Editorial: Psychedelic sociality: Pharmacological and extrapharmacological perspectives

Abstract

The heralded psychedelic renaissance is currently at a new level where psychedelics are being normalized. Medicalization and the ongoing introduction of market forces are imposing a trend in which psychedelic treatments are reduced to focus into strictly pharmacological and psychological effects on the self, rather than interactions with broader social context. Such narrowing of how psychedelic treatments are being conceived, used, and researched is a source of concern for those who understand that psychedelics’ therapeutic effects as also derived from socially and culturally meaningful elements. Alienation – the sense of isolation from others – and the mental health problems associated with it are on the rise. Consequently, there is not only a need for new therapies but also for a renewed social adhesion and a commitment to a more just and equal society. Psychedelics have a long history of bringing people together, facilitating intense shared experiences, and revitalizing cultures. This social dimension of use of psychedelics—psychedelic sociality—should be considered in the current mainstreaming, as therein lies their potential to support change in individual therapy and beyond.
This multidisciplinary research topic of psychedelic sociality invited scholars to discuss these issues through empirical research, reviews, perspectives, and theoretical papers. Overall, 21 papers were accepted to this research topic, covering different sections of Frontiers (Neuropharmacology, Psychopharmacology, Ethnopharmacology, Personality and Social Psychology, and Consciousness Research). We are especially proud of the broad scope of this issue and the diversity of disciplines represented in it. We believe that a beneficial mainstreaming of psychedelics requires going beyond the boundaries of disciplinary orientation. Interdisciplinary integration is necessary for the paradigmatic shift in mental health that many are yearning for: a shift from a narrow biomedical model to an expanded biopsychosocial model that emphasizes the interplay between biological, psychological, sociopolitical and environmental factors in mental health. The centrality of the experience and set & setting in psychedelic research is an invitation to transcend some of the boundaries between the natural sciences and the humanities (see Langlitz et al. (2021). The biopsychosocial model is especially relevant to psychedelic research because to answer questions regarding how psychedelics function, we must incorporate different levels of inquiry – from receptors to persons to culture.

Full text

Editorial: Psychedelic sociality:
Pharmacological and
extrapharmacological
perspectives
Leor Roseman
1
*, Katrin H. Preller
2
, Evgenia Fotiou
3
and
Michael J. Winkelman
4
1
Centre for Psychedelic Research, Faculty of Medicine, Imperial College London, London,
United Kingdom,
2
Pharmaco-Neuroimaging and Cognitive-Emotional Processing, Department of
Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zürich,
Switzerland,
3
Independent Researcher, Cleveland, OH, United States,
4
Retired, School of Human
Evolution and Social Change, Arizona State University, Tempe, AZ, United States
KEYWORDS
biopsychosocial, set and setting, culture, 5-HT2A receptor, social pharmacology,
psilocybin, LSD, interdisciplinary research
Editorial on the Research Topic
Psychedelic sociality: Pharmacological and extrapharmacological
perspectives
The heralded psychedelic renaissance is currently at a new level where
psychedelics are being accepted by the scientific community and the public.
Medicalization and the ongoing introduction of market forces are imposing a
trend in which psychedelic treatments are reduced to focus into strictly
pharmacological and psychological effectsontheself,ratherthaninteractions
with broader social context. Such narrowing of how psychedelic treatments are
being conceived, used, and researched is a source of concern for those who
understand that psychedelics’therapeutic effects as also derived from socially
and culturally meaningful elements. Alienation–the sense of isolation from
others–and the mental health problems associated with it are on the rise.
Consequently, there is not only a need fornewtherapiesbutalsoforarenewed
social adhesion and a commitment to a more just and equal society. Psychedelics
have a long history of bringing people together, facilitating intense shared
experiences, and revitalizing cultures. This social dimension of use of
psychedelics—psychedelic sociality—should be considered in the current
mainstreaming, as therein lies their potential to support change in individual
therapy and beyond.
