Psychedelic medicalization, public discourse, and the morality of ego dissolution

This critical commentary (2021) examines a tendency of psychedelic research and popular media to frame subjective experiences, such as psychedelic ego dissolution, as a pharmacological outcome of using ayahuasca, rather than just one specific or desired outcome for certain societies, cultures, and individuals. This highlights the pitfalls of naturalizing socially constrained orientations towards psychedelics as amoral and objective criteria that conceptualize mental health as an individualized process.


“Emerging from a diverse and long history of shamanic and religious cultural practices, psychedelic substances are increasingly being foregrounded as medicines by an assemblage of scientific research groups, media institutions, government drug authorities, and patient and consumer populations. Considering scientific studies and recent popular media associated with the medicalization of psychedelic substances, this article responds to scholarly debates over the imbrication of scientific knowledge and moral discourse. It contends that, while scientific research into psychedelic medicine presents itself as amoral and objective, it often reverts to moral and political claims in public discourse. We illustrate how psychedelic medicine discourse in recent popular media in the United States and the United Kingdom is naturalizing specific moral and political orientations as pharmacological and healthy. The article traces how psychedelic substances have become ego-dissolving medicines invested with neoliberal and anti-authoritarian agency.”

Authors: Alex K. Gearin & Neşe Devenot


Scientific research into psychedelic substances presents itself as amoral and objective, but often reverts to moral and political claims in public discourse. This article traces how psychedelic substances have become ego-dissolving medicines invested with neoliberal and anti-authoritarian agency.

Peter Furst’s point that psychedelic experiences are profoundly constituted by society and culture is still relevant and has been proven to help cure psychological distress, mood disorders, and addictions. Unlike common psychiatric medications, psychedelic-assisted psychotherapy typically involves just one or two drug sessions that are closely managed by medical specialists. These sessions can induce states of consciousness that scholars have associated with global shamanic and religious diversity.

Clinical researchers at New York University are using psilocybin, LSD, or MDMA to facilitate experiences of mystical “ego dissolution” or “ego death”. The research contexts are decorated with landscape paintings, books of art and mythology, aboriginal “tchotchkes”, a statue of the Buddha, and a glazed ceramic mushroom.

Psychedelic plants and fungi have been employed across diverse forms of religious, cultural and moral life, well beyond any ethnomedical or therapeutic context. They may embody or represent ancestors, deities, plant-helper allies, morally ambiguous spirits, or social and convivial lubricators.

In the last five to ten years, the science of psychedelic therapy has been widely shared across Western social media networks by psychedelic consumers and enthusiasts, fueling perceptions among therapists and patients that psychedelic substances can help cure a wide variety of problems.

Psychedelics are becoming unique examples of medicalization, with the use of certain psychoactive substances being shaped by medical and scientific institutions, government regulatory bodies, and secular imaginations. These institutions are defining human problems in medical terms and services, and tight defining substances as medicines.

Mental health and its therapies are culturally contingent processes that are impoverished when reduced to natural law. By emphasising mental disorders as mainly brain disorders that have psychological corollaries, a sensitivity to the broader cultural and societal processes that inform psychedelic states of consciousness risk being disguised and reduced by naturalist renditions.

Government regulatory criteria aim to objectify psychedelic therapy by narrowing the phenomenologies of psychedelic states of consciousness into the shape of psychometric and psychological instruments used to measure them. This narrowing is an essential logic in the revival of psychedelic medicine. This article is based on a critical discourse analysis of psychedelic medicine and “ego-dissolution” representations in popular media in the United States and the United Kingdom. It argues that the medicalization of psychedelics has contributed to specific transformations of scientific thinking into public moral discourse.

Psychedelic medicine and psychiatry

LSD was used in experimental psychiatry in the 1950s, and became the topic of over a thousand research articles. Psychedelic researchers and enthusiasts of the 1960s showed an abiding interest in ego dissolution, and Aldous Huxley, Timothy Leary, Ralph Metzner, and Richard Alpert developed a popular guide to “lose your ego” with mental techniques largely imported from Tibetan Buddhist texts.

In the 1950s and early 1960s, psychedelic substances were viewed as possible therapeutic or religious compounds, but had become associated with deviance, crime, and political rebellion. The “ego death” experience became the ultimate initiation pathway for many psychedelic enthusiasts, and included a culturally critical potential among some activist youth circles. Psychedelic substances were used by the New Left student organization and the Black Panther Party of the civil rights movement to express moral liberation and social distress. By the mid to late 1970s, psychedelics had been absorbed into mainstream culture and had become “integral to the sensory indulgences and leisured life of Americans”.

In the early 2000s, medicine research began to gain currency again, with the goal of integrating psychedelic therapy into modern health care services.

New psychedelic therapies and the individual

Current clinical psychedelic therapy sessions tend to share some fundamental similarities, including preparation meetings with the therapists, dosing of the substance, and listening to music for 6 to 12 hours. The ultimate goal is to transform the patient into a mentally healthier and more satisfied individual.

Psychedelic therapy locates disorder at the level of the patient’s mind, but fails to address the systemic causes of suffering, and lacks integration with community-based approaches to healing. This can be emblematic of the “last man” and suppresses potential social transformation. Charles Taylor (1989) explained that moral orientations are shaped by ideas of social distress and disorder. Neoliberal ideology dominates contemporary models of distress and intervention focused on reconfiguring individualistic states of mind.

