Psychedelics use predicts more positive emotional reactivity and greater self-awareness: the mediating role of ego dissolution and mystical experiences

This cross-sectional preprint survey study (n=2516) investigated how the frequency of using psychedelics in naturalistic settings and mystical aspects of the induced experiences are related to psychological functioning in the domains of emotional reactivity and self-consciousness. They found that mystical aspects of psychedelic experiences mediated positive emotional reactivity, weaker outward-focused aspects of self, and an adaptive pattern of features constituting internally-focused self among the respondents.

Abstract

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

Aim: To test three hypotheses: i) psychedelics use is related to higher positive and lower negative emotional reactivity; ii) psychedelics use is related to enhanced inward-focused self-consciousness and diminished outward-focused self-consciousness; iii) these relationsare mediated by the intensity of past ego-dissolution and mystical experiences.

Methods: Data from 2,516 participants (1,661 psychedelics users) were collected via an online survey. The survey included questions about the history of psychoactive substanceuse, questionnaires measuring trait-levels of emotional reactivity and self-consciousness, and questionnaires for retrospective assessment of ego-dissolution and mystical experiences. Data were analyzed using robust linear regression and mediation analysis.

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

Conclusions: Lifetime psychedelics use predicts an adaptive pattern of trait-level emotional reactivity and self-consciousness. The past 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, Maksymilian Bielecki & Michał Bola

Summary

Data were collected from 2,516 participants via an online survey, and analyzed using robust linear regression and mediation analysis.

Results: Higher number of psychedelic experiences predicted greater positive and lower negative emotional reactivity, greater reflection and internal self-awareness, and reduced rumination tendency.

1. Introduction

Psychedelics are psychoactive substances that affect perception, emotions, and thought. Recent studies demonstrate that psychedelics cause long-lasting psychological effects.

Even a single psychedelic experience can lead to long-term changes in psychological functioning. Participants reported increased well-being and quality of life lasting from several days up to months.

Psychedelics users exhibit higher scores on scales of spirituality and empathy, and report lower distress and suicidal tendencies, in comparison to users of other psychoactive substances. However, cross-sectional studies indicate that psychedelics users are not at a greater risk of experiencing a mental disorder in comparison to non-users.

The present study aimed to investigate psychological effects associated with regular, naturalistic use of psychedelics. It was hypothesized that more frequent use of psychedelics will be related to increased positive emotional reactivity and decreased negative emotional reactivity, as well as a profound acute change in the sense of self.

The ability to access one’s own internal states could both be beneficial and maladaptive. The intensity of mystical and ego-dissolution experiences caused by past naturalistic use might mediate the expected effects of psychedelics on emotionality and self.

2.1. Data collection

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

We collected data regarding psychedelic use, including the number of occasions on which participants administered LSD, psilocybin mushrooms, synthetic psilocybin, DMT, changa, ayahuasca, mescaline, and derivatives of classic psychedelics, as well as the number of occasions on which participants administered other psychoactive substances. In this study, we used three items of the Polish version of the Alcohol Use Disorder Identification Test (AUDIT) questionnaire to shorten the time needed to fill the questionnaire.

The Perth Emotional Reactivity Scale (PERS) is an 18-item short form of the 30-item PERS that measures trait levels of negative and positive emotional reactivity. f) The Self-Consciousness Scale (SCS), which measures three distinct psychological components of self-consciousness: public, private, and social anxiety. The SCS measures two dimensions of private consciousness: internal self-awareness and self-reflectiveness. The Polish adaptation of SCS did not distinguish between internal self-awareness and self-reflectiveness, so we performed an exploratory factor analysis to recreate the four-factor structure. The analysis allowed us to identify four dimensions: public self, social anxiety, and two new factors: internal self-awareness and self-reflectiveness. We used the Ego Dissolution Questionnaire (EDI), Hood’s Mysticism Scale (HMS), and a Polish adaptation of the abridged (12-item) version of HMS to measure the recalled intensity of the past ego-dissolution experiences induced by psychedelics.

Inclusion and exclusion criteria

Data of 2,561 participants were analyzed in the study. Additional 712 participants were collected but excluded due to answering attention-check questions incorrectly, careless responding, having a diagnosis of substance dependence, and little or no variation while responding to SCS, RRQ, or PERS-S.

Variables coding

The relationship between lifetime psychedelic use intensity and psychological indicators of interest was studied using a factored lifetime psychedelic use measure. The measure was created by summing the reported number of lifetime administrations of all classes of psychedelic substances and converting the obtained estimate into a 4-level categorical factor.

Data concerning use of other psychoactive substances, lifetime meditation hours, and age and education level were converted into 4-level categorical factors to ensure comparability and facilitate comparisons.

Robust regression

We examined the relationships between psychedelic use and psychological variables using robust linear regression, with KS2014 estimator, using the robustbase package in R. We controlled for age, sex, education, lifetime meditation hours, and frequency of alcohol use.

We performed mediation analysis using a Python PyProcessMacro package to examine the relations between factored lifetime psychedelics use and psychological variables. We used HMS and EDI scores as mediators, and calculated confidence intervals for indirect effects using bootstrapping.

Negative emotional reactivity

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

Positive emotional reactivity

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

Public self

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

Lifetime psychedelics use was not a significant predictor of social anxiety, but male sex, lifetime meditation hours, and lifetime empathogenes use were.

