ArticleLiterature Review

Positive psychology in the investigation of psychedelics and entactogens: A critical review

Authors:
  • MIND Foundation
  • OVID Clinic Berlin
  • Freiburger Netzwerk für psychische Gesundheit
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... Moreover, psychedelics are argued to generate acute and long-term effects on mood, personality (e.g. increases in openness), subjective wellbeing, empathy, pro-social attitudes, connectedness, compassion, cognitive flexibility, creativity, value orientation, spirituality, self-transcendence, and mindfulness (Jungaberle et al., 2018). These components also comprise personal expressions of sustainability (Ives et al., 2019) and are strong predictors of connection with nature and pro-environmental behaviour (Forstmann & Sagioglou, 2017). ...
... Despite literature on classic psychedelics indicating potential societal and environmental benefits (e.g. Jungaberle et al., 2018), the connections between classic psychedelic research and sustainability has not previously been systematically outlined. Therefore, this paper strives to narrow this knowledge gap by outlining links between psychedelic research and the personal sphere of transformation for sustainability. ...
... For example Gandy (2019), presented a literature review on the benefits of classic psychedelics in "healthy normals'', which covers results on increases in the personality trait of openness, mystical-type experiences, and makes the link to personal sustainability through nature relatedness as a key predictor of pro-environmental awareness and behaviour. Similarly Jungaberle et al. (2018) conducted a literature review on psychedelics (and entactogens) related to positive psychology and reported acute and long-term effects across a range of psychological capacities and factors, and emphasise the link to pro-environmental behaviour through increased nature relatedness. Geiger at al. (2018) provide a synthesis of research on psilocybin in chemical neuroscience, and describe how studies show increased empathy, simultaneous emotions, enhanced objective and situational analysis, increased spirituality, and a sense of interconnection between humanity and a higher power. ...
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Tackling sustainability issues requires engagement with inner dimensions of sustainability, including the beliefs, values, worldviews and paradigms that influence how people perceive and behave in society and in relation to the natural world. Research on classic psychedelics is undergoing a renaissance, and despite the often-stated positive effects and potentials for perceptual and behavioural change, research on psychedelics has previously not been systematically linked with sustainability. This paper aims to explore the role of classic psychedelics for sustainability transformations by outlining the links between the inner dimensions of sustainability and psychedelic research. Through a systematic literature review, we identify how the effects of classic psychedelics have been linked to inner dimensions of sustainability across a range of fields including neuroscience, psychology, psychopharmacology, sustainability studies, ecopsychology, and psychotherapy up until June 2020. We categorise the literature into the overlapping themes: i) values & personality, ii) (nature) connectedness, and iii) worldviews & spirituality. Overall, a small sample of papers made explicit links to inner dimensions of sustainability, and a larger sample of papers could be implicitly linked to inner sustainability. This review shows that classic psychedelics bear potential as a deep leverage point for inner sustainability transformations, and further research is warranted.
... Classic psychedelics and MDMA have been found to produce acute and persistent positive personality changes and improved well-being in healthy individuals (Elsey, 2017;Jungaberle et al., 2018). These substances have been linked to heightened mindfulness (Soler et al., 2016, a sense of connection to nature (Forstmann and Sagioglou, 2017), creativity (Kuypers et al., 2016;Uthaug et al., 2018;Mason et al., 2019), and openness (Liechti et al., 2017). ...
... However, the acute and long-term or persistent effects (more relevant for treatment effects) differ substantially , so the specific psychological mechanisms that account for their therapeutic efficacy are still not comprehensively understood. Various acute and persistent effects of psychedelics and entactogens were outlined by Jungaberle et al. (2018) and include, amongst others, positive effects on wellbeing, mood, empathy, cognitive flexibility, self-transcendence, and openness. However, individual experiences might be extremely variable and generalizations based on single sessions and small sample sizes are problematic (Grof, 2000;Bogenschutz et al., 2018) due to different personality structures of the client (Sandison and Whitelaw, 1957;Cohen, 1960;Gucker, 1963) amongst other individual differences. ...
... Thereby, prior fixed beliefs may be more easily challenged and restructured by novel information. This might be reflected by lasting changes in attitudes (i.e., increased openness and extraversion and decreased neuroticism; Erritzoe et al., 2018) and beliefs in individuals who used psychedelics (Nour et al., 2017;Jungaberle et al., 2018). ...
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The present narrative review is the first in a series of reviews about the appropriate conduct in substance-assisted psychotherapy (SAPT). It outlines a current perspective onpreconditions and theoretical knowledge that have been identified as valuable in the literaturefor appropriate therapeutic conduct in SAPT. In this context, considerations regarding ethics and the spiritual emphasis of the therapeutic approaches are discussed. Further, current methods, models, and concepts of psychological mechanism of action and therapeutic effects of SAPT are summarized, and similarities between models, approaches, and potential mediators for therapeutic effects are outlined. It is argued that a critical assessment of the literature might indicate that the therapeutic effect of SAPT may be mediated by intra- and interpersonal variables within the therapeutic context rather than specific therapeutic models per se. The review provides a basis for the development and adaptation of future investigations, therapeutic models, training programs for therapists, and those interested in the therapeutic potential of SAPT. Limitations and future directions for research are discussed.
... For instance, psilocybin has been found to lead to increased social connection, enhanced spirituality, self-transcendence, as well as mental well-being (Forstmann et al., 2020). Similarly, Ayahuasca rituals are described as enhancing mindfulness (Hendricks, 2018) and inducing intense physical, mental, and emotional changes (Robledo and Batle, 2017), whereas the hallucinogen lysergic acid diethylamide is associated with well-being, happiness, and openness (Jungaberle et al., 2018). Psychedelics can trigger powerful outcomes, such as a feeling of loss of self, termed ego-dissolution or ego-death (Nour et al., 2016). ...
... Yet, these experiences require more than just intense substances to unfold their full transformative potential (Yaden et al., 2017). Openness to change and the potential risks associated with hallucinogen use all play a role in determining the likelihood of transformation (Jungaberle et al., 2018). ...
... For instance, psilocybin has been found to lead to increased social connection, enhanced spirituality, self-transcendence, as well as mental well-being (Forstmann et al., 2020). Similarly, Ayahuasca rituals are described as enhancing mindfulness (Hendricks, 2018) and inducing intense physical, mental, and emotional changes (Robledo and Batle, 2017), whereas the hallucinogen lysergic acid diethylamide is associated with well-being, happiness, and openness (Jungaberle et al., 2018). Psychedelics can trigger powerful outcomes, such as a feeling of loss of self, termed ego-dissolution or ego-death (Nour et al., 2016). ...
... Yet, these experiences require more than just intense substances to unfold their full transformative potential (Yaden et al., 2017). Openness to change and the potential risks associated with hallucinogen use all play a role in determining the likelihood of transformation (Jungaberle et al., 2018). ...
... Psychedelic use and mindfulness seem to be different paths that may occasionally lead to the same destination. Reported benefits common to both practices include: decreased negative affect, decreased mood disorder symptoms, as well as increased positive affect, spirituality, life purpose, life meaning, and wisdom (Anderson et al. 2019;Garland et al. 2017;Goyal et al. 2014;Johnson et al. 2019;Jungaberle et al. 2018;Montero-Marin et al. 2016;Móró et al. 2011;Raglan 2014). ...
... Remarkably, the addition of psychedelic use as an interaction term inverts the association between mystical experience and negative mood. The interaction suggests that mystical experience-as specifically elicited by psychedelics-predicts improved mood, which is consistent with previous findings (Aday et al. 2020;Haijen et al. 2018;Jungaberle et al. 2018). However, nonpsychedelic related mystical experiences predict decreased mood, a novel finding. ...
Article
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Both psychedelics and mindfulness are recently emerging topics of interest in academia and popular culture. The Prevalence of personal meditation practices and recreational psychedelic use has consistently increased in the past decade. While clinical work has shown both to improve long-term wellbeing, data on naturalistic applications of psychedelics and mindfulness are lacking. The current study examined the relationship between psychedelic use, mindfulness, and multi-faceted wellbeing as an outcome. Hierarchical regression was used to quantify these associations on a sample of people (N = 1,219) who engage in both meditation practices and psychedelic use. Results show that both mindfulness and mystical experiences are associated with substantial increases in wellbeing. Psychedelics were found to be a moderator of the relationship between mystical experience wellbeing. These data are among the first to establish a strong relationship between personal mindfulness practice, recreational psychedelic use, and overall psychological wellbeing in a naturalistic framework.
... Though many experimental, non-clinical studies have examined the effects of MDMA in humans (for reviews see Feduccia & Mithoefer, 2018;Jungaberle et al., 2018), some of which are reviewed below, processes of change associated with MDMA have been notably understudied. Quantitative data on the subject are sparse, with only one available randomized, controlled trial showing that MDMA-AT resulted in larger changes in the personality trait of openness to experience compared to a placebo condition among people with PTSD (Wagner et al., 2017). ...
... Accordingly, clients ingesting MDMA are likely to engage in warm and positive expressions toward therapists that will in turn trigger greater expressions of affiliative emotions from therapists, as research shows that affiliative behavior cues affiliative behavior in others (Markey et al., 2003;Sadler et al., 2009), at least in part through the operation of the mirror neuron system (Jeon & Lee, 2018). The tendency for MDMA to strengthen responses (measured at both a subjective and neurophysiological level and often called emotional empathy) to positive interpersonal situations and emotional expressions of others (Bedi et al., 2009;Hysek et al., 2014;Jungaberle et al., 2018;Kuypers et al., 2017; may make therapist expressions of positive emotion such as compassion and liking more salient at both a visceral and cognitive level. This may also be enhanced by the tendency for MDMA to make people perceive others as more empathic of them (Bershad et al., 2016). ...
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Objective Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated during sessions involving MDMA administration in the treatment of social anxiety disorder. Design This is a narrative review that integrates research on the etiology and maintenance of social anxiety disorder and mechanisms of action of MDMA to examine how MDMA may enhance psychotherapy outcomes. Results We first outline how MDMA may enhance memory reconsolidation in social anxiety disorder. We then discuss how MDMA may induce experiences of self-transcendence and self-transcendent emotions such as compassion, love, and awe; and how these experiences may be therapeutic in the context of social anxiety disorder. We subsequently discuss the possibility that MDMA may enhance the strength and effectiveness of the therapeutic relationship which is a robust predictor of outcomes across many disorders as well as a potential key ingredient in treating disorders where shame and social disconnection are central factors. Conclusion We discuss how processes of change may extend beyond the MDMA dosing sessions themselves.
... MDMA has been shown across multiple studies to affect the action of brain systems related to social bonding and positive reinforcement related to social encounters (22). At a subjective level, people ingesting MDMA report feeling peace, safety, and love (27) and a subjective sense of desire to be with others (44), which comports with observations that MDMA increases motivation to affiliate with others during active dosing. At a neurochemical level, MDMA has been shown to induce the release of oxytocin and prolactin, two hormones centrally implicated in the ability to form social connections (45,46). ...
... MDMA-AT participants often report feeling very safe with therapists during dosing sessions (78) and the tendency for MDMA to elicit expressions of warm and positive emotions toward therapists is also likely to elicit reciprocal responding from therapists (120,121). Furthermore, the tendency for MDMA to strengthen emotional responses to positive social stimuli (44,122) is likely to make therapists' responses of compassion and warmth more salient at a visceral level. If the core fear of people with SAD is that the exposure of a seemingly flawed and inferior self will result in rejection and shaming from others (94), then this enhanced therapeutic bond should potentiate corrective interpersonal learning experiences by both encouraging the person to be authentic and thereby reveal this core defective self, while also resulting in a prediction error when the person experiences acceptance and caring as a response, rather than the expected ridicule or rejection. ...
