Naturalistic use of psychedelics is related to emotional reactivity and self-consciousness: The mediating role of ego-dissolution and mystical experiences

This survey (n=1,661) found that a higher number of lifetime uses of psychedelics predicted greater positive and lower negative emotional reactivity while measures of self-consciousness predicted greater reflection and internal state awareness, reduced rumination tendency and public self-consciousness. The intensity of past mystical and ego-dissolution experiences mediated almost all the observed relationships between the lifetime number of psychedelic uses and psychological variables.

Abstract

“Background: Psychedelics are able to acutely alter emotional reactivity and self-consciousness. However, whether the regular naturalistic use of psychedelics can be linked to more persistent trait-level changes in these domains remains an open question.

Aim: To test the hypotheses that (1) using psychedelics is related to higher positive and lower negative emotional reactivity; (2) an adaptive pattern of self-consciousness, including diminished public self-consciousness and rumination, and increased reflection and self-awareness; and (3) these relations are mediated by the intensity of past ego-dissolution and mystical experiences.

Method: An online survey including questions about the history of psychoactive substance use; questionnaires measuring trait levels of emotional reactivity and self-consciousness; questionnaires for retrospective assessment of ego-dissolution and mystical experiences. Data collected from 2516 participants (1661 psychedelics users) were analyzed using robust linear regression and mediation analysis.

Results: A higher number of lifetime uses of psychedelics predicted greater positive and lower negative emotional reactivity; also, in the domain of self-consciousness, it predicted greater reflection and internal state awareness and reduced rumination tendency and public self-consciousness. Finally, the intensity of past mystical and ego-dissolution experiences mediated almost all the observed relationships between the lifetime number of psychedelic uses and psychological variables.

Conclusions: Lifetime psychedelics use predicts an adaptive pattern of trait-level emotional reactivity and self-consciousness. Ego-dissolution and mystical experiences are essential in understanding the long-lasting psychological effects of psychedelics use. Our findings might potentially explain previous observations of increased well-being in psychedelics users.”

Authors: Paweł Orłowski, Anastasia Ruban, Jan Szczypiński, Justyna Hobot, Maksymillian Bielecki & Michal Bola

Summary

Introduction

Psychedelics are psychoactive substances able to profoundly change the state of consciousness. Several studies have shown that psychedelics can have long-term effects on psychological functioning, including increases in well-being and quality of life, as well as reduced symptoms of depression and anxiety.

Psychedelics use is associated with increased positive and lower negative emotional reactivity, increased reflection and internal state awareness, and diminished public self-consciousness and rumination, and increased reflection and self-awareness. The intensity of past ego-dissolution and mystical experiences mediates the relationship between lifetime psychedelics use and psychological variables.

In cross-sectional studies, psychedelics users reported lower distress and suicidal tendencies, and exhibited higher scores on scales of spirituality and empathy compared to non-users. However, in naturalistic settings, psychedelics use might also be related to a higher occurrence of frightening and unpleasant experiences.

This study aimed to investigate the psychological effects associated with regular, naturalistic use of psychedelics, with a specific focus on the domains of emotional reactivity and self-consciousness.

Psychedelics are able to acutely alter self-consciousness, resulting in a sense of unity with the world and other people, and disintegration of a coherent concept of “self”. More frequent use of psychedelics is associated with decreased public self-consciousness, decreased rumination, and increased reflective thinking.

The intensity of past mystical and ego-dissolution experiences caused by psychedelics predicted long-term psychological outcomes in single-dose studies.

Data collection

A Polish-language online survey was created in the LimeSurvey open-source software and distributed online via the social media profiles of Polish research institutions and associations committed to education concerning use of psychoactive substances and harm reduction.

We collected data regarding psychedelics use and intended use. The total reported number of uses was 34,186 (LSD, psilocybin mushrooms, synthetic psilocybin, DMT, changa, ayahuasca, mescaline, and derivatives of classic psychedelics).

Participants reported using 1,133,866 different psychoactive substances in their lifetime (cannabis, empathogens, dissociatives, stimulants, synthetic cannabinoids, benzodiazepines, and opioids were the most commonly used substances).

The Alcohol Use Disorder Identification Test (AUDIT) questionnaire was used to screen for alcohol use disorder. It consisted of three items and was answered on a 5-point ordinal scale.

The Perth Emotional Reactivity Scale – Short Form (PERSS) measures the ease of activation, intensity, and duration of one’s emotional responses for positive and negative emotions separately.

The Self-Consciousness Scale (SCS) measures three distinct psychological components of self-consciousness: public, private, and social anxiety. Private self-consciousness has two dimensions: internal state awareness and self-reflectiveness.

The Polish adaptation of SCS did not distinguish between internal state awareness and self-reflectiveness, so we performed an exploratory factor analysis to recreate the four-factor structure.

A self-report scale called the Ego-Dissolution Questionnaire (EDI) was used to measure the intensity of previous ego-dissolution experiences induced by psychedelics.

Hood’s Mysticism Scale (HMS): This scale allows the assessment of mystical experience qualities, such as feelings of unity, bliss, and ego-dissolution.

Data analysis

Inclusion and exclusion criteria. Data were collected from 2561 participants, and 712 participants were excluded for various reasons, including incorrectly answering attention-check questions, careless responding, having a diagnosis of substance dependence, and little or no variation while responding to SCS, RRQ, or PERS-S.

This study used a four-level categorical factor to predict psychological indicators. The factor was created by summing the reported number of lifetime administrations of all classes of psychedelic substances and dividing all psychedelics users into tertiles.

