This review (2015) looks at the influence of subjective (therapeutic) effects on the (treatment) outcomes of psychedelic experiences. This is put in context of the neuronal mechanism of psychedelics, but that relationship is still something that we know little about.
Abstract
“Interest in the therapeutic potential of psychedelic substances has recently resumed. During an early phase of human psychedelic research, their therapeutic application in different pathologies had been suggested, and the first evidence for efficacy was provided. The range of recent clinical applications of psychedelics spans from cluster headaches and obsessive-compulsive disorder to addiction and the treatment of fear and anxiety in patients suffering from terminal illness, indicating potentially different therapeutic mechanisms. A variety of approaches in psychotherapy emphasize subjective experiences, such as so-called peak experiences or afterglow phenomena, as differentially mediating therapeutic action. This review aims to re-evaluate earlier and recent concepts of how psychedelic substances may exert beneficial effects. After a short outline of neurophenomenological aspects, we discuss different approaches to how psychedelics are used in psychotherapy. Finally, we summarize evidence for the relationship between subjective experiences and therapeutic success. While the distinction between pharmacological and psychological action obviously cannot be clear-cut, they do appear to contribute differently from each other when their effects are compared with regard to pathologies.”
Authors: Tomislav Majić, Timo T Schmidt & Jürgen Gallinat
Notes
This paper is included in our ‘Top 10 Articles for Psychedelic Novices‘
Summary
PEAK EXPERIENCES OF PSILOCYBIN USERS AND NON-USERS
Peak experiences are defined as the most wonderful experiences of a person’s life and may include sensory-aesthetic experiences to heightened spiritual understanding. Psilocybin, a naturally occurring alkaloid compound found in some species of mushrooms, may produce exceptional experiences that may have lasting effects on attitudes and behavior.
Psilocybin induces a state of transcendence by interacting with the specific serotonin receptor 5-HT2A. This interaction increases activation of the prefrontal cortex and produces visual hallucinations.
Regardless of the mechanism, recent studies have shown that psilocybin users exhibit a heightened sense of spirituality and transcendence compared to non-psilocybin users. The effects of psilocybin have been shown to persist for 14 months after the experience.
Experimental research has not investigated whether recreational psilocybin users in naturalistic settings subjectively report their drug-related experiences to be personally meaningful or spiritually significant.
Individuals who use psilocybin may have different values, beliefs, and empathy from those who do not. This may be because hallucinogen use induces certain mystical beliefs or because hallucinogen users are predisposed to such beliefs.
A double-blind, placebo-controlled study by Hasler et al. (2004) evaluated the effects of various doses of psilocybin on eight volunteers. The majority of participants reported an overall “pleasurable” and “magic” experience.
This study investigated the peak experiences reported by three groups: participants who reported a peak experience while under the influence of psilocybin, participants who reported a peak experience while under the influence of psilocybin but did not occur while they were under the influence of psilocybin, and participants who had never used psilocybin.
Participants
Participants were recruited at a musical event that many psilocybin users attend. They were given flyers soliciting participation and were asked to complete a questionnaire.
Instruments
A two-part questionnaire was used to gather data. Participants were asked to report their age, gender, religion, and race, and if they had ever used psilocybin.
The APZ is a 72-item questionnaire that assesses four factors of altered states of consciousness: oceanic boundlessness (OB), dread of ego dissolution (DED), visionary restructuralization (VR), and global scale assessing overall alteration of consciousness (ASC).
Procedure
A questionnaire was administered to all participants, and they were instructed to think about a peak experience. The questionnaire asked how they recalled feeling during their peak experience.
The timing of participant’s peak experience was also asked, as well as whether they were under the influence of any other drugs.
Descriptive Statistics
101 participants were recruited from the undergraduate sample and the music festival, and were 82% Caucasian, 7% African American, 6% Hispanic, 3% Asian, and 2% Other. Sixty-six percent reported they had never used psilocybin, whereas 34% reported they had.
Psilocybin users were more likely to be male than non-users, and the results are reported for the full sample.
MANOVA
Post-hoc tests indicated that the PPE and NPPE groups reported more oceanic boundlessness than the NU group, but did not differ significantly. The PPE group reported more total alteration in consciousness than the other two groups.
DISCUSSION
The majority of psilocybin users reported that their peak experience occurred during psilocybin use, and this finding is consistent with the experiments done by Griffiths et al. (2006, 2008). However, the proportion of participants who reported a full-blown mystical experience induced by psilocybin was substantially lower in this study.
This study investigated whether psilocybin use affects the degree of oceanic boundlessness experienced during peak experiences, and whether personality characteristics, psilocybin use, or other factors make psilocybin users more prone to oceanic boundlessness than non-users.
Participants who experienced their peak experiences while under the influence of psilocybin experienced significantly more fear of ego dissolution than either of the other two groups. However, the fear of ego dissolution was not sufficient to make these experiences uncomfortable.
The total estimation of alteration of consciousness was greatest for psilocybin-using participants who reported their peak experiences occurred under the influence of psilocybin. However, future research may gather more information about the characteristics that make peak experiences valued by the experiencer.
The majority of recreational psilocybin users experienced their peak moments while using the drug, but more work is necessary to fully understand how peak experiences differ between psilocybin users and non-users.