Article
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Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promising adjunctive treatment to psychological interventions for disorders characterized by social dysfunction. A small randomized, placebo-controlled trial of MDMA-assisted therapy (MDMA-AT) for social anxiety in autistic adults offered encouraging results, but more research is sorely needed to explore the potential for MDMA-AT in treating SAD. This review aims to stimulate future study by summarizing research on disruptions in neurological, perceptual, receptive, and expressive systems regulating social behavior in SAD and proposing how MDMA-AT may alter these systems across four domains. First, we review research highlighting the roles of social anhedonia and reduced social reward sensitivity in maintaining SAD, with specific attention to the reduction in positive affect in social situations, infrequent social approach behaviors, and related social skills deficits. We posit that MDMA-AT may enhance motivation to connect with others and alter perceptions of social reward for an extended period following administration, thereby potentiating extinction processes, and increasing the reinforcement value of social interactions. Second, we review evidence for the central role of heightened social evaluative threat perception in the development and maintenance of SAD and consider how MDMA-AT may enhance experiences of affiliation and safety when interacting with others. Third, we consider the influence of shame and the rigid application of shame regulation strategies as important intrapersonal processes maintaining SAD and propose the generation of self-transcendent emotions during MDMA sessions as a mechanism of shame reduction that may result in corrective emotional experiences and boost memory reconsolidation. Finally, we review research on the role of dysfunctional interpersonal behaviors in SAD that interfere with social functioning and, in particular, the development and maintenance of close and secure relationships. We discuss the hypothesized role of MDMA-AT in improving social skills to elicit positive interpersonal responses from others, creating a greater sense of belonging, acceptance, and social efficacy.
... Psychedelic use and mindfulness seem to be different paths that may occasionally lead to the same destination. Reported benefits common to both practices include: decreased negative affect, decreased mood disorder symptoms, as well as increased positive affect, spirituality, life purpose, life meaning, and wisdom (Anderson et al. 2019;Garland et al. 2017;Goyal et al. 2014;Johnson et al. 2019;Jungaberle et al. 2018;Montero-Marin et al. 2016;Móró et al. 2011;Raglan 2014). ...
... Remarkably, the addition of psychedelic use as an interaction term inverts the association between mystical experience and negative mood. The interaction suggests that mystical experience-as specifically elicited by psychedelics-predicts improved mood, which is consistent with previous findings (Aday et al. 2020;Haijen et al. 2018;Jungaberle et al. 2018). However, nonpsychedelic related mystical experiences predict decreased mood, a novel finding. ...
Preprint
Full-text available
Both psychedelics and mindfulness are a recently emerging topic of interest in academia and popular culture alike. Personal meditation practices and recreational psychedelic use have consistently increased in the past decade. While clinical work has shown both to improve long-term wellbeing, the data on naturalistic applications of psychedelics and mindfulness is rather lacking. The current study aims to examine the relationship between psychedelic use, mindfulness, and multi-faceted wellbeing as an outcome. Hierarchical regression was used to quantify these associations on a large sample of people (N = 1219), who engage in both meditation practices and psychedelic use. These results show that both mindfulness and mystical experiences each predict substantial increases in wellbeing. Psychedelics were found to be an important moderator of mystical experience to explain improvements in wellbeing. These data are among the first to establish a strong relationship between personal mindfulness practice, recreational psychedelic use, and overall psychological wellbeing in a naturalistic framework.
... Psychedelics acting as 5-hydroxytryptamine 2A receptor (5-HT 2A R) agonists have gained immense interest as potential treatments for anxiety, substance use disorder, and treatment-resistant depression (Carhart-Harris and Goodwin, 2017;Nichols et al., 2017). Psychedelic drugs are suggested to promote cognitive flexibility through a 5-HT 2A R-mediated increase in brain entropy that possibly underlies the lasting therapeutic effects of these drugs (Petri et al., 2014;Carhart-Harris et al., 2016;Kuypers et al., 2016;Carhart-Harris and Nutt, 2017;Nichols et al., 2017;Jungaberle et al., 2018). Rat studies show that the nonselective 5-HT 2A R agonist lysergic acid diethylamide (LSD) can promote reversal learning (King et al., 1974), while selective blockade of 5-HT 2A Rs impairs reversal learning (Boulougouris et al., 2008;Furr et al., 2012). ...
... Our results also raise attention to challenges with studying cognitive flexibility. If psychedelics induce an entropic state of brain networks and produce lasting changes in psychological measures of cognitive flexibility (MacLean et al., 2011;Carhart-Harris et al., 2016;Jungaberle et al., 2018), then why do they not improve performance in standard tests of cognitive flexibility in the laboratory (Pokorny et al., 2020;Amodeo et al., 2020)? Psychedelics can impair executive functions related to attentional performance (Umbricht et al., 2003;Carter et al., 2005), which could affect performance in other standardized cognitive laboratory tests in humans and rodents, possibly explaining the contradictory results. ...
Article
Psychedelic 5-hydroxytryptamine 2A receptor (5-HT2AR) agonists are showing promise in the treatment of psychiatric disorders, such as treatment-resistant depression and anxiety. Human studies suggest that enhanced cognitive flexibility may contribute to their clinical efficacy. Both improvement and impairment of cognitive flexibility has been reported with 5-HT2AR ligands, making the link between 5-HT2AR pharmacology and cognitive flexibility equivocal. We tested the selective 5-HT2AR agonist 25CN-NBOH in healthy male C57BL/6JOlaHsd mice in a touchscreen-based mouse reversal learning test. No effects were observed on acquisition of the new stimulus-reward contingency, learning errors, or perseverative responses during reversal. Our results suggest that 25CN-NBOH does not affect reversal learning in the schedule used in this study.
... Second, the majority of studies on the socioemotional effects of MDMA provide converging evidence that MDMA specifically increases social reward processing (e.g., increased emotional disclosure, increased recognition of positive facial cues; Baggott et al., 2016;Bedi, Hyman, & de Wit, 2010;Bedi, Phan, Angstadt, & de Wit, 2009;Carlyle et al., 2019;Gabay et al., 2018;Hysek, Domes, & Liechti, 2012;Hysek et al., 2014). As a result, MDMA has been discussed as increasing feelings of positive emotional empathy, as well as associated feelings of trust, both within the self and with others, all of which have been posited to improve the therapeutic alliance and treatment outcomes (Bershad, Miller, Baggott, & de Wit, 2016;Jungaberle et al., 2018). Importantly, the experience of emotional empathy implicates awareness and recognition of a variety of emotions both in the self and others, the opposite of which is, arguably, alexithymia, or difficulties in identifying and labeling emotional feelings (Taylor, Bagby, & Parker, 1997). ...
... This in turn might have facilitated approach toward and adaptive reprocessing and reconsolidation of traumatic memories, when empathically supported throughout the dosing and integrations sessions by study therapists Johansen & Krebs, 2009). Second, MDMA might have reduced participants' difficulties in effectively recognizing rewarding internal and external emotional cues in the therapeutic space (e.g., understanding feelings of joy or even euphoria during dosing, and/or recognizing empathic validation by study therapists while revisiting traumatic memories; Bershad et al., 2016;Jungaberle et al., 2018). In removing these alexithymic barriers to adequate emotional engagement with trauma-related memories, MDMA might have also facilitated corrective interpersonal interactions and concurrent PTSD symptom reduction during dosing and integration sessions . ...
Thesis
MDMA-assisted psychotherapy was shown in previous clinical trials to be efficacious and safe for alleviating treatment-resistant posttraumatic stress disorder (PTSD). However, due to low ethnoracial diversity, the question remains as to whether ethnoracial minority participants would benefit similarly. Thus, in Study 1, ethnoracial differences in PTSD symptoms, secondary outcomes (emotion regulation, alexithymia, self-compassion), and suicidality were examined for a recent multisite, open-label trial of MDMA-assisted psychotherapy. In Study 2, a mixed-methods case study was conducted on an ethnoracial minority participant from the same open-label trial, to provide a culturally informed lens on recovery from PTSD in a participant of color. Lastly, recommendations for diversifying ongoing MDMA-assisted psychotherapy trials were provided. [Dissertation defended; portions of abstract not shown pending MAPS approval for public release]
... This basis of trust is often seen as a decisive factor in psychedelic therapy. Agreeing on the framework and rules for behavior during the substance session supports safe implementation and provides a safe framework (Jungaberle et al., 2018). "Dry runs" in the form of music-guided imagination or mindfulness exercises (e.g. ...
... Furthermore, positive psychology research (i.e., of healthy functioning and wellbeing) has provided strong evidence for positive effects on wellbeing, prosocial behaviours, creativity, personality, values, and mindfulness from 77 clinical trials and epidemiological studies (N = 9876) using psychedelics (Jungaberle, 2018). Altogether, amassing research has led to the general acceptance that psychedelic compounds are clinically and physiologically safe, with low abuse liability and low potential for dependence and medical harms (Nutt, 2015;Rucker, Illif & Nutt, 2018;Schlag et al., 2022). ...
... Finally, holistic self interventions involve spiritual transformation, which eco-psychology theory suggests can foster pro-environmental behaviour when combined with connectedness to nature and environmental learning (Rezapouraghdam et al., 2018). These experiences can be supported by niche forms of tourism like spiritual, nature-based, and Indigenous tourism, along with the safe, controlled, and ethical use of psychedelics and entactogens, as they are associated with positive psychology and deepened human-nature relatedness, contributing to inner-outer transformation (Jungaberle et al., 2018;Manuel-Navarrete et al., 2024). Figure 8 illustrates the relationship between interventions and the IRDF elements. ...
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Regenerative tourism argues that addressing the current ecological crisis requires inner transformation, referring to changes in people’s mindsets, values, beliefs, and worldviews. Combined, they influence the systems we create and, as such, represent deep levers for systems change. Yet, an in-depth analysis of the inner dimension in the context of regeneration is missing. It is unclear which qualities foster inner development towards regenerative change. Using the concept of leverage points and through a scoping review and thematic analysis of 309 articles on regenerative approaches, regenerative tourism, and the inner dimension of sustainability, this study proposes the Inner Regenerative Development Framework, a whole-person approach constituting aspects of our inner world that enhance our ability to work regeneratively; conceptualised here as Inner Regenerative Development. The framework brings together cognitive, affective, grounded, and holistic aspects of ourselves, encompassing 12 inner leverage points and 85 inner qualities serving as the basis for interventions, a few of which are proposed as starting points for inner-outer transformation. Collectively, these elements highlight the inner domains, capacities, and practices that can be cultivated to support regenerative tourism from the inside out.
... MDMA trials show significant reductions in posttraumatic stress disorder symptoms , and reviews note positive effects on existential well-being, quality of life and mental health in terminal illness patients (Schimmers et al., 2022). Psychedelics also exhibit good tolerability and safety profiles in clinical settings (Andersen et al., 2021;Dos Santos et al., 2016), while non-clinical studies associate them with positive behaviour change and improved well-being (Garcia-Romeu and Richards, 2018;Jungaberle et al., 2018;Nayak et al., 2023;Teixeira et al., 2021). The emerging promise of psychedelics, despite regulatory, and scepticism barriers , suggests a potential breakthrough, but delays in translating evidence into practice may drive individuals towards self-exploration for alternative solutions. ...
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Introduction This study explores how individuals self-treat psychiatric conditions with psychedelics outside medical guidance bridging the gap in understanding unregulated therapeutic use. Aims The primary objective was to extract specific factors underlying the effects of psychedelics, exploring their relationship with the need for medication, particularly for mental health conditions like depression and anxiety. Additionally, we aimed to understand how the likelihood of being prescribed pharmacological medication varies based on mental health diagnoses and demographic factors. Methods This research utilised the Global Drug Survey 2020, an annual online survey focused on substance use patterns and demographics, incorporating modules addressing mental health and psychedelic use. The study employed Exploratory Factor Analysis to discern latent factors underlying the self-reported effects of psychedelics. Bivariable and multivariable logistic regressions were conducted to investigate the association between identified factors and the likelihood of current prescribed medication usage. Results In all, 2552 respondents reported using psychedelics for self-treatment of mental health conditions. Three significant factors were identified: Improved Mental Health, Improved Self-Awareness and Neuro-Sensory Changes. The majority of the sample reported a history of depression (80%) or anxiety (65.6%), with a significant association observed between reported factors of psychedelics’ effects and current medication usage for mental health, especially notable in cases of depression or comorbid depression and anxiety. Conclusions Perceived symptom improvement following psychedelic self-treatment may reduce the need for medically supervised pharmacological interventions. These findings highlight the potential of psychedelics to positively influence mental health and self-awareness, paving the way for further research into their therapeutic application.
