on psychedelics evinced a stunning diversity of interpretations of hallucinogenic effects. While some researchers viewed psychedelics as invaluable tools for psychotherapy, others persisted in treating them as psychosis-inducing agents. As some groups considered psychedelics as catalysts for artistic creativity, others investigated their potential use as psychochemical weapons in the battlefield, or conversely as tools for spiritual ecstasy and revelation. This bewildering array of perceptions regarding the nature of hallucinogenic effects led to stark contrasts in the contexts (set and setting) of psychedelic research and experimentation, leading to wildly divergent outcomes and reports on the effects of the drugs, and strident disagreements between the actors in the field. Examining this remarkable historical moment of epistemological unclarity regarding psychedelics and their effects, this article describes how distinct scientific and cultural trends and moments of mid-20th-century America contributed to the creation of diverse microclimates of set and setting that reproduced investigator beliefs and attitudes and brought about a beguiling Pygmalion effect that left researchers befuddled and perplexed. I propose the concept of psychedelic modality to describe how distinct sociocultural microclimates lead to thematic aggregates in which distinct types of expectations, intentions as well as physical, social, and cultural environments all tend to cluster, producing characteristic outcomes and results. By exploring the historical context and consequences of the emergence of seven psychedelic modalities (psychotomimetic, military, psychotherapeutic, spiritual, artistic-creative, tech-innovative, and political) in mid-20th-century America, this article outlines the varieties of psychedelic experiences in their relationship with culture at large, and subcultures in particular.
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Affiliation(s)
- Ido Hartogsohn
- Program in Science, Technology and Society, Bar Ilan University, Ramat Gan, Israel
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16
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Roseman L, Preller KH, Fotiou E, Winkelman MJ. Editorial: Psychedelic sociality: Pharmacological and extrapharmacological perspectives. Front Pharmacol 2022; 13:979764. [PMID: 35935854 PMCID: PMC9355415 DOI: 10.3389/fphar.2022.979764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Leor Roseman
- Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London, United Kingdom
- *Correspondence: Leor Roseman,
| | - Katrin H. Preller
- Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich, Switzerland
| | | | - Michael J. Winkelman
- Retired, School of Human Evolution and Social Change, Arizona State University, Tempe, AZ, United States
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17
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James E, Keppler J, L Robertshaw T, Sessa B. N,N-dimethyltryptamine and Amazonian ayahuasca plant medicine. Hum Psychopharmacol 2022; 37:e2835. [PMID: 35175662 PMCID: PMC9286861 DOI: 10.1002/hup.2835] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/13/2022] [Accepted: 01/26/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Reports have indicated possible uses of ayahuasca for the treatment of conditions including depression, addictions, post-traumatic stress disorder, anxiety and specific psychoneuroendocrine immune system pathologies. The article assesses potential ayahuasca and N,N-dimethyltryptamine (DMT) integration with contemporary healthcare. The review also seeks to provide a summary of selected literature regarding the mechanisms of action of DMT and ayahuasca; and assess to what extent the state of research can explain reports of unusual phenomenology. DESIGN A narrative review. RESULTS Compounds in ayahuasca have been found to bind to serotonergic receptors, glutaminergic receptors, sigma-1 receptors, trace amine-associated receptors, and modulate BDNF expression and the dopaminergic system. Subjective effects are associated with increased delta and theta oscillations in amygdala and hippocampal regions, decreased alpha wave activity in the default mode network, and stimulations of vision-related brain regions particularly in the visual association cortex. Both biological processes and field of consciousness models have been proposed to explain subjective effects of DMT and ayahuasca, however, the evidence supporting the proposed models is not sufficient to make confident conclusions. Ayahuasca plant medicine and DMT represent potentially novel treatment modalities. CONCLUSIONS Further research is required to clarify the mechanisms of action and develop treatments which can be made available to the general public. Integration between healthcare research institutions and reputable practitioners in the Amazon is recommended.