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

Self-reflectiveness

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

Rumination

Lifetime psychedelics use, male sex, age, education, lifetime meditation hours, empathogenes use, and benzodiazepines use were associated with lower rumination, while alcohol use and benzodiazepines use were associated with higher rumination.

Reflection

Lifetime psychedelics use, education, and meditation hours were associated with higher reflection, while age, lifetime stimulant use, and alcohol use were associated with lower reflection (Figure 2).

Ego-dissolution

Lifetime psychedelics use, lifetime meditation hours, lifetime opioid use, and lifetime alcohol use were associated with reports of higher ego-dissolution, but age and lifetime cannabis use were also significant predictors.

Mystical experience

Lifetime psychedelics use, lifetime meditation hours, and lifetime alohol use were associated with reports of more pronounced mystical experience, but not male sex or lifetime cannabis use.

3.2 Mediation analysis

The results showed that the intensity of mystical aspects of psychedelic experiences mediated the relationship between lifetime psychedelics use and personality characteristics, and that the size of the indirect effect increased with the amount of psychedelic experiences.

In a mediation analysis, lifetime hours of meditation were added as a controlled variable to the model of psychedelics use. The results suggest that some proportion of the psychedelics’ effects might be explained by the meditation practices.

4. Discussion

Experimental studies reveal that classic psychedelics cause robust changes in perception, cognition, and brain activity. Using psychedelics more frequently may be related to even more pronounced and persistent changes in psychological functioning.

4.1. Psychedelics use predicts emotional reactivity and self-consciousness

Our results show that more frequent intake of psychedelic substances is associated with greater positive and lower negative emotional reactivity. This confirms our hypothesis that psychedelics affect the way emotional processing interacts with perception and attention.

The quality of life and subjective well-being increase after a single psychedelic administration, in both healthy participants and patients diagnosed with depression or anxiety disorders. We found that using psychedelics is related to an adaptive pattern of psychological features, including greater reflection and self-awareness, and reduced rumination. This is in line with previous cross-sectional studies and is supported by the observation that psychedelics do not constitute a risk factor for mental health problems.

Using psychedelics is associated with diminished outward-focused self-consciousness. This finding is consistent with previous studies showing that the ego-dissolution phenomenon occurs during an intense psychedelic state.

Psychedelic users have been found to have altered brain connectivity within the default mode network, which is related to the sense and narrative aspects of self. However, psychedelic users have rarely been investigated from an individual differences, trait-oriented perspective. When discussing the role of self, one has to keep in mind that there is no consensus on what constitutes self.

4.2. Mediating effect of mystical aspects of psychedelic experiences

The intensity of ego-dissolution and mystical aspects of past psychedelic experiences predicted positive long-term clinical outcomes in patients with depression, and mediated the antidepressive and anxiolytic effects of psychedelics in patients with life-threatening diagnosis. The ego-dissolution experienced during a psychedelic session predicted the levels of affect, life satisfaction, and mindfulness observed one day but not a month after the session in healthy volunteers. The presence of mediatory effects suggests that the reported differences in emotional reactivity and self-consciousness are consequences of psychedelics use rather than its causes.

While there is growing evidence that mystical aspects of psychedelic experience mediate long-term psychological changes, there is also evidence that other subjective aspects of psychedelic experience mediate the positive effects of psychedelics.

Previous evidence does not clearly conclude that mystical aspects of psychedelic experience are related to awe or required for emotional response to psychedelics. Perhaps, there are other factors affecting the mediating role of the mystical experience or other aspects of psychedelic experience playing affecting profoundness of changes.

Even though mystical aspects of psychedelic experience were found to mediate the psychological effects of psychedelic use, it remains to be determined whether any psychological-long term effects occur without psychedelic experience.

Due to a cross-sectional design, the cause-effect relation cannot be inferred. However, frequent use of psychedelics can change trait-level emotional-reactivity and self-consciousness, and this effect is not driven by a mere predisposition to try psychedelics. The indirect effect of EDI and HMS increased in a frequency-related manner, with frequent users experiencing greater effects than moderate users and occasional users.

We collected detailed data about use of other psychoactive substances and found that psychedelics exhibited a pattern of associations that was distinct from these other groups.

The lifetime use of empathogens was associated with enhanced positive reactivity, diminished negative reactivity, social anxiety, and rumination, but not with depressive symptoms. Additionally, MDMA assisted psychotherapy decreased anxiety and distress in patients with life-threatening diseases, and social anxiety in patients with autism.

In a study of cannabis users, positive emotional reactivity was increased and public self-consciousness decreased. The effects of cannabis use on emotion processing are conflicting, but our results suggest an enhanced positive emotionality in cannabis users. Although it is difficult to draw clear conclusions from studies on cannabis, our data suggests that cannabis use might be related to positive emotional reactivity and changes in the public aspect of self-consciousness.

Alcohol consumption was strongly related with enhanced negative reactivity, rumination, public self-consciousness, and diminished reflection. Alcohol use disorder and mood disorders are frequently comorbid, and psychedelics may be used as a treatment for alcohol addiction.

The reported amount of lifetime meditation hours was the strongest predictor of both emotional reactivity and self-consciousness. Interestingly, psilocybin intake combined with assisted mindfulness meditation led to positive changes in psycho-social functioning detectable even after 4 months.

4.5. Conclusions

Participants using psychedelics in a naturalistic context were characterized by more positive emotional reactivity, weaker outward-focused aspects of self, and an adaptive pattern of features constituting internally-focused self.