... 21 Psychedelic drug use can be viewed as a transformative mystical experience, and its induction of the ability to think positively may contribute to significant increases in well-being and mood. 22 Moreover, psychedelic substances can induce alterations in consciousness, amplify individuals' awareness of their internal experiences, and offer avenues for profound contemplation and introspection. Consequently, these effects converge with the objectives pursued through mindfulness training. ...
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Objective The purpose of this study was to investigate whether a virtual reality (VR) program designed and developed based on the hallucinogenic harm reduction and integration (PHRI) clinical model could be more effective in guiding positive thinking training, improving positive thinking awareness and ability, and, to some extent, facilitating personal efficacy and emotional state compared to a traditional VR program that places users in a virtual natural ecological environment to guide positive thinking training. We also sought to understand the factors that may influence the effectiveness of VR interventions and user experience. Method Seventy-six randomly recruited participants were divided into a control group and an experimental group of 38 participants, each according to a random number table, and were trained in VR meditation for eight weeks. The experimental group used a PHRI-based mindfulness program, while the control group used a traditional mindfulness meditation program. We used The Mindful Attention Awareness Scale and the PAD emotional three-dimensional scale to assess the level of state mindfulness and changes in the emotional state before and at the end of the experiment. The Immersive Tendencies Questionnaire measured the user's sense of presence and immersion in the virtual environment. The Five Facet Mindfulness Questionnaires and the Depression Anxiety and Stress Scale (DASS-21) were used at the baseline assessment stage before and at the 4-week follow-up after the experiment to assess the change in trait mindfulness levels due to the mindfulness training. The Five Facet Mindfulness Questionnaires and the DASS-21 were used to assess changes in mindfulness and mental health trait levels. Results At the end of the experiment, the MMSQ score was significantly lower in the control group than in the experimental group, while the ITQ score was significantly higher than in the experimental group, and both scores were statistically significant (p < 0.05). In the follow-up assessment four weeks after the end of the experiment, the FFMQ-15 score and the DASS-21 were significantly and statistically higher in the experimental group than in the control group (p < 0.05). Since the scores of the PAD scale did not obey a normal distribution, we used the Wilcoxon signed-rank test to assess the results, which proved that the experimental group had higher levels of emotional activation and arousal. Conclusion The VR positive thinking program developed based on PHRI can significantly increase the positive thinking state and emotional arousal and activation of the general population participants but does not directly lead to the growth of positive emotions. Moreover, this detached psychedelic scene brings users a weaker sense of presence and presence than traditional natural space scenes. Furthermore, it does not bring any intense simulator motion sickness symptoms. These findings suggest that VR programs developed based on PHRI have a more positive facilitation effect on the positive state and that this increase lasts longer than conventional VR-positive programs.
... These results have been interpreted as support for the notion that the temporary loss of the ego and self-boundaries induced by psilocybin diminishes self-referential and egocentric processing and in turn fosters an altered perspective towards oneself, others, and the environment (Smigielski et al., 2019). In a review about the effect of psychedelics on human functioning, Jungaberle et al. (2018) concluded that the current body of literature provides preliminary evidence for the beneficial effects of psychedelics in terms of well-being in both clinical and healthy populations. ...
Article
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Background and aims This scoping review employed a multifaceted conceptualization of well-being to examine how psilocybin use affects well-being and related sub-concepts in healthy individuals. It investigated which factors influence the relationship between psilocybin use and well-being, what research protocols have been employed, and what underlying mechanisms have been proposed in existing studies. Methods A comprehensive literature search in line with the PRISMA guidelines was conducted. Scopus, PubMed, PsycINFO, Web of Science, and Google Scholar were searched for peer-reviewed articles about psilocybin and well-being in healthy populations. Results Studies were heterogeneous in regard to study objectives, study design, study procedure, sample size and psilocybin dosage. In all studies, psilocybin use led to positive well-being-related outcomes for the majority of participants. Facets of well-being positively affected by psilocybin use in this review were self-acceptance, positive relationships, and meaning/purpose in life. Conclusions This scoping review provided preliminary evidence for the beneficial effects of psilocybin on well-being and related sub-concepts such as self-acceptance, positive relationships, and meaning/purpose in life in healthy individuals. Ego-dissolution, unity, connectedness, and mystical-type experiences are interrelated concepts that seem to be crucial for explaining such positive well-being-related effects of psilocybin. Under conducive conditions, the use of psilocybin may contribute to healthy functioning, through broad and sustained improvements in a variety of well-being concepts. Due to the heterogeneous nature of the studies, more definite conclusions require further research with a rigorous and homogeneous design.
... As an increasing number of people are interested in having psychedelic experiences, and PAT being gradually mainstreamed into the existing health care systems, it is reasonable to expect that the application of various models/methods of psychedelic integration will grow in the upcoming years. It will thus have an impact on the health and well-being of an increasing number of people seeking support for their health conditions, as well as positive behavioral/ lifestyle changes (Teixeira et al., 2022), and personal growth (Jungaberle et al., 2018). It thus have a public health significance. ...
Article
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The use of psychedelics for various purposes was common in different civilizations throughout human history and has been explored scientifically for more than a century. Although the applications of psychedelics show promise in the treatment of various psychiatric and neurological indications, as well as in facilitation of well-being and personal growth, several psychedelic-related risks and challenges have also been identified. Psychedelic integration (PI) refers to various practices that serve to either minimize harms or maximize benefits associated with psychedelic use. PI is also recognized as a substantial part of psychedelic-assisted therapy (PAT), following preparation to and facilitation of the psychedelic experience. In the context of clinical/psychotherapeutic practice, several PI models/methods have already been proposed. However, while a number of these models/methods are theory-driven, or have a history of clinical application, each lack any empirical support and thus cannot be described as evidence based. This is to the disadvantage to countless people who had and who will have their psychedelic experiences in various contexts, as the prevalence of using psychedelics increased in recent years and is expected to grow further. Therefore, consistent with general recommendations for developing and implementing evidence-based mental health practices, this article calls for scientific efforts to the development, examination, and evaluation of psychedelic integration models/methods. This article also briefly summarizes the current literature on psychedelic integration, provides a list of exemplary avenues that research on psychedelic integration might take, as well as anticipates and discusses the limitations and challenges of PI-focused research.
... On the other hand, controlled clinical studies evaluating the effects of psilocybin in cancer patients found that a single administration of the substance produced improvements in parameters of spirituality and spiritual well-being (Agin-Liebes et al. 2020;Griffiths et al., 2016;Ross et al., 2016). In a review on psychedelics and their relationship with positive psychology and healthy human functioning and well-being, preliminary evidence was found that psychedelics can support and enhance psychospiritual practices (Jungaberle et al. 2018), for example, through improved levels of selftranscendence (Bouso et al. 2012), the possibility of mystical experiences, and ego dissolution (Barrett and Griffiths 2017;Griffiths et al. 2006). ...
Article
This study evaluated the psychometric properties of the Spiritual Well-Being Scale (SWBS) in a Brazilian sample. We analyzed spiritual well-being, defined as existential well-being (EWB) and religious well-being (RWB), among individuals with varying religious and spiritual experiences, both users and non-users of psychedelics. The online cross-sectional survey was conducted in Brazil, from April to June 2022. The psychometric analyses demonstrated reliability and validity based on the internal structure and the relationship with satisfactory external variables concerning the RWB and EWB factors of the SWBS. Validity evidence was shown for both factors (RWB, EWB) with adequate reliability ratings. However, the RWB factor, which was entirely replicated, demonstrated the best group differentiation and internal consistency. Although both factors showed validity, the RWB factor exhibited superior psychometric indices for validity, group discrimination, and reliability. Regarding psychedelics, the association with RWB and EWB demonstrates a U-shaped pattern, as participants who never use these substances typically exhibit higher RWB and EWB indices, succeeded by frequent users. This finding underscores the need for additional studies to further explore the intricate interplay between psychedelics and spiritual well-being.
... Today there is a growing recognition of the merit of positive psychology; a domain that draws insights from across contemplative traditions, psychologies East, West and Indigenous, and is grounded not merely in a tacit bioreductionism, but also a recognition of both existential concerns and the importance of psychodynamic approaches to understanding consciousness (Jungaberle et al., 2018). Such a broad perspective is required for conceiving and understanding psychedelics' therapeutic means; as well as inviting a reimagining of psychiatric nosology and the potential undoing of conventional understandings of both pathology and wellbeing, through an overturning of specified and discrete deficit models of psychopathology. ...
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In the monograph Philosophy and Psychedelics: Frameworks for Exceptional Experience, Hauskeller raises the important subject of individualization and alienation in psychedelic psychotherapy. Under the prevailing conditions of neoliberalism, Hauskeller contends that psychedelic-assisted psychotherapy appropriates Indigenous knowledges in an oppressive fashion, may be instrumentalised to the ends of productivity gain and symptom suppression, and may be utilised to mask societal systems of alienation. Whilst offering a valuable socio-political critique of psychedelics' clinical uptake, we suggest that Hauskeller's view does not adequately acknowledge the ways in which psychedelics offer a challenge to the Western reductive bio-medical understanding of healing and wellbeing. It is contended herein that Indigenous knowledges, in alliance with a range of emerging sciences, offer both an engagement with ethnomedicines in a less harmfully appropriative fashion, and a renewed understanding of the means by which psychedelics achieve therapeutic change. With this understanding, what becomes apparent are the potential ways in which psychedelic medical usage may produce positive feedback upon the oppressive systems in which we are embedded. That is, transpersonal experience through encounters with the ineffable may offer a revisioning of Western psychology and cognitive science. Indeed, if psychedelics are approached with an understanding of the actual means by which they produce therapeutic outcomes—changing mental representations of the self, or self-insight derived through non-ordinary states of consciousness—then psychedelic psychotherapy offers a reimagining of psychiatric nosology, challenging conventional understandings of both pathology and wellbeing through an overturning of specified and discrete deficit models of psychopathology. This may provide both a critique of the prevailing categories used to describe madness and an expansion of our understanding of the mind-body relation, as well as an increased recognition of positive psychology grounded in cross-cultural contemplative traditions. This provides an implicit challenge to the pharmaceutical industrial-complex and its profit motives; and the corresponding neoliberalist, globalising tendencies which Hauskeller seeks to address.
... Nedávná rešerše klinických a epidemiologických studií (n = 77; celkem s 9 876 účastníky) dokumentovala, že užívání psychedelik v různých prostředích a populacích souviselo s akutním či dlouhodobým pozitivním účinkem na náladu, duševní pohodu, prosociální chování, empatii, kognitivní flexibilitu, kreativitu, osobnostní faktory, jako otevřenost, hodnotové orientace, vztah k přírodě, spiritualitu, transcendenci či všímavost. 56 Kromě toho byla psychedelika v kvalitativních studiích identifikována jako účinné faktory kontaktu/napojení (orig. connectedness) se sebou, s druhými či s okolním světem nebo napomáhají k (sebe)přijetí. ...
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Tato publikace představuje komplexní úvod do problematiky a dosud první souhrnný přehled situace v oblasti fenoménu užívání psychedelik v České republice, shrnující výsledky výzkumného projektu Aplikace výzkumných metod při tvorbě návrhu systému služeb pro uživatele psychedelických látek realizovaného v letech 2019–2021 v Národním ústavu duševního zdraví a spolufinancovaného se státní podporou Technologické agentury České republiky. This publication is a comprehensive introduction to the phenomenon and so far the first complex overview of the situation in the field of psychedelics use in the Czech Republic, summarizing the results of the research project Application of Research Methods in Creating a Design of a System of Services for Users of Psychedelics (hereinafter referred to as National Psychedelic Research) implemented in 2019–2021 at the National Institute of Mental Health.
... MDMA has been shown across many studies to affect brain systems and hormones related to social bonding and positive social reinforcement (49,81) and may increase motivation to connect with others even after the medicine session. Subjectively, ingestion of MDMA is associated with people reporting increased feelings of love, peace, and safety (81), and a subjective sense of wanting to be with others (82). A recent series of studies with mice indicate that the effects of MDMA on social behavior likely extend beyond the context of acute medicine, and crucially may re-open a critical window for social reinforcement among adult mice that otherwise disappears with age for more detail see (54). ...