This multidisciplinary Research Topic of psychedelic sociality invited scholars to
discuss these Research Topic through empirical research, reviews, perspectives, and
theoretical papers. Overall, 21 papers were accepted to this Research Topic, covering
OPEN ACCESS
EDITED AND REVIEWED BY
Nicholas M. Barnes,
University of Birmingham,
United Kingdom
*CORRESPONDENCE
Leor Roseman,
leor.roseman13@imperial.ac.uk
SPECIALTY SECTION
This article was submitted to
Neuropharmacology,
a section of the journal
Frontiers in Pharmacology
RECEIVED 27 June 2022
ACCEPTED 29 June 2022
PUBLISHED 22 July 2022
CITATION
Roseman L, Preller KH, Fotiou E and
Winkelman MJ (2022), Editorial:
Psychedelic sociality: Pharmacological
and extrapharmacological perspectives.
Front. Pharmacol. 13:979764.
doi: 10.3389/fphar.2022.979764
COPYRIGHT
© 2022 Roseman, Preller, Fotiou and
Winkelman. This is an open-access
article distributed under the terms of the
Creative Commons Attribution License
(CC BY). The use, distribution or
reproduction in other forums is
permitted, provided the original
author(s) and the copyright owner(s) are
credited and that the original
publication in this journal is cited, in
accordance with accepted academic
practice. No use, distribution or
reproduction is permitted which does
not comply with these terms.
Frontiers in Pharmacology frontiersin.org01
TYPE Editorial
PUBLISHED 22 July 2022
DOI 10.3389/fphar.2022.979764

different sections of Frontiers (Neuropharmacology,
Psychopharmacology, Ethnopharmacology, Personality and
Social Psychology, and Consciousness Research). We are
especially proud of the broad scope of this Research Topic
and the diversity of disciplines represented in it. We believe
that a beneficial mainstreaming of psychedelics requires going
beyond the boundaries of disciplinary orientation.
Interdisciplinary integration is necessary for the paradigmatic
shift in mental health that many are yearning for: a shift from a
narrow biomedical model to an expanded biopsychosocial model
that emphasizes the interplay between biological, psychological,
sociopolitical and environmental factors in mental health. The
centrality of the experience and set and setting in psychedelic
research
1
is an invitation to transcend some of the boundaries
between the natural sciences and the humanities (see Langlitz
et al.). The biopsychosocial model is especially relevant to
psychedelic research because to answer questions regarding
how psychedelics work, we must incorporate different levels
of inquiry–from receptors to persons to culture.
Psychedelic pharmacological interventions are influenced by
contextual factors such as social relations, language, books,
theories, symbols, music, and beliefs. Notably, this is a
reciprocal relationship, and the psychedelic effects can, in
turn, change context, e.g., enhance openness, facilitate the
creation of new music, modify social relationships, change
personalities, and revitalize cultures. Psychedelic communities,
Western and indigenous, each have their own musical and
artistic expression, suggesting that the communal use of
psychedelics intensifies cultural modes of communication. The
context-sensitive role of 5-HT2A receptors in sociality is also
noticeable in that they can be anxiogenic when trust is
compromised but rewarding within secure contexts, and
hence enhancing sociality by encouraging healthy contexts.
These facts amplify the relevancy of the human sciences for
psychedelic research, and vice versa, as what makes humans so
unusual are two interrelated aspects: our capacity for culture
(especially cumulative technological and social knowledge); and
our sociality, an unprecedented and unparalleled ability to live in
large groups of unrelated people. The human capacity for
sociality involved a Darwinian coevolution of culture and
genes (Richerson and Boyd, 2008); our biology evolved to
create our capacity for culture and culture shaped our
biological evolution. As psychedelics are notoriously context-
dependent, one can speculate that their effects on the 5-HT2A
receptor function could have played a crucial role in the selection
for this unique human capacity. The activation of the 5-HT2A
receptor intensifies the influence of social relations, stories,
beliefs, and symbols by incorporating them with our sensory
experience, making them more tangible, hence enhancing their
meaning and increasing our capacity for sociality. This
suggestion is also supported by a number of human fMRI
studies from various labs, showing increased functional
connectivity between sensory regions (especially visual) and
higher level regions (Roseman et al., 2014;Carhart-Harris
et al., 2016;Tagliazucchi et al., 2016;Müller et al., 2018;
Preller et al., 2018;Mason et al., 2020;Preller et al., 2020).
