This review looked at 77 studies with psychedelics and entactogens, to see how their effects relate to concepts of positive psychology. Psychedelics and entactogens showed positive effects e.g. on well-being, prosocial behaviors, empathy, creativity, personality, values, and mindfulness. However, the authors stress that more longitudinal data on positive and adverse effects is needed.
Abstract
“Rationale: We reviewed the concepts and empirical findings in studies with psychedelics and entactogens related to positive psychology – the study of healthy human functioning, well-being and eudaemonia. It is an unresolved question how beneficial effects of psychedelics and entactogens are related to the potential risks of these substances – particularly in non-clinical settings.
Methods: We searched in PubMed, PsychINFO and the Cochrane Library for controlled clinical and epidemiological studies which applied concepts from positive psychology. We included N = 77 eligible studies with 9876 participants published before November 1st, 2017: (1) quantitative studies (N = 54), (2) preliminary or exploratory studies and reviews not including meta-analyses (N = 17), and (3) studies evidencing primarily negative results (N = 6).
Results: Positive psychology concepts have been applied for measuring effects of clinical trials, recreational and ceremonial use of psychedelics and entactogens. Psychedelics and entactogens were shown to produce acute and long-term effects on mood, well-being, prosocial behaviours, empathy, cognitive flexibility, creativity, personality factors like openness, value orientations, nature-relatedness, spirituality, self-transcendence and mindfulness-related capabilities.
Conclusions: There is preliminary evidence for beneficial effects of psychedelics and entactogens on measures of positive psychology in clinical and healthy populations, however their sustainability remains largely unresolved. The reported results must be considered preliminary due to methodological restrictions. Since longitudinal data on both positive and adverse effects of psychedelics are lacking, more rigorous and standardized measures from positive psychology should be applied in less biased populations with prospective longitudinal designs to carefully assess the benefit-risk-ratio.”
Authors: Henrik Jungaberle, Sascha Thal, Andrea Zeuch, Ansgar Rougemont-Bücking, Maximilian von Heyden, Helena Aicher & Milan Scheidegger
Summary
Previous psychedelic research focused on pathophysiological disease models and clinical applications. However, the potential beneficial effects of psychedelics and entactogens on healthy human functioning remain barely investigated.
Basic research on psychedelics focuses on understanding mental functions and their relationship with neuronal processes in the brain. Clinical research focuses on improving symptom measures in the treatment of diagnosed patients.
Clinical settings supervised by medical doctors and psychotherapists provide safe environments for the administration of psychedelics and entactogens with marginal risks for severe incidents. The recreational use of psychedelics and entactogens has generally been considered unsafe, but MDMA related deaths are on the rise in several countries. The risks associated with the recreational use of classical psychedelics include anxiety and panic attacks, manifestation or exacerbation of psychotic disorder and hallucinogenic persisting perception disorders. LSD and other psychedelics are listed in Schedule 1 of the US Controlled Substances Act because of their potential for harmful effects. However, some people may find that these substances have beneficial effects across different intra- and interpersonal domains. Positive psychology is the scientific study of positive human functioning and flourishing on multiple levels, including the biological, personal, relational, institutional, cultural, and global dimensions of life. It provides a valuable conceptual framework to further elucidate the potential beneficial effects of psychedelics and entactogens on healthy human functioning. An extensive literature search and critical review was conducted including papers until November 1 st , 2017. We excluded qualitative studies, case reports, opinion papers, field studies as well as treatment or pre-clinical studies that either were not controlled and randomized, that exclusively used pathological measurements or that only screened for the worsening of clinical parameters in recreational user.
The electronic searches resulted in 2550 hits, of which 54 were quantitative empirical studies, 17 were preliminary or exploratory studies and reviews not including meta-analyses, and 6 were studies evidencing primarily negative results. The studies were divided into four categories: acute social change, persistent social change, acute personal change and persistent personal change. Table 1 summarizes the selected studies with positive psychology measures, Table 2 summarizes the preliminary, exploratory studies and reviews, and Table 3 summarizes the negative results within the eligible studies.
Psilocybin induces positive changes in mood and reduces responses to negative stimuli. This effect is associated with increased self-reports of positive mood and decreased neural reactivity to self-reported social exclusion.
Lysergic acid diethylamide (LSD) was shown to decrease right medial prefrontal cortex and left amygdala responses during the presentation of anxiety inducing stimuli, and to increase openness, trust, desire to be with other people, prosocial behavior, and implicit and explicit emotional empathy.
MDMA improves people’s self-reported perception of and responses to emotional stimuli with social content, influences how people talk about significant others, and increases empathy for positive emotional situations and enhances interpersonal empathy in social interactions. MDMA increased self-report ratings of loving and friendly emotions, whereas lower dose MDMA increased self-report ratings of loneliness. MDMA attenuated left amygdala reactivity to angry facial expressions, but did not affect reactivity to fearful expressions. Under the acute influence of MDMA, participants showed enhanced accuracy in decoding positive stimuli but decreased ability to decode negative stimuli, and self-reported mood and self-esteem may be influenced to a lesser degree by social rejection.
Acute personal change
Lysergic acid diethylamide (LSD) was found to enhance participants’ emotional response to music, produce acute increases in subjective well-being, happiness, openness, and trust, and increase global connectivity within the brain.