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Background Social anxiety disorder (SAD) is a serious and prevalent psychiatric condition that heavily impacts social functioning and quality of life. Though efficacious treatments exist for SAD, remission rates remain elevated and a significant portion of those affected do not access effective treatment, suggesting the need for additional evidence-based treatment options. This paper presents a protocol for an open-label pilot study of MDMA-assisted therapy (MDMA-AT) for social anxiety disorder. The study aims to assess preliminary treatment outcomes, feasibility and safety, and psychological and physiological processes of change in the treatment of SAD with MDMA-AT. A secondary aim includes the development of a treatment manual for MDMA-AT for SAD. Method The outlined protocol is a randomized, open-label delayed treatment study. We will recruit 20 participants who meet criteria with moderate-to-severe social anxiety disorder (SAD) of the generalized subtype. Participants will be randomly assigned to an immediate treatment (n = 10) or delayed treatment condition (n = 10). Those in the immediate treatment condition will proceed immediately to active MDMA-AT consisting of three preparation sessions, two medicine sessions in which they receive oral doses of MDMA, and six integration sessions over approximately a 16-week period. The delayed treatment condition will receive the same intervention after a 16-week delay. Our primary outcome is SAD symptom reduction as measured by the Liebowitz Social Anxiety Scale administered by blinded raters at post-treatment and 6 month follow up. Secondary outcomes include changes in functional impairment, feasibility and safety measures, and novel therapeutic processes of change including shame and shame-related coping, belongingness, self-concealment, and self-compassion at post-treatment. Exploratory outcomes are also discussed. Discussion The results of this pilot trial advance the field’s understanding of the acceptability and potential effectiveness of MDMA-AT for social anxiety disorder and provide an overview of relevant therapeutic mechanisms unique to SAD. We hope findings from this protocol will inform the design of subsequent larger-scale randomized controlled trials (RCT) examining the efficacy of MDMA-AT for SAD. Clinical trial registration https://clinicaltrials.gov/, NCT05138068.
... Chen and Mongrain [57] noted that one of the least discussed but most important aspects of the psychedelic experience is the encounter with a state of awe and interconnectedness: the suspension of ego boundaries and cultivation of emotional states of gratitude, connection, and wonder intermingle in the promotion of social wellbeing. Jungaberle and his team [58] noted that positive psychology measures had been applied in 77 clinical trials on psychedelics and entactogens thus far. They derive that outcome-centric measures show pro-social benefits in the domains of empathy, creativity, personality, values, mindfulness, and wellbeing (all central to positive psychology intervention). ...
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Psychedelics have been studied extensively in their broad treatment potential for a variety of mental health disorders. Recently, scholars have turned their attention to the role of psychotherapy in the augmentation, follow-up, and support mechanisms relevant to psychedelic administration. While it is tempting to position psychedelic substances as standalone medicines akin to SSRIs or SNRIs, their unique neurochemical action and potential for psychological transformation calls for a broader examination of the role of counseling and psychotherapy, within the context of a bio-psychosocial model. I outline well-established and emerging therapeutic modalities that are well-placed in complementary and augmented psychedelic treatment. I do so with the intention of opening a broader conversation to those situated in medical and medical-adjacent fields, including psychoanalysts, counselors, support workers, and other allied professionals. Ultimately, practitioners working in medical-aligned fields hold diversly vested interests in understanding the place of psychedelic therapies in mental health, and more attention should be given to a balanced consideration of treatment and support mechanisms.
... So könnten Psychedelika auch eine vermeidung umgehende Auseinandersetzung mit bestimmten Konfliktfeldern oder Traumata unterstützen, mit korrigierenden Neuerfahrungen einhergehen und zu einer akzeptierenden oder lösungsorientierten Haltung wie auch einer autobiographischen Integration führen, u. a. [42]. dies könnte mittelfristig zu einer Betonung von Aspekten der Positiven Psychologie führen [43], wenn auch langfristige positive wie auch potenziell negative Entwicklungen noch genauer zu beobachten sind. davis et al. [44] beschrieben eine erhöhte kognitive Flexibilität basierend auf Einsicht und Bedeutungsbewusstsein unter Psychedelika und führten diese auf erweiterte Assoziationen und auf reduzierte dysfunktionale Filter zurück, wie auch auf ein Übersteuern von kognitiven Fixierungen und durchbrechen rigider denkmuster. ...
Article
Zusammenfassung In den letzten Jahren erlebte die klinische Forschung zur therapeutischen Wirksamkeit von Psychedelika eine Art Renaissance. Der aktuelle Stand wissenschaftlicher Erkenntnisse zur Wirksamkeit bei verschiedenen psychiatrischen Indikationen, wie auch die bereits unter bestimmten Voraussetzungen genehmigungsfähige Anwendung einiger psychedelischer Substanzen in der klinischen Praxis in manchen Ländern der Welt, legen die Möglichkeit einer zukünftigen Anwendung im klinischen Setting auch in Deutschland nahe. Dabei steht das Feld noch vor großen Herausforderungen inklusive der Notwendigkeit einer kritischen Gestaltung der Rahmenbedingungen für einen möglichen klinischen Einsatz. In diesem Artikel wird auf die historischen Hintergründe der klinischen Anwendung von Psychedelika eingegangen, um dann Aspekte wie Psychophänomenologie, Wirkmodelle, mögliche Indikationen und Pharmakosicherheit zu beleuchten. Anschließend wird der aktuelle Stand der Forschung und auch der Organisation von Fachgesellschaften in Deutschland im historischen und internationalen Kontext betrachtet, wie auch kritische Aspekte und noch zu klärende Fragen in dem Themenfeld.
... identifier 04052568), depression in early Alzheimer's disease (ClinicalTrials.gov identifier 04123314) (Reiff et al. 2020), post-traumatic stress disorder (Chi and Gold 2020), cluster headaches (Tylš et al. 2016a, b;Castellanos et al. 2020), chronic pain (Castellanos et al. 2020), behaviour disorder and mental health problems (Hanks and González-Maeso 2016;Carhart-Harris et al. 2016;Jungaberle et al. 2018). A number of patents have been obtained or were abandoned in the past (Gerber et al. 2021). ...
Article
Humans have collected and used hallucinogenic mushrooms for ethnic medicinal, recreational, and religious purposes since before recorded history. Currently, the use of these mushrooms is illegal in most countries, but where their use is legal they are applied as self medication. Psilocybin and psilocin, two psychoactive alkaloids, are naturally synthesized by hallucinogenic mushrooms. The chemical structure of these compounds are similar to the neurotransmitter serotonin. Activation of this system by psilocybin and psilocin may produce temporary changes in the brain that induce hallucinations and feelings of euphoria. Adjustment of the serotonin system in this way can moderate symptoms of related mental disorders. This review summarizes relevant and current information regarding the discovery of hallucinogenic mushrooms and their contained psychoactive compounds, the events that lead to their criminalization and decriminilization, and the state of knowledge of psilocybin, psilocin, and derivatives. Last, research on the psychoactive properties of these mushrooms is placed in perspective to possible applications for human dysfunctions.
... A psychedelic experience may have short or long-term effects on the mental state, health, behaviour, attitudes, and personality (15)(16)(17)(18)(19). Current clinical research suggests a therapeutic potential of psychedelics (e.g., LSD, psilocybin, MDMA) in the treatment of a variety of mental health problems (18,20,21), as well as somatic illnesses (mainly cannabinoids) (22). ...
Article
Objectives: Different psychoactive substances are widely used in today's society. So far limited data are available on the use of psychedelics in the general population. The main aim of this study is to estimate the numbers of users of substances with psychedelic properties (classical psychedelics, cannabis, ecstasy, and ketamine) in the Czech Republic. Methods: Data from two samples enrolled in representative cross-sectional questionnaire surveys in the Czech adult population in 2016 (n = 2,785) and 2018 (n = 1,665) were analysed. Prevalence rates were extrapolated to estimate numbers of current, i.e., last-year, users of psychedelics, and their socio-demographic profiles were compared with non-users and users of cannabis. Results: An estimated 5-6% of the Czech adult population (350-430 thousand people) used classical psychedelics (LSD, psilocybin mushrooms, ayahuasca) in their lifetime, increasing up to 28-30% when cannabis is included (1.9-2.1 million users). Current use of classical psychedelics reached 0.7-1.9% (50-130 thousand people), and 9-11% (590-750 thousand users) when cannabis was included. Users of psychedelics were more often males, of younger age and single. Conclusions: No significant socio-demographic differences were found between users of classical psychedelics and recreational cannabis users, however, differences were significant when compared to non-users and users of other illicit drugs. Findings should further serve to inform drug policy and social and healthcare systems in respect to the use of psychedelics.
... A review by Jungaberle, et al. (2018) found that psychedelics may be able to sustain and enhance aspects such as mood, wellbeing, openness and flexibility, as well as mindfulness-related capabilities. While a state of mindfulness can be cultivated through dedicated practice or psychological therapy, this may be further facilitated through use of psychedelic substances. ...
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Background and aims The benefits of classic serotonergic psychedelics (e.g. psilocybin, LSD, DMT, ayahuasca) are becoming more widely known with the resurgence in research in the past decade. Furthermore, the benefits of mindfulness are well documented. However, no systematic reviews have examined linkage of mindfulness and psychedelics use. The aim of this systematic review is to explore the link between psychedelics and characteristics of mindfulness. Methods We conducted a systematic search across multiple databases, inclusive of grey literature and backwards/forward-citation tracking, on the 18 January 2021. The search strategy included terms relating to mindfulness and psychedelics, with no restriction on clinical or non-clinical conditions. Study quality was assessed. An exploratory random-effects meta-analysis was conducted on pre-post mindfulness data relative to psychedelic ingestion. Results Of 1805 studies screened, 13 were included in the systematic review. There was substantial variability in participant characteristics, psychedelic administration method and measurement of mindfulness. The ingestion of psychedelics is associated with an increase in mindfulness, specifically relating to domains of acceptance, which encompasses non-judgement of inner experience and non-reactivity. The meta-analysis of a subset of studies (N = 6) showed small effects overall relative to ayahuasca ingestion, increasing mindfulness facets of non-judgement of inner experience and non-reactivity, as well as acting with awareness. Conclusions Further methodologically robust research is needed to elucidate the relationship between psychedelics and mindfulness. However, mindfulness and specific facets relating to acceptance have been shown to increase following ingestion of psychedelics in a number of studies.
... Although the classic psychedelics have clear relevance for psychiatry (Hendricks, 2018), their potential to enhance wellness is believed to be at least as substantial as their effectiveness as therapeutic tools (Gandy, 2019;Jungaberle et al., 2018). In the initial era of psychedelic research, it was noted that beneficial outcomes could occur when psychedelics were used under non-medical conditions, and it was argued that they held legitimate uses beyond the therapeutic context (Masters & Houston, 1966). ...
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Recent studies implicate the use of psychedelic substances in the treatment of psychiatric conditions. However, this literature also suggests that the psychedelics may have utility in the promotion of positive adult development. Accordingly, this paper outlines a study exploring this premise. An online sample (n = 684) of psychedelic users and non-users (age range: 18–24 to 75–84; median = 25–34) was recruited. Conditional process analysis was used to assess whether the relationship between psychedelic use and two facets of adult development, adjustment and growth, would be mediated by openness to experience, awe-proneness, and mystical experiences, and whether these relationships would be moderated by drug-use reflection/integration. Results show that the direct relationship between psychedelic use and growth was moderated by drug-use reflection/integration. In addition, the indirect relationship between psychedelic use and adjustment was mediated through awe-proneness, while the indirect relationships between psychedelic use and growth were mediated via awe-proneness and openness to experience; drug-use reflection/integration moderated these mediated relationships. In addition, drug-use reflection/integration directly predicted openness, awe-proneness, and growth. These findings suggest that, when used with self-expansive intentions and actively reflected upon and integrated post use, psychedelics may augment positive adult development.
... There are a number of studies examining personality change after psychedelic use (Jackson et al., 2022), although primarily focusing on effects of lysergic acid diethylamide (LSD) and psilocybin (i.e., the primary psychoactive chemical in "shrooms"). Common results are both acute and long-term effects on neuroticism, depression, well-being, self-esteem, life satisfaction, and openness to experience (Jungaberle et al., 2018;Nour et al., 2017;Weiss et al., 2021). Similar to what has been found for LSD, lasting changes in personality (i.e., neuroticism, conscientiousness) after the administration of psilocybin have also been documented in longitudinal studies ranging from three months to more than a year in duration MacLean et al., 2011). ...