Erik Davis (2019) argues that the psychedelic therapy approach to suffering and wellbeing throws an etiological anchor in the sand of the ego or individual, yet the pathological expressions of psychedelic patient experiences and post-session integration narratives raise questions about potentially “disordered” social and cultural configurations.

Psychedelic science and public discourse

Researchers have developed several psychometric instruments to measure psychedelic experiences, including the hallucinogen rating scales, altered states of consciousness questionnaire, and ego dissolution inventory. These instruments focus on a diminishing sense of self as the central measurement. Psychedelic neuroscientists describe ego dissolution experiences as an objective process that mirrors neurological signals. The ecstatic diminishing self is foregrounded as a natural itinerary of psychedelic therapy sessions.

During the same period, 95 articles about psychedelic medicine were published across 16 major news websites in the United States and the United Kingdom. The articles were analyzed for qualitative information.

In many media representations, psychedelic substances are given a kind of direct ego-destroying agency, and this is imputation of particular forms of moral and political agency to psychedelic substances that is subtle in scientific research papers and often explicit in popular media representations of the research. A popular media article based on a study indicated that men incarcerated for intimate partner violence were less likely to be arrested after being released from jail if they had consumed psychedelic substances.

Psychedelic substances are presented as having a phenomenological action of ego dissolution, and higher scores of political liberalism, nature relatedness, and psychological openness are reported among individuals who consume psychedelics.

In a popular news article entitled “How meditation and psychedelic drugs could fix tribalism”, the journalist describes ingesting the substances and connecting to something much bigger than himself. He states that this experience altered his self-understanding at a deep, instinctual level.

There are soft and hard examples of scientific objectivity being employed to define psychedelic substances as agents of social and political life. The soft explanations are where the personal experience is validated and naturalized by scientific explanation.

Neoliberalism is a theory of political-economic practices that aims to promote individual entrepreneurial freedoms and skills within an institutional framework characterized by strong property rights, free markets, and free trade. This ideology has become hegemonic in late-capitalist societies and informs how people conceive of and understand themselves as individuals.

Scholars have explored how neoliberal subjectivity correlates with psychological pressures to succeed and persevere as atomized individuals within increasingly precarious social configurations. However, the neoliberalization of psychedelic medicine risks exacerbating the very problems that some claim it solves.

Maya Singer turned to Mindbloom for ketamine therapy to treat a smoking addiction that had been exacerbated during the coronavirus pandemic. Her interviews with Michael Pollan and clinicians highlight the consensus of clinical objectivism that pervades the popular framing of psychedelic medicine.

Singer’s interviewees suggest that her problems can be solved by intervening individualistically at the level of her self-image.

Singer’s article suggests that psychedelic effects are recuperated in neoliberal terms, including the imperative to self-monitor and cope with demanding workloads in precarious labor markets.

While psychedelics may offer psychological relief, the discourse of psychedelic medicalization circumvents the systemic causes of distress by placing the burden on individuals to manage their own sense of wellbeing.

Singer’s article highlights how the clinical objectivism of psychedelic medicine can function as a “technology of the self” that functionally “increases the tautness of the neoliberal noose at the level of subjectivity” (Reveley, 2016: 508).

Media claims about psychedelic research present the research as objective and matter-of-fact, an inevitable outcome of human neurology. This objectivity can generate diverse consequences outside scientific communities and among public audiences.

Universities are increasingly tied to industries, and scientists studying psychedelics who straddle universities and industries face the broader challenges of such relations, whereby knowledge produced at universities is isomorphic with corporate agendas, market-related activity, and wider capitalist dynamics.

Contemporary popular media about psychedelic medicine is arguably having some impact upon patient behavior and practice. A 2019 New York Times article attributes an uptick in psychedelic experimentation for achieving health and wellbeing to Michael Pollan’s bestselling book about psychedelic psychotherapy, How to Change Your Mind (2018). The impact of medicalization discourse may be particularly striking among populations that use psychedelic substances.

The wide anthropological literature on ayahuasca use by indigenous Amazonian societies does not mention ego dissolution, but rather the switching of ego positions in acts of becoming animal, plant, or other beings. These alternate moral perspectives and capacities are embodied in different ways by different ayahuasca users.

Popular media portrayals of ego dissolution are inconsistent with academic evidence, and the role of ego dissolution as a motivation for imperialistic violence in early 20th-century Japan shows that this state of consciousness can be employed for violent political ends. The ego-dissolving properties of LSD attracted the US military during the 1970s, and the powerful Amazonian psychedelic brew ayahuasca was consumed by the Shuar of Ecuador and Peru to promote homicidal abilities. These darker histories of psychedelic use should act as a warning against scientists, therapists, and journalists who naively associate psychedelic altered states with non-violence, anti-authoritarianism, or any other a-cultural and a-social essentialism.


In the last decade, bioethicists have discussed the potential for pharmacological moral enhancement. Brian Earp considers psychedelic substances as potential moral bioenhancers, but avoids the question of moral determinism by taking an “agnostic” approach.

Psychedelic substances are context-dependent and have an ambiguous potential, depending on the perspectives of different social and cultural agents and contexts of use.

There are important moral differences associated with psychedelic substance use, and scientific and media groups are actively entangled in their production.

This article has examined popular media representations of psychedelic science and medicine, and points to novel research questions such as how psychedelic users codify their psychedelic experiences and mental life in response to such media.