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Affiliation(s)
- Edward James
- School of Pharmacy and Pharmaceutical SciencesCardiff UniversityCardiffUK
| | | | | | - Ben Sessa
- Centre for NeuropsychopharmacologyDivision of Brain SciencesFaculty of MedicineImperial College LondonLondonUK
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18
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Golden TL, Magsamen S, Sandu CC, Lin S, Roebuck GM, Shi KM, Barrett FS. Effects of Setting on Psychedelic Experiences, Therapies, and Outcomes: A Rapid Scoping Review of the Literature. Curr Top Behav Neurosci 2022; 56:35-70. [PMID: 35138585 DOI: 10.1007/7854_2021_298] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The health and well-being impacts of art and aesthetic experiences have been rigorously studied by a range of disciplines, including cognitive neuroscience, psychiatry, public health, and translational clinical research. These experiences, encompassed in the concepts of set and setting, have long been claimed to be pivotal in determining the acute and enduring effects of psychedelic experiences. Responding to the field's longstanding emphasis on the role and value of setting, a rapid scoping review was undertaken to identify the extent to which effects of setting and aesthetics on psychedelic experiences and therapies have been explicitly studied. It offers an analysis of the strengths and limitations of the extant literature and discusses evidentiary gaps as well as evidentiary opportunities for the field. The 43 included studies indicate apparent consensus regarding the importance of setting in psychedelic therapies, as well as consistent interest in theorizing about these effects. However, this consensus has yet to generate consistent, prospective, rigorous tests of setting and its complexities. As a result, the field continues to lack understanding or agreement regarding the effects of various specific elements of setting, the mechanisms by which they affect outcomes, for whom these effects occur, under what circumstances, given what conditions, and other critical factors. Further studies of setting and aesthetics in the context of psychedelic therapies are likely to not only improve these therapies and their delivery, but also inform considerations of setting and aesthetics for non-psychedelic interventions.
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Affiliation(s)
- Tasha L Golden
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Susan Magsamen
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clara C Sandu
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shuyang Lin
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Grace Marie Roebuck
- International Arts + Mind Lab, Center for Applied Neuroaesthetics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kathy M Shi
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Frederick S Barrett
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Kelly JR, Gillan CM, Prenderville J, Kelly C, Harkin A, Clarke G, O'Keane V. Psychedelic Therapy's Transdiagnostic Effects: A Research Domain Criteria (RDoC) Perspective. Front Psychiatry 2021; 12:800072. [PMID: 34975593 PMCID: PMC8718877 DOI: 10.3389/fpsyt.2021.800072] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
Accumulating clinical evidence shows that psychedelic therapy, by synergistically combining psychopharmacology and psychological support, offers a promising transdiagnostic treatment strategy for a range of disorders with restricted and/or maladaptive habitual patterns of emotion, cognition and behavior, notably, depression (MDD), treatment resistant depression (TRD) and addiction disorders, but perhaps also anxiety disorders, obsessive-compulsive disorder (OCD), Post-Traumatic Stress Disorder (PTSD) and eating disorders. Despite the emergent transdiagnostic evidence, the specific clinical dimensions that psychedelics are efficacious for, and associated underlying neurobiological pathways, remain to be well-characterized. To this end, this review focuses on pre-clinical and clinical evidence of the acute and sustained therapeutic potential of psychedelic therapy in the context of a transdiagnostic dimensional systems framework. Focusing on the Research Domain Criteria (RDoC) as a template, we will describe the multimodal mechanisms underlying the transdiagnostic therapeutic effects of psychedelic therapy, traversing molecular, cellular and network levels. These levels will be mapped to the RDoC constructs of negative and positive valence systems, arousal regulation, social processing, cognitive and sensorimotor systems. In summarizing this literature and framing it transdiagnostically, we hope we can assist the field in moving toward a mechanistic understanding of how psychedelics work for patients and eventually toward a precise-personalized psychedelic therapy paradigm.