Article
Personality traits predict both the initiation and continued usage of alcohol and drugs. Less established is if substance use is associated with subsequent changes in personality, especially during the sensitive period of adolescence. We used three approaches to disentangle selection and socialization effects to address whether substance use is associated with personality development (impulsivity, sensation-seeking, depression, self-esteem). First, we used a multi-wave longitudinal sample of adolescents (N = 8,303) from the National Longitudinal Survey of Youth-Child and Young Adult dataset to study the first use of several substances. Second, we used propensity score weighting to equate users and abstainers on a range of background variables. Third, we investigated changes before, during, and after initiation of substances. Overall, there was unique variability and effects in personality across time for average levels, trajectories, and magnitudes of change both between users and abstainers as well as within users of specific substances. Results suggest that initiation of substance use is associated with changes in personality; the specifics of which are largely contingent upon the substance being used. Impulsivity and sensation-seeking were the traits associated with the most change while cocaine and cigarettes were the substances associated with the greatest changes.
... Knowledge regarding the psychological mechanisms of MDMA-AT remains sparse, however, in spite of numerous academic discussions of putative factors, such as openness to experiences (M. T. Wagner et al., 2017), enhanced emotion regulation (Johansen & Krebs, 2009;Sessa, 2017), trust and connectedness (Carhart-Harris et al., 2018;Jungaberle et al., 2018), discovery of insights about past trauma(s) (Grinspoon & Doblin, 2001;Hendricks, 2018), and self-compassion (McDaniel, 2017). One qualitative study conducted at 1-year follow-up examined perceived benefits of MDMA-AT beyond PTSD symptom reduction (Barone et al., 2019). ...
Article
MDMA (±3,4-methylenedioxymethamphetamine)-assisted therapy (MDMA-AT) was shown in previous clinical trials to have promising efficacy and safety for alleviating treatment-resistant posttraumatic stress disorder (PTSD). However, due to low ethnoracial diversity, the question remains as to whether ethnoracial minority participants would benefit similarly. Thus, a mixed-methods case study was conducted on a participant of color from an open-label trial of MDMA-AT for PTSD to provide a culturally informed lens on symptom recovery with this treatment approach. An additional aim was to elucidate mechanisms of change underlying this treatment for the participant. A case profile was provided, documenting quantitative improvement in PTSD symptoms. This was followed by an interpretative phenomenological analysis (IPA) of effects and mechanisms of action for this participant, based on integration session transcripts. Results of IPA indicated recurrent themes related to psychological mechanisms of symptom change, reduced PTSD symptoms, and additional effects (positive and negative) beyond PTSD symptom reduction. These themes were discussed and recommendations for attuning to culturally relevant material during MDMA-AT were provided.
... Recreational psychedelic users with complete mystical experiences had substantially higher self-reported wellbeing than those without, echoing clinical studies of psychedelic positive psychology (Aday et al., 2020;Griffiths et al., 2011;Griffiths et al., 2006;Jungaberle et al., 2018). However, our data are novel in that they describe a recreational context and employ a broader array of metrics spanning nonparallel facets of psychological and human wellbeing. ...
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A growing proportion of the population is engaging in recreational psychedelic use. Psychedelics are uniquely capable of reliably occasioning mystical experiences in ordinary humans without contemplative or religious backgrounds. While clinical research has made efforts to characterize psychedelic experiences, comparably little is understood about how humans naturalistically engage with psychedelics. The present study employs a mixed-methods approach to examine the content and implications of psychedelic and mystical experiences, occurring outside of laboratory settings. We use text mining analyses to arrive at a qualitative description of psychedelic experiential content by abstracting from over two-thousand written reports of first-person psychedelic experiences. Following up, we conducted quantitative analyses on psychometric data from a large survey (N = 1424) to reveal associations between psychedelic use practices, complete mystical experiences, and psychological wellbeing. Topic-modelling and sentiment analyses present a bottom-up description of human interactions with psychedelic compounds and the content of such experiences. Psychometric results suggest psychedelic users encounter complete mystical experiences in high proportions, dependent on factors such as drug type and dose-response effects. Furthermore, a salient association was established between diverse metrics of wellbeing and those with complete mystical experiences. Our results paint a new picture of the growing relationships between humans and psychedelic experiences in the real-world use context. Ordinary humans appear to encounter complete mystical experiences via recreational psychedelic use, and such experiences are strongly associated with improved psychological wellbeing.
... Naturalistic research into peyote (71) and ayahuasca (72) "users" revealed a better mental health profile in this population than in matched controls. A recent review of clinical trials and epidemiological studies (N = 77 eligible studies with 9,876 participants) documented that the use of psychedelics in various settings and populations was associated with aggregate improvements in a variety of indices of mental health (73). Other psychological changes linked to psychedelic use include prosocial attitudes and behavior (74), increased nature-relatedness (75,76), and increases in the personality traits "self-transcendence" and "openness to experience" (77,78). ...
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Addressing global mental health is a major 21st-century challenge. Current treatments have recognized limitations; in this context, new ones that are prophylactic and effective across diagnostic boundaries would represent a major advance. The view that there exists a core of transdiagnostic overlap between psychiatric disorders has re-emerged in recent years, and evidence that psychedelic therapy holds promise for a range of psychiatric disorders supports the position that it may be transdiagnostically effective. Here, we propose that psychedelic therapy's core, transdiagnostically relevant action lies in its ability to increase neuronal and mental plasticity, thus enhancing the potential for change, which we consider to be a key to its therapeutic benefits. Moreover, we suggest that enhanced plasticity via psychedelics, combined with a psychotherapeutic approach, can aid healthy adaptability and resilience, which are protective factors for long-term well-being. We present candidate neurological and psychological markers of this plasticity and link them with a predictive processing model of the action of psychedelics. We propose that a model of psychedelic-induced plasticity combined with an adequate therapeutic context has prophylactic and transdiagnostic potential, implying that it could have a broad, positive impact on public health.
... Another important area of psychedelic treatments that needs conceptual, risk mitigation, and legal consideration concerns the salutogenic effects of psychedelics [54]. "Patients frequently report on clinical effects beyond their own psychiatric diagnosis, which may be indicative of the cross-diagnostic action of psychedelic drugs, by setting in motion therapeutic processes that address core elements of a shared psychopathology across mental disorders" [28]. ...
Article
Serotonergic psychedelics such as psilocybin, lysergic acid diethylamide (LSD), or dimethyltryptamine (DMT), as well as psychoactive drugs that trigger phenomenologically- related experiences like 3,4-methylenedioxymethamphetamine (MDMA) and ketamine, belong to the most promising treatment approaches in contemporary psychiatry. Psychedelic-assisted psychotherapy is not only a new treatment paradigm in psychopharmacology, but it also requires a redefinition of psychotherapeutic processes and the contextualization of psychopharmacological interventions within a new treatment infrastructure. Crucial for future practice and research in the field are (1) informed patient referral and co-treatment practices, (2) screening (e. g., choosing the right patients for these therapies), (3) the dosing preparation sessions, (4) the assisted dosing sessions as well as after-care procedures such as (5) psychological integration and (6) supporting the development of structured patient communities. Definition of future treatment delivery infrastructures and requirements for therapist training are further challenges for research and practice. Finally, the implementation of psychedelic-assisted psychotherapy in routine mental health care must be embedded into public communication about the potential and risks of these innovative therapeutic approaches. This paper provides a synopsis of challenges for practitioners, researchers, and regulators to be addressed in the approval processes of psychedelics. Publication History Received: 15 February 2021 Received: 06 April 2021 Accepted: 13 April 2021 Publication Date: 12 May 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
... The effects of MDMA are believed to be mediated by a number of mechanisms, including monoamine release, serotonin and norepinephrine transporter reuptake inhibition, monoamine oxidase inhibition, partial agonism of serotonin receptors (5-HT 2A , 5-HT 1A , and 5-HT 2C receptors), and increase in blood concentrations of oxytocin (94)(95)(96)(97)(98). To date, studies with healthy volunteers have confirmed that MDMA produces an easily controlled and reversible state of altered consciousness characterized by euphoria, empathy, well-being, insightfulness, extraversion, positive mood, gregariousness, feelings of authenticity, increased access to emotionally intense material, increased interpersonal trust, and compassion for oneself and others (96,(99)(100)(101)(102)(103). In the clinical population, anxiety has been reported in a majority of study participants, and painful emotions such as grief, fear, and rage are not uncommon in participants with a diagnosis of PTSD (104-106). ...
Article
(Reprinted with permission from The American Journal of Psychiatry 2020; 177:391-410).
... Relatedly, data indicate the deployment of this intervention may yield benefits beyond diagnosed mental illness. For example, given observed improvements in psychological wellbeing (Jungaberle et al., 2018;Walsh, 1982) including resilience-related changes (Close et al., 2020;Davis et al., 2019), it is conceivable that psychedelic therapy could be used as a prophylactic or preventative intervention, for example, promoting adaptability in adversity (Close et al., 2020;Davis et al., 2020;Murphy Beiner and Soar, 2020). We are aware that similar inferences have Figure 6. ...
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This paper introduces a new construct, the ‘pivotal mental state’, which is defined as a hyper-plastic state aiding rapid and deep learning that can mediate psychological transformation. We believe this new construct bears relevance to a broad range of psychological and psychiatric phenomena. We argue that pivotal mental states serve an important evolutionary function, that is, to aid psychological transformation when actual or perceived environmental pressures demand this. We cite evidence that chronic stress and neurotic traits are primers for a pivotal mental state, whereas acute stress can be a trigger. Inspired by research with serotonin 2A receptor agonist psychedelics, we highlight how activity at this particular receptor can robustly and reliably induce pivotal mental states, but we argue that the capacity for pivotal mental states is an inherent property of the human brain itself. Moreover, we hypothesize that serotonergic psychedelics hijack a system that has evolved to mediate rapid and deep learning when its need is sensed. We cite a breadth of evidences linking stress via a variety of inducers, with an upregulated serotonin 2A receptor system (e.g. upregulated availability of and/or binding to the receptor) and acute stress with 5-HT release, which we argue can activate this primed system to induce a pivotal mental state. The pivotal mental state model is multi-level, linking a specific molecular gateway (increased serotonin 2A receptor signaling) with the inception of a hyper-plastic brain and mind state, enhanced rate of associative learning and the potential mediation of a psychological transformation.
... The search was conducted between October 23rd and 31st, 2019. In addition, we hand searched recent systematic reviews (Aday et al., 2020;Bouso, dos Santos, Alcázar-Córcoles, & Hallak, 2018;dos Santos et al., 2018;Jungaberle et al., 2018;Muttoni et al., 2019;Reiche et al., 2018;Reiff et al., 2020;Schenberg, 2018). ...
Article
Background: Scientific interest in the therapeutic effects of classical psychedelics has increased in the past two decades. The psychological effects of these substances outside the period of acute intoxication have not been fully characterized. This study aimed to: (1) quantify the effects of psilocybin, ayahuasca, and lysergic acid diethylamide (LSD) on psychological outcomes in the post-acute period; (2) test moderators of these effects; and (3) evaluate adverse effects and risk of bias. Methods: We conducted a systematic review and meta-analysis of experimental studies (single-group pre-post or randomized controlled trials) that involved administration of psilocybin, ayahuasca, or LSD to clinical or non-clinical samples and assessed psychological outcomes ⩾24 h post-administration. Effects were summarized by study design, timepoint, and outcome domain. Results: A total of 34 studies (24 unique samples, n = 549, mean longest follow-up = 55.34 weeks) were included. Classical psychedelics showed significant within-group pre-post and between-group placebo-controlled effects on a range of outcomes including targeted symptoms within psychiatric samples, negative and positive affect-related measures, social outcomes, and existential/spiritual outcomes, with large between-group effect in these domains (Hedges' gs = 0.84 to 1.08). Moderator tests suggest some effects may be larger in clinical samples. Evidence of effects on big five personality traits and mindfulness was weak. There was no evidence of post-acute adverse effects. Conclusions: High risk of bias in several domains, heterogeneity across studies, and indications of publication bias for some models highlight the need for careful, large-scale, placebo-controlled randomized trials.