The data concerning the use of other psychoactive substances, alcohol use, and meditation hours were transformed in the same manner, and the age and education level of the participants were converted into 4-level categorical factors.

We used robust linear regression to examine the relationships between factored lifetime psychedelic use and psychological variables, controlling for age, sex, education, lifetime meditation hours, measures of lifetime use of psychoactive substances, and frequency of alcohol use.

We performed a mediation analysis using the Python PyProcessMacro package and statsmodels to examine the relations between factored lifetime psychedelics use and the psychological variables. We used three levels of factored lifetime psychedelics use and performed a separate mediation analysis for each level.

Robust linear regression

Lifetime psychedelics use, male sex, lifetime meditation hours and empathogen use were associated with less negative emotional reactivity, while lifetime benzodiazepine, opioid and alcohol use were associated with more negative emotional reactivity.

Lifetime psychedelics use, lifetime meditation hours, lifetime cannabis use, and lifetime empathogen use were associated with higher positive emotional reactivity, while male sex and lifetime opioid use were associated with lower positive emotional reactivity.

Lifetime psychedelics use, age, meditation hours, and cannabis use were associated with lower public self-consciousness, while education and alcohol use were associated with increased public self-consciousness.

Social anxiety was not significantly associated with lifetime psychedelics use, but male sex, lifetime meditation hours, and lifetime empathogen use were.

Higher internal state awareness was associated with lifetime psychedelics use, education, lifetime meditation hours, and benzodiazepine use, while male sex, age, and alcohol use were associated with lower internal state awareness.

Lifetime psychedelics use was not a significant predictor of self-reflectiveness. Male sex, age, education and lifetime meditation hours were associated with higher self-reflectiveness.

Rumination was associated with lifetime psychedelics use, male sex, age, education, lifetime meditation hours, and empathogen use, while lifetime benzodiazepine use and alcohol use were associated with higher rumination.

Higher reflection was associated with lifetime psychedelics use, education, and meditation hours, while lower reflection was associated with age, lifetime stimulant use, and alcohol use.

Lifetime psychedelics use, lifetime meditation hours, lifetime opioid use, lifetime alcohol use, and age were associated with reports of higher ego-dissolution, but neither of the revealed relationships were monotonic.

Lifetime psychedelics use, lifetime meditation hours, and male sex were all associated with more pronounced mystical experience, but cannabis use was also significant but non-monotonic.

Mediation analysis

The number of lifetime psychedelics uses was associated with increased internal state awareness, reflection and positive reactivity, and decreased public self, rumination, and negative reactivity. This effect was mediated by ego-dissolution.

In addition to psychedelics use, meditation practice predicted the investigated psychological variables in a similar manner. The effects of meditation attenuated the size of the significant indirect effects of psychedelics, but did not undermine the postulated role of psychedelics use.

Discussion

Using psychedelics in naturalistic settings can cause lasting psychological effects, such as a shift toward a more panpsychism-based worldview and a better self-assessed state of one’s own mental health.

Use of psychedelics predicts emotional reactivity and self-consciousness

Our study found that psychedelic users have greater positive and lower negative trait-level emotional reactivity. This finding can be interpreted in relation to experimental studies that found healthy participants to be less reactive to stimuli with negative valence, but more reactive to positive ones during a psychedelic state.

We investigated different aspects of self-consciousness at the individual-differences trait-like level, and found that using psychedelics is associated with diminished projected self-consciousness, which might be related to the previously reported increased self-directedness in psychedelics users. We found that psychedelics use is associated with increased internal state awareness, decreased rumination, and increased reflection. These results can be linked to previous research on the effects of psychedelics on personality traits. Franquesa et al. (2018) found that regular ayahuasca users have higher decentering scores than non-users, but did not find differences in public control of the self, while we found that users of psychedelics score lower on the public-self subscale of SCS.

In our study, psychedelics users showed a trait-level emotional “positivity-bias”, which might potentially contribute to greater well-being. This finding is in line with previous studies, which have shown that using psychedelics in a naturalistic context is associated with higher self-assessed well-being and quality of life. These conclusions are based on self-report studies, which might not provide a complete picture of the effects of naturalistic psychedelics use.

Indirect effect of subjective aspects of psychedelic experiences

A cross-sectional study found that acute subjective effects are important for observing lasting psychological changes induced by psychedelics. The intensity of acute psilocybin-induced mystical experiences predicted positive long-term clinical outcomes in patients with depression and in healthy volunteers.

The likelihood of having a mystical experience increases according to substance dose, and the effect of a mystical experience and the effect of substance dose are hardly separable. Furthermore, other subjective aspects of the psychedelic experience such as awe and emotional breakthrough are also hypothesized to mediate the positive effects.

Interpretation of cross-sectional findings

Our findings are in line with previous research, including single-dose experiments, but the cause-effect relation cannot be inferred. Nevertheless, the relation between psychedelics use and psychological variables is monotonic and increases with frequency of use, so it seems unlikely that mere predisposition to try psychedelics drove the observed effects. Third, collecting data about the use of other psychoactive substances allowed us to demonstrate that psychedelics exhibited a pattern of associations that was distinct from the other groups of investigated substances.

The study has several limitations, such as self-selection biases and expectancy effects, and the presence of an indirect effect in mediation analysis does not provide information about the direction of the relationships among subjective ego-dissolution, mystical experiences, and psychological variables.

Conclusion

We found that regular psychedelic use was related to positive emotional reactivity and an adaptive pattern of self-consciousness. These effects were mediated by the mystical- and ego-dissolution-related aspects of psychedelic experiences.