In this Research Topic, Arce and Winkelman theorize that
psychedelics enhanced human evolution in the cultural niche as
hominins became dependent on shared cultural models for basic
survival. The sociality-amplifying effects of psilocybin and its
ability to enhance openness and increase novel representations
and flexibility in cognitive processes could have created
considerable fitness differences among ancestral hominin
populations. Individual and eventually population differences
in abilities to respond to these effects would have provided
genetic variation upon which selection pressures could act in
favour of those with the capacities for sociality and cognition
stimulated by psilocybin. Their paper provides a summary of the
role of 5-HT2A activation and reviews clinical research showing
how psychedelics promote sociality through managing
psychological stress, improving interpersonal relations,
facilitating of collective relations, and enhancing group
decision making.
The influence set and setting have on psychedelic experiences
provides some of the most convincing arguments for psychedelic
sociality. The recent book American Trip by Ido Hartogsohn
(2020), reviewed here by Lansky, presents an historical analysis
that clearly shows how different set and setting factors embodied
in research orientations led to different psychedelic experiences
and different understandings of psychedelics’action. Some
papers in this Research Topic are also examining how social
and cultural context affect the psychedelic experience. Pontual
et al. and Pontual et al. presents results from a large online cross-
cultural study used in development of the Setting Questionnaire
for the Ayahuasca Experience (SQAE), and showed its relation to
the quality of the psychedelic experience. The SQAE has six
dimensions (Leadership, Decoration, Infrastructure, Comfort,
Instruction, and Social). High ratings on the SQAE were
associated with low ratings of challenging experiences and
high ratings of mystical experiences in three different
ayahuasca practices (Santo Daime, UDV, and neoshamanic).
A similar observation is presented here by Hartogsohn, who
researched the migration of Santo Daime ceremonies to online
zooms during the COVID-19 pandemic. While online
ceremonies created new possible global connections, the lack
of immediate and embodied social context was also associated
with reduced intensity of the experience. Murphy et al. present
similar results in a seminal controlled clinical trial comparing
psilocybin-assisted therapy for depression versus a control group
with escitalopram. They found pre-session therapeutic alliance
1 All pharmacological interventions are dependent on
extrapharmacological factors to some extent, exemplified in the
placebo response, yet this interaction seems much more
pronounced with serotonergic psychedelics.
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and rapport predicted the intensity of the acute psychedelic
experience (emotional breakthrough and the mystical
experience); these in turn were associated with improvements
in depressive symptom severity 6 weeks after the experience. The
above studies show that social bonding and trust are vital
components for effective and safe psychedelic therapy.
It is important to recognize that it is not only the immediate
interpersonal context that interacts with psychedelics, but also
the cultural context. In this Research Topic, de Mori, using
ethnographic data, shows that the attribution of efficacy in
diverse psychedelic practices differs based on cultural priors,
ideologies or biases. Along similar lines, Dupuis expands on his
previous ethnographic work to show that psychedelic-induced
belief transmission is a process that oscillates between adherence
and doubt. This oscillation strongly mobilizes the reflexivity and
agentivity of the recipient and can paradoxically enhance belief
transmission. Furthermore, as the phenomenological content of
the experience itself is influenced by cultural priors, it can
strengthen the newly acquired belief through “experiential
verification.”When stories become visions, they also become
more convincing.