... Some of the strongest evidence that drug use can lead to changes in personality comes from the effect of psychedelics on personality change, usually through controlled clinical trials (Jackson, Beck & Mike, in press). Common results are both acute and long-term effects on depression, well-being, self-esteem, life satisfaction, and openness to experience (Jungaberle et al., 2018;Nour, Evans, & Carhart-Harris, 2017). Previous studies have not directly examined the relationship of psychedelics on impulsivity or sensation-seeking, although sensation-seeking's association with openness suggests the possibility of a relationship. ...
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Personality traits predict both the initiation and continued usage of alcohol and drugs. Less established is if substance use is associated with subsequent changes in personality, especially during the sensitive period of adolescence. We used three approaches to disentangle selection and socialization effects to address whether substance use is associated with personality development (impulsivity, sensation-seeking, depression, self-esteem). First, we used a multi-wave longitudinal sample of adolescents (N = 8,303) from the National Longitudinal Survey of Youth - Child and Young Adult dataset to study the first use of several substances. Second, we used propensity score weighting to equate users and abstainers on a range of background variables. Third, we investigated changes before, during, and after initiation of substances. Overall, there was unique variability and effects in personality across time for average levels, trajectories, and magnitudes of change both between users and abstainers as well as within users of specific substances. Results suggest that initiation of substance use is associated with changes in personality; the specifics of which are largely contingent upon the substance being used. Impulsivity and sensation- seeking were the traits associated with the most change while cocaine and cigarettes were the substances associated with the greatest changes.
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Introduction Post-traumatic stress disorder (PTSD) is associated with significant patient burden. While pharmacotherapies and evidence-based psychotherapy interventions (EBPI) are effective, studies consistently highlight inadequate outcomes and high treatment dropout. Psychedelic therapy (PT) has shown preliminary promise across difficult-to-treat conditions, including MDMA-assisted therapy for PTSD, however trials of classical psychedelics in PTSD are lacking. Understanding patients’ experiences of EBPI could help promote safety in PT. Aim To systematically review qualitative research on patients’ subjective experience of EBPI for PTSD, and of PT, and examine areas of overlap and divergence between them. Methods Systematic literature searches for studies published between 2010 and 2023 were conducted on OVID, PubMed, Web of Science, and PsycInfo. Included were original studies in English that presented qualitative data of patient experiences of EBPI in PTSD, or PT for any indication. Extracted data from included studies were analysed using thematic synthesis. Syntheses were completed separately for EBPI and PT, before similarities and differences between the therapies were identified. Results 40 research articles were included for review: 26 studies on EBPI for PTSD, and 14 studies on PT. EBPI studied were CBT, EMDR, CPT and PE. Psychedelic compounds studied were psilocybin, ibogaine, LSD, MDMA and ketamine, for treatment of substance use disorders, anxiety relating to physical illness, depression, and PTSD. Core themes from patient experiences of EBPI: 1) patient burden in PTSD treatment; 2) readiness; 3) key mechanisms of change; 4) psychological safety and trust. Themes identified in the review of PT: 1) indirect trauma processing; 2) reorganisation of self-narratives via processes of relatedness and identification; 3) key treatment characteristics. Conclusion This study suggests overlap between patients’ experience of EBPI and PT in terms of key mechanisms of change, the importance of psychological safety and readiness to engage in treatment. Trauma-informed care paradigms and practices may improve safety and acceptability of PT research.
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Psychedelics are psychoactive substances that receive renewed interest from science and society. Increasing empirical evidence shows that the effects of psychedelics are associated with alterations in biochemical processes, brain activity, and lived experience. Still, how these different levels relate remains subject to debate. The current literature presents two influential views on the relationship between the psychedelic molecule, neural events, and experience: The integration view and the pluralistic view. The main aim of this article is to contribute a promising complementary view by re-evaluating the psychedelic molecule-brain-experience relationship from an enactive perspective. We approach this aim via the following main research questions: (1) What is the causal relationship between the psychedelic drug and brain activity? (2) What is the causal relationship between brain activity and the psychedelic experience? In exploring the first research question, we apply the concept of autonomy to the psychedelic molecule-brain relationship. In exploring the second research question, we apply the concept of dynamic co-emergence to the psychedelic brain-experience relationship. Addressing these two research questions from an enactive position offers a perspective that emphasizes interdependence and circular causality on multiple levels. This enactive perspective not only supports the pluralistic view but enriches it through a principled account of how multi-layered processes come to interact. This renders the enactive view a promising contribution to questions around causality in the therapeutic effects of psychedelics with important implications for psychedelic therapy and psychedelic research.
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The article reviews progress made in psychology toward defining the parameters of what Maslow called the “Good Person.” The article concludes that considerable empirical support has been found for the character traits Maslow associated with self-actualization. That is, the fundamental description of the “Good Person” has not changed significantly since Maslow’s original work with two exceptions. One, there is now considerable research on self-transcendence and transpersonal states. Two, cross-cultural research has shown that Maslow’s description of self-actualizing people was more dependent on social, historical, and cultural norms that he was aware of. These lines of research significantly expand Maslow’s thinking about the parameters of the “Good Person.”
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This paper explores both transpersonal psychology and ecopsychology individually and in conjunction, followed by an inspection of their relationship with mystical experiences and the impact of these within a transpersonal ecopsychological context. Specifically, nature as a trigger for such experiences is examined, alongside an analysis of the effect of these nature mystical experiences on an individual’s ego-boundaries and their psychological wellbeing. A special case is made for the re-emerging study of psychedelics – as positive agents of mental health, wellbeing, spiritual and creative growth, and social change – as inherently belonging to a transpersonal ecopsychology. The final thoughts will be based upon a more critical evaluation of these key concepts and their implications in modern psychology.
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Expanding on the work of Forstmann and Sagioglou, this study investigated the differences in personality and pro-environmental behavior (PEB) as a function of psychedelic-occasioned mystical experiences. A sample of 240 participants with prior psychedelic experience completed an online survey. Data were collected on participants’ psychedelic-occasioned mystical states, personality, and self-reported PEB. A measure of behavioral PEB was also included (Charity Task). The mean scores on self-reported PEB, openness and agreeableness of participants who met the criteria for a “complete” mystical state, were significantly higher than those who did not. Specifically, those who experienced a mystical state scored higher on the PEB types “eco-shopping and eating” and “one-off domestic conservation actions.” Participants who demonstrated PEB in the Charity Task scored higher on self-reported PEB than those who did not, supporting the task’s validity. Findings suggest that mystical experiences influence PEB. Future research with experimental designs could further illuminate potential causal relationships.
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Psychedelic science has generated hundreds of compelling published studies yet with relatively little impact on mainstream psychology. I propose that social psychologists have much to gain by incorporating psychoactive substances into their research programs. Here I use (±)-3,4-methylenedioxymethamphetamine (MDMA) as an example because of its documented ability in experiments and clinical trials to promote bonding, love, and warmth. Social connection is a fundamental human need, yet researchers still possess few tools to effectively and durably boost it. MDMA allows investigators to isolate the psychological mechanisms—as well as brain pathways—underlying felt social connection and thus reveal what should be targeted in future (nondrug) studies. Accordingly, I introduce a conceptual model that presents the proximal psychological mechanisms stimulated by MDMA (lowered fear, increased sociability, more chemistry), as well as its potential long-term impacts (improved relationships, reduced loneliness, stronger therapeutic alliances). Finally, I discuss further questions (e.g., whether using MDMA for enhancing connection can backfire) and promising research areas for building a new science of psychedelic social psychology. In sum, psychopharmacological methods can be a useful approach to illuminate commonly studied social-psychological processes, such as connectedness, prejudice, or self, as well as inform interventions to directly improve people’s lives.
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In the last 15 years, psychedelic substances, such as LSD and psilocybin, have regained legitimacy in clinical research. In the general population as well as across various psychiatric populations, mental well-being has been found to significantly improve after a psychedelic experience. Mental well-being has large socioeconomic relevance, but it is a complex, multifaceted construct. In this naturalistic observational study, a comprehensive approach was taken to assessing well-being before and after a taking a psychedelic compound to induce a “psychedelic experience.” Fourteen measures of well-being related constructs were included in order to examine the breadth and specificity of change in well-being. This change was then analysed to examine clusters of measures changing together. Survey data was collected from volunteers that intended to take a psychedelic. Four key time points were analysed: 1 week before and 2 weeks, 4 weeks, and 2 years after the experience (N = 654, N = 315, N = 212, and N = 64, respectively). Change on the included measures was found to cluster into three factors which we labelled: 1) “Being well”, 2) “Staying well,” and 3) “Spirituality.” Repeated Measures Multivariate Analysis of Variance revealed all but the spirituality factor to be improved in the weeks following the psychedelic experience. Additional Mixed model analyses revealed selective increases in Being Well and Staying Well (but not Spirituality) that remained statistically significant up to 2 years post-experience, albeit with high attrition rates. Post-hoc examination suggested that attrition was not due to differential acute experiences or mental-health changes in those who dropped out vs. those who did not. These findings suggest that psychedelics can have a broad, robust and sustained positive impact on mental well-being in those that have a prior intention to use a psychedelic compound. Public policy implications are discussed.
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Background and aims The COVID-19 pandemic and its consequences represent a major challenge to the mental health and well-being of the general population. Building on previous work on the potential long-term benefits of psychedelics, we hypothesized that lifetime use of these drugs could be linked to better mental health indicators in the context of the ongoing pandemic. Methods Two anonymous online surveys were conducted between April and June 2020, including questions about lifetime experience with psychedelics and other psychoactive drugs, and psychometric scales designed to measure personality traits, anxiety, negative, and positive affect, well-being, and resilience. Principal component analysis was applied to divide the sample into groups of subjects based on their drug use reports. Results Five thousand six hundred eighteen participants (29.15 ± 0.12 years, 71.97% female) completed both surveys and met the inclusion criteria, with 32.43% of the sample reporting at least one use of a psychedelic drug. Preliminary analyses showed that certain psychedelics were linked to improved mental health indicators, while other psychoactive drugs exhibited the opposite behavior. Lifetime psychedelic use was linked to increased openness and decreased conscientiousness, and to higher scores of positive affect. The reported number of past psychedelic experiences predicted higher scores of the secondary personality trait beta factor, which has been interpreted as a measure of plasticity. No significant associations between lifetime use of psychedelics and indicators of impaired mental health were observed. Conclusion We did not find evidence of an association between lifetime use of psychedelics and poor mental health indicators. Conversely, experience with psychedelic drugs was linked to increased positive affect and to personality traits that favor resilience and stability in the light of the ongoing crisis.
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Existing research demonstrates a positive connection between psychedelics and increased nature relatedness. Enhanced affective ties toward nature are widely framed as being built into the pharmakon itself, and the relevance of experiences remains little understood. This paper turns to neoshamanic ayahuasca ceremonies in Europe, exploring the way specialists and attendants refer to nature in speech and performance. I argue that ritual framings performed during these ceremonies provide fertile ground for affective ties to emerge through substance‐induced experiences. I trace such framings by exploring how medicine and healers are being coded; how specific materialities are rendered meaningful; and how individual experiences are discussed at such retreats. I argue that even while participants prioritize individual healing, personal development, or the satisfaction of psychonautical curiosity, environmentalism appears to be anchored by the proceedings themselves. Thus, this paper opens up for analysis ceremonial substance use as a contact zone where coherence is produced intersubjectively.