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Affiliation(s)
- John R. Kelly
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Department of Psychiatry, Tallaght University Hospital, Dublin, Ireland
| | - Claire M. Gillan
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- School of Psychology, Trinity College, Dublin, Ireland
- Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Jack Prenderville
- Transpharmation Ireland Ltd, Institute of Neuroscience, Trinity College, Dublin, Ireland
- Discipline of Physiology, School of Medicine, Trinity College, Dublin, Ireland
| | - Clare Kelly
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- School of Psychology, Trinity College, Dublin, Ireland
| | - Andrew Harkin
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Gerard Clarke
- Department of Psychiatry and Neurobehavioral Science, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Veronica O'Keane
- Department of Psychiatry, Trinity College, Dublin, Ireland
- Department of Psychiatry, Tallaght University Hospital, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland
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20
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Roseman L, Karkabi N. On Revelations and Revolutions: Drinking Ayahuasca Among Palestinians Under Israeli Occupation. Front Psychol 2021; 12:718934. [PMID: 34512477 PMCID: PMC8429789 DOI: 10.3389/fpsyg.2021.718934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 08/02/2021] [Indexed: 11/21/2022] Open
Abstract
The ritualistic use of ayahuasca can induce a feeling of unity and harmony among group members. However, such depoliticized feelings can come in the service of a destructive political status quo in which Palestinians are marginalized. Through 31 in-depth interviews of Israelis and Palestinians who drink ayahuasca together, and through participatory observations, such rituals were examined. In this setting marginalization was structurally rooted by the group's inability to recognize Palestinian national identity or admit the ongoing Israeli injustice toward Palestinians. Although the groups avoided politics, they still find their way into these rituals. This happened through occasional ayahuasca-induced revelatory events, in which individuals were confronted with a pressing truth related to the oppressive relations between Jewish Israelis and Palestinians. Three case studies of such revelatory events are described in this paper. Affected by emotions of pain, anger, and guilt, these participants developed resistance toward the hegemonic Israeli ritual structure. This was followed by an urge to deliver an emancipatory message to the rest of the group, usually through a song. Moreover, affected subjects developed a long-lasting fidelity to the truth attained at these events. In time, this fidelity led to the expansion of ayahuasca practices to other Palestinians and the politicization of the practice. The article draws on Badiou's theory in Being and Event (1988) to analyze the relations between the Israeli ritual structure, the Palestinian revelatory event, and the emancipatory fidelity that followed. Badiou's theory elucidates the egalitarian revolutionary potential, which is part of the sociopsychopharmacology of psychedelics.
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Affiliation(s)
- Leor Roseman
- Centre for Psychedelic Research, Imperial College London, London, United Kingdom
| | - Nadeem Karkabi
- Department of Anthropology, University of Haifa, Haifa, Israel
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21
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Kettner H, Rosas FE, Timmermann C, Kärtner L, Carhart-Harris RL, Roseman L. Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness. Front Pharmacol 2021; 12:623985. [PMID: 33995022 PMCID: PMC8114773 DOI: 10.3389/fphar.2021.623985] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/26/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Recent years have seen a resurgence of research on the potential of psychedelic substances to treat addictive and mood disorders. Historically and contemporarily, psychedelic studies have emphasized the importance of contextual elements ('set and setting') in modulating acute drug effects, and ultimately, influencing long-term outcomes. Nevertheless, current small-scale clinical and laboratory studies have tended to bypass a ubiquitous contextual feature of naturalistic psychedelic use: its social dimension. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats. Methods: In this observational, web-based survey study, participants (N = 886) were measured across five successive time-points: 2 weeks before, hours before, and the day after a psychedelic ceremony; as well as the day after, and 4 weeks after leaving the ceremony location. Demographics, psychological traits and state variables were assessed pre-ceremony, in addition to changes in psychological wellbeing and social connectedness from before to after the retreat, as primary outcomes. Using correlational and multiple regression (path) analyses, predictive relationships between psychosocial 'set and setting' variables, communitas, and long-term outcomes were explored. Results: The adapted Communitas Scale demonstrated substantial internal consistency (Cronbach's alpha = 0.92) and construct validity in comparison with validated measures of intra-subjective (visual, mystical, challenging experiences questionnaires) and inter-subjective (perceived emotional synchrony, identity fusion) experiences. Furthermore, communitas during ceremony was significantly correlated with increases in psychological wellbeing (r = 0.22), social connectedness (r = 0.25), and other salient mental health outcomes. Path analyses revealed that the effect of ceremony-communitas on long-term outcomes was fully mediated by communitas experienced in reference to the retreat overall, and that the extent of personal sharing or 'self-disclosure' contributed to this process. A positive relationship between participants and facilitators, and the perceived impact of emotional support, facilitated the emergence of communitas. Conclusion: Highlighting the importance of intersubjective experience, rapport, and emotional support for long-term outcomes of psychedelic use, this first quantitative examination of psychosocial factors in guided psychedelic settings is a significant step toward evidence-based benefit-maximization guidelines for collective psychedelic use.
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Affiliation(s)
- H. Kettner
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - F. E. Rosas
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
- Data Science Institute, Imperial College London, London, United Kingdom
- Centre for Complexity Science, Imperial College London, London, United Kingdom
| | - C. Timmermann
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - L. Kärtner
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - R. L. Carhart-Harris
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - L. Roseman
- Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom
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