Ayahuasca, a plant from the Amazonian region, was found to decrease inner reactivity and judgmental processing, increase cognitive flexibility, and increase self-compassion. These effects were sustained for at least two weeks and were correlated with increases in the Five Facets Mindfulness Questionnaire.
In a general population online study with 1487 participants, self-reported engagement in pro-environmental behaviors was predicted by respondents’ past experiences with classical psychedelics. Furthermore, LSD experience produced long lasting subjective effects of prosocial and altruistic behaviors in participants. MDMA-assisted psychotherapy for treatment resistant PTSD results in long-term increases in openness and persistent decreases in neuroticism on the NEO-PI-R Personality Inventory. Classical psychedelics use is also associated with increased values of spirituality, mystical beliefs, concern for others, and creativity. A pilot study using psilocybin to treat smoking addiction found that participants’ life values changed following their psychedelic experience.
In two double-blind controlled studies of psilocybin, openness was significantly enhanced and mystical experiences were significantly related to smoking cessation. Additionally, 84% of participants endorsed having benefited from their most challenging experience with psilocybin mushrooms. Lysergic acid diethylamide (LSD) increases brain entropy, ego-dissolution occurs during the LSD-state, and improved psychological well-being is measured two weeks after LSD administration. Ayahuasca and DMT are two other psychedelics that have demonstrated the potential to induce psychospiritual experiences.
Ayahuasca and DMT should be investigated as two different substances. DMT increased psychospiritual insights by 75.5% in an online questionnaire study. Regular users of ayahuasca demonstrated improved neuropsychological performance, life attitudes, personality and psychopathology compared to non-users, including higher scores on the Frontal System Behavior Scale, the Letter-Number Sequencing task, as well as the Stroop test and the Wisconsin Card Sorting Test. Bouso et al. (2015) found that participants who regularly used ayahuasca had reduced cortical thickness in the posterior cingulate cortex, and that this was linked to measures of spirituality and self-transcendence. Frecska et al. (2012) found that participants’ visual creativity was enhanced after the repeated ingestion of ayahuasca in a ritual setting.
We reviewed 77 studies on the effects of psychedelics and entactogens on well-being, happiness, resilience, creativity and personality factors. We found 3 treatment/follow-up of treatment studies, 54 neurophysiological/neuropsychological or psychological studies, 7 epidemiological studies, 11 reviews and 2 pooled-/meta-analyses.
Psilocybin, LSD, and MDMA have been shown to cause acute changes in mood and psychological well-being, including altered neural responses to negative or fearful stimuli.
MDMA and LSD may influence self-reported mood and self-esteem to a lesser degree than social rejection, and long-term increases in openness may be associated with improved psychological well-being and long lasting subjective effects of improved mood, life satisfaction and an overall positive view on life. LSD and MDMA may have beneficial effects on personality factors like openness, but it remains unclear which social and psychological factors mediate and sustain these effects under real life conditions. Social cognition, empathy and prosocial behaviors were enhanced after LSD administration, and these effects were sustained after 12 months. MDMA was also found to enhance prosocial feelings and behaviors as well as interpersonal empathy in social interactions.
Serotonergic psychedelics and entactogens increase prosocial behaviors and attitudes, which makes them suitable tools to support psychotherapeutic processes. However, it remains to be shown how sustainable these effects are in the medium or long-term interval. Psychedelics may enhance cognitive flexibility, creativity and imagination, and may have long-term effects on creative problem-solving abilities and personality trait of openness. Ayahuasca may have the potential to increase cognitive flexibility through divergent thinking and enhanced visual creativity. Psychedelic users showed higher values of spirituality and concern for others, less appreciation of financial prosperity, and less addictive behaviors compared to non-psychedelic users and non-illicit drug-using social drinkers.
Ritual users of ayahuasca have better psychosocial adaptation and better core life values, which might be associated with prosocial and pro-environmental behaviors. Psychospiritual experiences and mindfulness-related capabilities are correlated with reduced cortical thickness in the posterior cingulate cortex in regular ayahuasca users and heightened global connectivity in thalamo-cortical networks in regular LSD users. Psilocybin users report mystical-type experiences that are frequently rated among the five most significant spiritual experiences of their lives. These experiences have been found to correlate with improved well-being and life satisfaction 12 months after LSD administration.
Ayahuasca intake may increase levels of mindfulness, self-compassion, and “decentering”, which may contribute to the increase in wellbeing and mood observed after exposure to psychedelics. Psychedelics and entactogens may play a role in promoting positive personal and social change by promoting feelings of trust, empathy, bonding, closeness, tenderness, forgiveness, acceptance, and connectedness. There are many studies exploring the neurobiological basis of prosocial feelings and their impact on psychological health and wellbeing. Entactogens and psychedelics may be informative to further explore quantitative changes in brain network dynamics by means of specific pharmacological interventions to identify neurocircuitries of prosocial feelings that serve personal growth and well-being.
While a risk-oriented discourse may prevail in public media, a dominant positive experience or self-treatment discourse seems to prevail in clandestine discourses. A critical and harm-reduction focussed voice that acknowledges potential gains, but is supporting to distinguish real benefits from illusionary gains is necessary for the prevention of problematic drug use. Limitations include small sample sizes, use of convenient samples, and lack of statistically sufficient control of the experimental variables. More randomized controlled studies with specific hypotheses are needed to corroborate this preliminary evidence. Future research on factors related to positive psychology should focus on psychedelics and entactogens, especially on causal relationships between the use of those substances, genetical predispositions, personality traits and environmental factors.
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