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Background The COVID-19 pandemic and its consequences represent a major challenge to the mental health and well-being of the general population. Some groups may be more vulnerable than others, depending on factors such as preexisting conditions, personality, and past life experiences. Building on previous work on the potential long-term benefits of psychedelics, we hypothesized that lifetime use of these drugs could be linked to better mental health indicators in the context of the ongoing pandemic. Methods Two anonymous online surveys were conducted between April 2020 and June 2020, including questions about lifetime experience with psychedelics and other psychoactive drugs, and psychometric scales designed to measure personality traits, anxiety, negative and positive affect, well-being and resilience. Principal component analysis was applied to divide the sample into groups of subjects based on their drug use reports. Results 5618 participants (29.15 ± 0.12 years, 71.97% female) completed both surveys and met the inclusion criteria, with 32.43% of the final sample reporting at least one use of a psychedelic drug. Lifetime psychedelic use was linked to increased openness and decreased conscientiousness, and with higher scores of positive affect. The reported number of past psychedelic experiences predicted higher scores of the secondary personality trait beta factor, which has been interpreted as a measure of plasticity. No significant associations between lifetime use of psychedelics and indicators of impaired mental health were observed. Conclusion We did not find evidence of an association between lifetime use of psychedelics and poor mental health indicators. Conversely, experience with psychedelic drugs was linked to increased positive affect and to personality traits that favor resilience and stability in the light of the ongoing crisis. Future studies should be conducted to investigate these results from a causal perspective.
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Despite a politically vilified past, classical psychedelics, including lysergic acid diethylamide (LSD), psilocybin, and dimethyltryptamine (DMT), are experiencing a revival in scientific and clinical research. When used under the appropriate guidance and setting, these substances show promise for substantially improving well-being and reducing mental ill-health alongside an excellent safety profile. Elite athletes are known to experience mental health disorder symptomatology and psychological distress at similar, if not higher, rates to the general population. Therefore, this promising line of research may be relevant to mental health treatment within elite sport. Psychedelic treatment may reduce the incidence and experience of mental ill-health in athletes, particularly when related to a range of issues commonly seen in elite sport, including therapeutic resistance, challenges to identity and meaning through career transitions and injury, and managing interpersonal stress and conflict. As a number of psychedelic treatments are currently advancing through the drug development pathway in the US and EU, it is timely to develop an understanding of the clinical application of psychedelics within elite sport, and the legislative and sport-specific regulations that will need to be addressed if psychedelics become registered medicines. In this article, we outline the sport-specific relevance of psychedelic treatments, the role of sports psychologists and psychiatrists in delivering and managing prospective psychedelic treatment, the key ethical and regulatory issues this treatment raises, as well as propose initial research questions the field could address. We argue that psychedelic-assisted psychotherapy should be investigated as a novel treatment option for addressing mental ill-health in elite athletes. Lay summary: Psychedelic-assisted treatments are attracting increased attention and impressive efficacy in early research. We outline the potential for psychedelic therapies to treat the mental health problems seen in athletes. We describe the rationale for their use specifically within elite athletes, the sport-specific considerations and challenges that need to be addressed, the role of sports clinicians, and define the research required to demonstrate their feasibility, safety and efficacy within athletes. • IMPLICATIONS FOR PRACTICE • With poor mental health a growing concern in elite sport, the clinically-supported application of psychedelics may be well positioned to treat these issues and the sport-specific factors that can contribute to them. • Various regulatory and sport-specific ethical factors will make research in this context challenging; however, these are tractable, and preliminary research in the application of psychedelic treatments for mental ill-health associated with elite sport is warranted. • There is no evidence yet to support the safety and efficacy of psychedelic treatment in elite sport, and psychedelic compounds are not currently registered for medical use. Accordingly, the ideas explored within this commentary should not be taken as support for independent self-medication or recreational use of psychedelics.
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Background: The increasing number of legally ambiguous and precarious Novel Psychoactive Substances (NPS) constitutes a challenge for policy makers and public health. Scientific and more in-depth knowledge about the motivations for using NPS is scarce and often consist of predetermined, non-systematic, or poorly described reasons deduced from top-down approaches. Therefore, the aim of the present study was to explore and characterize the users' self-reported reasons for NPS use inductively and more comprehensively. Methods: The self-reported reasons of a self-selected sample of 613 international NPS users were collected via an online survey promoted at the international drug discussion forum bluelight.org and later analyzed qualitatively using inductive thematic analysis. Results: The analysis showed that the participants used NPS because these compounds reportedly: 1) enabled safer and more convenient drug use, 2) satisfied a curiosity and interest about the effects, 3) facilitated a novel and exciting adventure, 4) promoted self-exploration and personal growth, 5) functioned as coping agents, 6) enhanced abilities and performance, 7) fostered social bonding and belonging, and 8) acted as a means for recreation and pleasure. The consumption of NPS was also driven by 9) problematic and unintentional use. Conclusion: The present study contributed to a more comprehensive understanding of the users' own and self-reported reasons for using NPS, which needs to be acknowledged not only in order to minimize drug related harm and drug user alienation but also to improve prevention efforts and reduce the potentially counter-intuitive effects of strictly prohibitive policies.
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Psychedelika (klassische bzw. serotonerge Halluzinogene) sind psychoaktive Substanzen, welche Wahrnehmung, Affekte sowie eine Reihe kognitiver Prozesse intensiv verändern können. Die Mehrheit ihrer Vertreter gilt als physiologisch sicher und nicht addiktiv. Ihre Geschichte reicht bis in prähistorische Zeit zurück. Mit der Entdeckung der Wirkstoffe Meskalin, Lysergsäurediethylamid (LSD), Dimethyltryptamin (DMT) und Psilocybin begann sowohl ihre wissenschaftliche Erforschung als auch die Verbreitung ihres nicht medizinischen Gebrauchs. Psychedelika stellen eine pharmakologisch, psychometrisch und tierexperimentell abgrenzbare Substanzklasse dar, die zunehmend im Interesse der medizinischen Grundlagen- und Therapieforschung steht. Dieses Kapitel strebt hinsichtlich der relevanten Wissensgebiete einen ausgewogenen Kurzüberblick über die Substanzklasse und ihre wichtigsten Vertreter an, wobei dem historisch komplexen Wirkgefüge zwischen Medizin- und Sozialgeschichte der Substanzklasse ein Schwerpunkt gewidmet ist.
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RationaleLysergic acid diethylamide (LSD) and other serotonergic hallucinogens can induce profound alterations of consciousness and mystical-type experiences, with reportedly long-lasting effects on subjective well-being and personality. Methods We investigated the lasting effects of a single dose of LSD (200 μg) that was administered in a laboratory setting in 16 healthy participants. The following outcome measures were assessed before and 1 and 12 months after LSD administration: Persisting Effects Questionnaire (PEQ), Mysticism Scale (MS), Death Transcendence Scale (DTS), NEO-Five Factor Inventory (NEO-FFI), and State-Trait Anxiety Inventory (STAI). ResultsOn the PEQ, positive attitudes about life and/or self, positive mood changes, altruistic/positive social effects, positive behavioral changes, and well-being/life satisfaction significantly increased at 1 and 12 months and were subjectively attributed by the subjects to the LSD experience. Five-Dimensions of Altered States of Consciousness (5D-ASC) total scores, reflecting acutely induced alterations in consciousness, and Mystical Experience Questionnaire (MEQ30) total scores correlated with changes in well-being/life satisfaction 12 months after LSD administration. No changes in negative attitudes, negative mood, antisocial/negative social effects, or negative behavior were attributed to the LSD experience. After 12 months, 10 of 14 participants rated their LSD experience as among the top 10 most meaningful experiences in their lives. Five participants rated the LSD experience among the five most spiritually meaningful experiences in their lives. On the MS and DTS, ratings of mystical experiences significantly increased 1 and 12 months after LSD administration compared with the pre-LSD screening. No relevant changes in personality measures were found. Conclusions In healthy research subjects, the administration of a single dose of LSD (200 μg) in a safe setting was subjectively considered a personally meaningful experience that had long-lasting subjective positive effects. Trial registrationRegistration identification number: NCT01878942.
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Chronic use of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") has repeatedly been associated with deficits in working memory, declarative memory, and executive functions. However, previous findings regarding working memory and executive function are inconclusive yet, as in most studies concomitant stimulant use, which is known to affect these functions, was not adequately controlled for. Therefore, we compared the cognitive performance of 26 stimulant-free and largely pure (primary) MDMA users, 25 stimulant-using polydrug MDMA users, and 56 MDMA/stimulant-naïve controls by applying a comprehensive neuropsychological test battery. Neuropsychological tests were grouped into four cognitive domains. Recent drug use was objectively quantified by 6-month hair analyses on 17 substances and metabolites. Considerably lower mean hair concentrations of stimulants (amphetamine, methamphetamine, methylphenidate, cocaine), opioids (morphine, methadone, codeine), and hallucinogens (ketamine, 2C-B) were detected in primary compared to polydrug users, while both user groups did not differ in their MDMA hair concentration. Cohen's d effect sizes for both comparisons, i.e., primary MDMA users vs. controls and polydrug MDMA users vs. controls, were highest for declarative memory (dprimary=.90, dpolydrug=1.21), followed by working memory (dprimary=.52, dpolydrug=.96), executive functions (dprimary=.46, dpolydrug=.86), and attention (dprimary=.23, dpolydrug=.70). Thus, primary MDMA users showed strong and relatively discrete declarative memory impairments, whereas MDMA polydrug users displayed broad and unspecific cognitive impairments. Consequently, even largely pure chronic MDMA use is associated with decreased performance in declarative memory, while additional deficits in working memory and executive functions displayed by polydrug MDMA users are likely driven by stimulant co-use.
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Psychedelic drugs are creating ripples in psychiatry as evidence accumulates of their therapeutic potential. An important question remains unresolved however: how are psychedelics effective? We propose that a sense of connectedness is key, provide some preliminary evidence to support this, and suggest a roadmap for testing it further.
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This paper argues that therapy with the drug MDMA (also known as Ecstasy) can have positive results in pain reduction for post-traumatic stress disorder and can also encourage moral development and the growth of compassion as well as religious and spiritual insight. Today, small-scale drug trials of MDMA are being performed in a highly controlled clinical environment without any spiritual or moral interpretative framework to help the subjects understand their experiences. Such a framework could help patients integrate and find meaning in the intense, traumatic experiences they have undergone. Pastoral counselors, psychologists, and religious professionals might find it useful to explore this form of therapy further.
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The potential of psychedelic drugs in the treatment of mental health problems is increasingly being recognized. However, relatively little thrust has been given to the suggestion that individuals without any mental health problems may benefit from using psychedelic drugs, and that they may have a right to do so. This review considers contemporary research into the use of psychedelic drugs in healthy individuals, including neurobiological and subjective effects. In line with findings suggesting positive effects in the treatment of mental health problems, such research highlights the potential of psychedelic drugs for the enhancement of wellbeing even in healthy individuals. The relatively low risk associated with usage does not appear to align with stringent drug laws that impose heavy penalties for their use. Some policy implications, and suggestions for future research, are considered.
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Background: Impaired empathic abilities lead to severe negative social consequences and influence the development and treatment of several psychiatric disorders. Furthermore, empathy has been shown to play a crucial role in moral and prosocial behaviour. Although the serotonin (5-HT) system has been implicated in modulating empathy and moral behaviour, the relative contribution of the various 5-HT receptor subtypes is still unknown. Methods: We investigated the acute effect of psilocybin (0.215mg/kg p.o.) in healthy human subjects on different facets of empathy and hypothetical moral decision-making using the Multifaceted Empathy Test (MET) (n=32) and the Moral Dilemma Task (MDT) (n=24). Results: Psilocybin significantly increased emotional, but not cognitive empathy compared to placebo, and the increase in implicit emotional empathy was significantly associated with psilocybin-induced changed meaning of percepts. In contrast, moral decision-making remained unaffected by psilocybin. Conclusions: These findings provide first evidence that psilocybin has distinct effects on social cognition by enhancing emotional empathy but not moral behaviour. Furthermore, together with previous findings psilocybin appears to promote emotional empathy presumably via activation of 5-HT2A/1A receptors suggesting that targeting 5-HT2A/1A receptors has implications for potential treatment of dysfunctional social cognition.
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A growing body of research suggests that traumatic events lead to persisting personality change characterized by increased neuroticism. Relevantly, enduring improvements in Post-Traumatic Stress Disorder (PTSD) symptoms have been found in response to 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy. There is evidence that lasting changes in the personality feature of “openness” occur in response to hallucinogens, and that this may potentially act as a therapeutic mechanism of change. The present study investigated whether heightened Openness and decreased Neuroticism served as a mechanism of change within a randomized trial of MDMA-assisted psychotherapy for chronic, treatment-resistant PTSD. The Clinician-Administered PTSD Scale (CAPS) Global Scores and NEO PI-R Personality Inventory (NEO) Openness and Neuroticism Scales served as outcome measures. Results indicated that changes in Openness but not Neuroticism played a moderating role in the relationship between reduced PTSD symptoms and MDMA treatment. Following MDMA-assisted psychotherapy, increased Openness and decreased Neuroticism when comparing baseline personality traits with long-term follow-up traits also were found. These preliminary findings suggest that the effect of MDMA-assisted psychotherapy extends beyond specific PTSD symptomatology and fundamentally alters personality structure, resulting in long-term persisting personality change. Results are discussed in terms of possible mechanisms of psychotherapeutic change.
