Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat

This placebo-controlled, double-blind study (n=39) assessed the impact of psilocybin (22mg/70kg) on the outcomes of a mindfulness group retreat. The authors found that psilocybin increased meditation depth and incidence of positively experienced self-dissolution without accompanying anxiety.

Abstract

“Meditation and psychedelics have played key roles in humankind’s search for self-transcendence and personal change. However, neither their possible synergistic effects, nor related state and trait predictors have been experimentally studied. To elucidate these issues, we administered double-blind the model psychedelic drug psilocybin (315 μg/kg PO) or placebo to meditators (n = 39) during a 5-day mindfulness group retreat. Psilocybin increased meditation depth and incidence of positively experienced self-dissolution along the perception-hallucination continuum, without concomitant anxiety. Openness, optimism, and emotional reappraisal were predictors of the acute response. Compared with placebo, psilocybin enhanced post-intervention mindfulness and produced larger positive changes in psychosocial functioning at a 4-month follow-up, which were corroborated by external ratings, and associated with magnitude of acute self-dissolution experience. Meditation seems to enhance psilocybin’s positive effects while counteracting possible dysphoric responses. These findings highlight the interactions between non-pharmacological and pharmacological factors, and the role of emotion/attention regulation in shaping the experiential quality of psychedelic states, as well as the experience of selflessness as a modulator of behavior and attitudes. A better comprehension of mechanisms underlying most beneficial psychedelic experiences may guide therapeutic interventions across numerous mental conditions in the form of psychedelic-assisted applications.“

Authors: Lukasz Smigielski, Michael Kometer, Milan Scheidegger, Rainer Krähenmann, Theo Huber & Franz X. Vollenweider

Critique of Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat

Critique graciously provided by Lila of the Psychedelic Science Collective Rotterdam. These constructive critiques aim to provide more context to the research articles.

A main limitation of this study is that it is subject to the methodological challenge in psychedelic research of maintaining proper blinding procedures. The study used an inactive placebo; hence subjects presumably recognized the condition they were in, which may, in turn, influence study outcomes. 

According to the researchers, the subjects presumed their usual meditation practice after administering either psilocybin or placebo in complete silence. However, in the footage of the study in “Descending the Mountain” (2021), several subjects started exclaiming, laughing, and talking in response to their experience, or received verbal guidance from facilitators present at the scene. This detail is important to note as these disruptions could have influenced the quality of meditation for those who received the inert placebo, further creating a discrepancy between the data of the control and treatment groups. 

The study uses several different scales and questionnaires. For instance, to assess self-dissolution (as a potential factor for positive outcomes), it uses the Consciousness Rating Scale (5D-ASC), and the Mysticism Scale (M-scale). The 5D-ASC contains scales such as “Oceanic Boundlessness” or “Anxious Ego Dissolution” measured via multiple items on a questionnaire. The M-scale measures eight facets of mystical-type experiences, such as ego loss, time and spacelessness, and ineffability. Here it is important to note that these scales, however useful, may not accurately represent the actual experience, as interpretations tend to be immensely subjective. Further, the possibility of language suggestibility is important to note. Would the subjects still answer in the same ways using open-ended questions?

The researchers further explored answers on the M-scale subscales, which indicated that the mystical-type experience in both placebo and psilocybin groups were very similar. Based on this finding, they concluded to have found the first experimental evidence that meditation and psilocybin can occasion “phenomenologically overlapping mystical-type experiences”. Considering the aforementioned point of language suggestibility in questionnaires, this must also be seen critically. Neuroimaging research showing similarities in brain activity in individuals that received psilocybin or are meditating would be more compelling evidence to make this statement. However, even then, a similarity in brain activity or questionnaire outcomes can’t conclusively equate to the subjective experience. The question of whether meditation and psilocybin occasion comparable states of consciousness surely remains open.

Lastly, it must be addressed that the results of this study can’t be generalized to the general population. The group, consisting entirely of expert meditators, is undoubtedly highly unique. This is an important aspect when discussing the positive outcomes and limited adverse effects (such as anxiety) experienced by the psilocybin group. These observations can likely be attributed to the group’s advanced mindfulness-based skills. At last, this observation may highlight the positive relationship between mindfulness and one’s ability to weather the storm of a psychedelic state.

In summary, this study reflects the current methodological challenge of finding proper blinding procedures in psychedelic research. Further, using data solely based on questionnaires must be seen critically in its capacity to make conclusive statements, and accurately reflect subjective experiences. Lastly, the presence of prior traits and skills in study groups must be extensively considered to understand the factors that contribute to the safety and positive outcomes of a psychedelic experience. 

Summary of Characterization and prediction of acute and sustained response to psychedelic psilocybin in a mindfulness group retreat