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Background: Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network (DMN), purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers, and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here we investigated in an open-label uncontrolled study in sixteen healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications, and their association with mindfulness measures. Methods: Using 1H-magnetic resonance spectroscopy (MRS) and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior (PCC) and anterior (ACC) cingulate cortex after a single ayahuasca dose. Results: MRS showed post-acute reductions in Glx (glutamate+glutamine), creatine and NAA-NAAG (N-acetylaspartate+N-acetylaspartylglutamate) in the PCC. Connectivity was increased between the PCC and the ACC, and between the ACC and limbic structures in the right medial temporal lobe (MTL). Glx reductions correlated with increases in the "Non-Judging" subscale of the Five Facets Mindfulness Questionnaire. Increased ACC-MTL connectivity correlated with increased scores on the Self-Compassion questionnaire. Post-acute neural changes predicted sustained elevations in "Non-Judging" two months later. Conclusions: These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the PCC, a key region within the DMN, and increased connectivity between the ACC and MTL structures involved in emotion and memory, potentially underlie the post-acute psychological effects of ayahuasca.
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The psychological mechanisms of action involved in psilocybin-assisted psychotherapy are not yet well understood. Despite a resurgence of quantitative research regarding psilocybin, the current study is the first qualitative study of participant experiences in psilocybin-assisted psychotherapy. Semistructured interviews were carried out with 13 adult participants aged 22 to 69 years (M = 50 years) with clinically elevated anxiety associated with a cancer diagnosis. Participants received a moderate dose of psilocybin and adjunctive psychotherapy with an emphasis on the process of meaning-making. Verbatim transcribed interviews were analyzed by a five-member research team using interpretative phenomenological analysis. General themes found in all or nearly all transcripts included relational embeddedness, emotional range, the role of music as conveyor of experience, meaningful visual phenomena, wisdom lessons, revised life priorities, and a desire to repeat the psilocybin experience. Typical themes found in the majority of transcripts included the following: exalted feelings of joy, bliss, and love; embodiment; ineffability; alterations to identity; a movement from feelings of separateness to interconnectedness; experiences of transient psychological distress; the appearance of loved ones as guiding spirits; and sharing the experience with loved ones posttreatment. Variant themes found in a minority of participant transcripts include lasting changes to sense of identity, synesthesia experiences, catharsis of powerful emotion, improved relationships after treatment, surrender or “letting go,” forgiveness, and a continued struggle to integrate experience. The findings support the conclusion that psilocybin-assisted psychotherapy may provide an effective treatment for psychological distress in cancer patients. Implications for theory and treatment are discussed.
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Lysergic acid diethylamide (LSD) induces profound changes in various mental domains, including perception, self-awareness and emotions. We used functional magnetic resonance imaging (fMRI) to investigate the acute effects of LSD on the neural substrate of emotional processing in humans. Using a double-blind, randomised, cross-over study design, placebo or 100 µg LSD were orally administered to 20 healthy subjects before the fMRI scan, taking into account the subjective and pharmacological peak effects of LSD. The plasma levels of LSD were determined immediately before and after the scan. The study (including the a priori-defined study end point) was registered at ClinicalTrials.gov before study start (NCT02308969). The administration of LSD reduced reactivity of the left amygdala and the right medial prefrontal cortex relative to placebo during the presentation of fearful faces (P<0.05, family-wise error). Notably, there was a significant negative correlation between LSD-induced amygdala response to fearful stimuli and the LSD-induced subjective drug effects (P<0.05). These data suggest that acute administration of LSD modulates the engagement of brain regions that mediate emotional processing.
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Previous placebo-controlled experimental studies have shown that a single dose of MDMA can increase emotional empathy in the multifaceted empathy test (MET) without affecting cognitive empathy. Although sufficiently powered to detect main effects of MDMA, these studies were generally underpowered to also validly assess contributions of additional parameters, such as sex, drug use history, trait empathy and MDMA or oxytocin plasma concentrations. The present study examined the robustness of the MDMA effect on empathy and investigated the moderating role of these additional parameters. Participants (n = 118) from six placebo-controlled within-subject studies and two laboratories were included in the present pooled analysis. Empathy (MET), MDMA and oxytocin plasma concentrations were assessed after oral administration of MDMA (single dose, 75 or 125 mg). Trait empathy was assessed using the interpersonal reactivity index. We confirmed that MDMA increased emotional empathy at both doses without affecting cognitive empathy. This MDMA-related increase in empathy was most pronounced during presentation of positive emotions as compared with negative emotions. MDMA-induced empathy enhancement was positively related to MDMA blood concentrations measured before the test, but independent of sex, drug use history and trait empathy. Oxytocin concentrations increased after MDMA administration but were not associated with behavioral effects. The MDMA effects on emotional empathy were stable across laboratories and doses. Sex did not play a moderating role in this effect, and oxytocin levels, trait empathy and drug use history were also unrelated. Acute drug exposure was of significant relevance in the MDMA-induced emotional empathy elevation.
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Lysergic acid diethylamide (LSD) is a non-selective serotonin-receptor agonist that was first synthesized in 1938 and identified as (potently) psychoactive in 1943. Psychedelics have been used by indigenous cultures for millennia [1]; however, because of LSD's unique potency and the timing of its discovery (coinciding with a period of major discovery in psychopharmacology), it is generally regarded as the quintessential contemporary psychedelic [2]. LSD has profound modulatory effects on consciousness and was used extensively in psychological research and psychiatric practice in the 1950s and 1960s [3]. In spite of this, however, there have been no modern human imaging studies of its acute effects on the brain. Here we studied the effects of LSD on intrinsic functional connectivity within the human brain using fMRI. High-level association cortices (partially overlapping with the default-mode, salience, and frontoparietal attention networks) and the thalamus showed increased global connectivity under the drug. The cortical areas showing increased global connectivity overlapped significantly with a map of serotonin 2A (5-HT2A) receptor densities (the key site of action of psychedelic drugs [4]). LSD also increased global integration by inflating the level of communication between normally distinct brain networks. The increase in global connectivity observed under LSD correlated with subjective reports of "ego dissolution." The present results provide the first evidence that LSD selectively expands global connectivity in the brain, compromising the brain's modular and "rich-club" organization and, simultaneously, the perceptual boundaries between the self and the environment.
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Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction. Their origin predates written history, and they were employed by early cultures in many sociocultural and ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action. Today there is a consensus that psychedelics are agonists or partial agonists at brain serotonin 5-hydroxytryptamine 2A receptors, with particular importance on those expressed on apical dendrites of neocortical pyramidal cells in layer V. Several useful rodent models have been developed over the years to help unravel the neurochemical correlates of serotonin 5-hydroxytryptamine 2A receptor activation in the brain, and a variety of imaging techniques have been employed to identify key brain areas that are directly affected by psychedelics. Recent and exciting developments in the field have occurred in clinical research, where several double-blind placebo-controlled phase 2 studies of psilocybin-assisted psychotherapy in patients with cancer-related psychosocial distress have demonstrated unprecedented positive relief of anxiety and depression. Two small pilot studies of psilocybinassisted psychotherapy also have shown positive benefit in treating both alcohol and nicotine addiction. Recently, blood oxygen level–dependent functional magnetic resonance imaging and magnetoencephalography have been employed for in vivo brain imaging in humans after administration of a psychedelic, and results indicate that intravenously administered psilocybin and LSD produce decreases in oscillatory power in areas of the brain’s default mode network. © 2016 by The American Society for Pharmacology and Experimental Therapeutics.
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3,4-Methylenedioxymethamphetamine (MDMA) is associated with changes in neurocognitive performance. Recent studies in laboratory animals have provided additional support for the neurodegeneration hypothesis. However, results from animal research need to be applied to humans with caution. Moreover, several of the studies that examine MDMA users suffer from methodological shortcomings. Therefore, a prospective cohort study was designed in order to overcome these previous methodological shortcomings and to assess the relationship between the continuing use of MDMA and cognitive performance in incipient MDMA users. It was hypothesized that, depending on the amount of MDMA taken, the continued use of MDMA over a 2-year period would lead to further decreases in cognitive performance, especially in visual paired association learning tasks. Ninety-six subjects were assessed, at the second follow-up assessment: 31 of these were non-users, 55 moderate-users, and 10 heavy-users. Separate repeated measures analyses of variance were conducted for each cognitive domain, including attention and information processing speed, episodic memory, and executive functioning. Furthermore, possible confounders including age, general intelligence, cannabis use, alcohol use, use of other concomitant substances, recent medical treatment, participation in sports, level of nutrition, sleep patterns, and subjective well-being were assessed. The Repeated measures analysis of variance (rANOVA) revealed that a marginally significant change in immediate and delayed recall test performances of visual paired associates learning had taken place within the follow-up period of 2 years. No further deterioration in continuing MDMA-users was observed in the second follow-up period. No significant differences with the other neuropsychological tests were noted. It seems that MDMA use can impair visual paired associates learning in new users. However, the groups differed in their use of concomitant use of illicit drugs. Therefore, performance differences between the groups cannot completely ascribed to the use of MDMA.
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Background: Ayahuasca is a psychotropic plant tea used for ritual purposes by the indigenous populations of the Amazon. In the last two decades, its use has expanded worldwide. The tea contains the psychedelic 5-HT2A receptor agonist N,N-dimethyltryptamine (DMT), plus β-carboline alkaloids with monoamine-oxidase-inhibiting properties. Acute administration induces an introspective dream-like experience characterized by visions and autobiographic and emotional memories. Studies of long-term users have suggested its therapeutic potential, reporting that its use has helped individuals abandon the consumption of addictive drugs. Furthermore, recent open-label studies in patients with treatment-resistant depression found that a single ayahuasca dose induced a rapid antidepressant effect that was maintained weeks after administration. Here, we conducted an exploratory study of the psychological mechanisms that could underlie the beneficial effects of ayahuasca. Methods: We assessed a group of 25 individuals before and 24 h after an ayahuasca session using two instruments designed to measure mindfulness capacities: The Five Facets Mindfulness Questionnaire (FFMQ) and the Experiences Questionnaire (EQ). Results: Ayahuasca intake led to significant increases in two facets of the FFMQ indicating a reduction in judgmental processing of experiences and in inner reactivity. It also led to a significant increase in decentering ability as measured by the EQ. These changes are classic goals of conventional mindfulness training, and the scores obtained are in the range of those observed after extensive mindfulness practice. Conclusions: The present findings support the claim that ayahuasca has therapeutic potential and suggest that this potential is due to an increase in mindfulness capacities.
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There is renewed interest in the therapeutic potential of psychedelic drugs such as lysergic acid diethylamide (LSD). LSD was used extensively in the 1950s and 1960s as an adjunct in psychotherapy, reportedly enhancing emotionality. Music is an effective tool to evoke and study emotion and is considered an important element in psychedelic-assisted psychotherapy; however, the hypothesis that psychedelics enhance the emotional response to music has yet to be investigated in a modern placebo-controlled study. The present study sought to test the hypothesis that music-evoked emotions are enhanced under LSD. Ten healthy volunteers listened to five different tracks of instrumental music during each of two study days, a placebo day followed by an LSD day, separated by 5-7 days. Subjective ratings were completed after each music track and included a visual analogue scale (VAS) and the nine-item Geneva Emotional Music Scale (GEMS-9). Results demonstrated that the emotional response to music is enhanced by LSD, especially the emotions "wonder", "transcendence", "power" and "tenderness". These findings reinforce the long-held assumption that psychedelics enhance music-evoked emotion, and provide tentative and indirect support for the notion that this effect can be harnessed in the context of psychedelic-assisted psychotherapy. Further research is required to test this link directly.