Some central qualities of psychedelic experiences exhibit
sociality. In some contexts, psychedelics acutely increase
relational feelings of connectedness with nature, other
humans, or with spirituality (Forstmann and Sagioglou,
2017;Watts et al., 2017;Yaden et al., 2019;Kettner et al.,
2021). Psychedelics can produce an animistic mindset, where
the natural world is humanized, personalized and socialized
with human traits (sentience, relationality, intentionality,
cooperation, intelligence) (Winkelman, 2013). In this
Research Topic, Michael et al. presents a
microphenomenological analysis of DMT experiences. Most
experiential reports described an encounter with “sentient
beings”that were experienced as “other.”The encounters
were rich in different features, such as the entities’
appearances, demeanour, roles, function, and included
communication and interaction. The complex interactive
social imagery likely reflects psychedelic action on the 5-
HT2A receptors; psychedelic entity experiences also reflect
activation of innate cognitive modules directly related to
unique human capacities for sociality (Winkelman, 2018).
Diverse findings indicate that psychedelics promote
prosocial effects. In this Research Topic, Holze et al. show in
a placebo-controlled trial that LSD acutely increases empathy
and plasma oxytocin levels. Weiss et al. online prospective
study found psychedelics increased social connectedness and
agreeableness. Luoma and Lear review evidence that MDMA-
assisted therapy can successfully treat Social Anxiety Disorder,
reminding us of the empathogenic effects of the serotonergic
system in general. Evens et al. found in an online retrospective
study that during the first wave of COVID-19 (April to August
2020), the quality of the psychedelic experience became more
prosocial. Their finding reflects some of the zeitgeist of the first
wave, when liminality and global communitas were
experienced, in which people found a momentary sense of
solidarity and liberation from day-to-day social hierarchies
and tensions. Another study in this Research Topic suggests
that regular psychedelic use is associated with better coping
with COVID-19 social confinements (Révész et al.). However,
causality cannot be inferred from this study as other factors
were different for psychedelic users, such as more substantial
social support during the pandemic. Newson et al. study here
with a preregistered online survey on people who attend raves
and “free-parties”found psychedelics and dancing lead to
personal transformation and that the acute experience of
awe mediated this transformation. In turn, both awe and
personal transformation increase bonding to fellow ravers
and prosocial behaviour (donation to a rave charity).
Similarly, Murphy et al. psilocybin clinical trial mentioned
above found not only that the therapeutic alliance facilitates
stronger emotional breakthroughs, but also that emotional
breakthroughs enhance the therapeutic alliance in return.
Shared intense emotional experiences can promote social
bonding, whether one is a patient or a raver.
Markopoulos et al. presents a compelling summary of
20 clinical and experimental trials since 2008 that show
psychedelics’prosocial and empathogenic effects. Drawing
from these findings and LSD trials from the 60s’that showed
that psychedelic-assisted therapy helped children with Autism
Spectrum Disorder (ASD), they argue for the potential use of
psychedelics in the treatment of ASD. Yet, they note, that some
children had adverse reactions which led to increased anxiety and
aggression, and even to self-harm. Importantly, in these trials
“greater improvements were observed when the therapist was
more actively involved with the children; when they were given
the possibility to experience meaningful interpersonal
psychotherapeutic interactions; and when the settings were
free of artificial or experimental restrictions.”Once again, we
see that the reaction to the drug is modulated by contextual
factors. Consequently, the prosocial effects cannot be attributed
to the drug alone but to drug and context interactions.
This point is illustrated in several papers in this Research
Topic. Pace and Devenot critique universal claims that
psychedelics–in their pharmacological essence—necessarily
improve society, increase environmental concern and
promote liberal politics. They present examples of right-wing
psychedelia in which conservative ideologies assimilate
psychedelic experiences of interconnection but amplify
authoritarian worldviews. They suggest that psychedelics are
“politically pluripotent”in that the changes they induce are
based on the political setting. Langlitz et al. also raise caution
against universal claims about psychedelics’moral
psychopharmacology, which requires an interdisciplinary
inquiry to prevent naïve interpretations of results: “While
members of the American counterculture used LSD,
mescaline, and psilocybin as psychopharmacological tools to
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liberate individuals from the ills of their society, Huichol youth
ingested peyote buttons to become full members of their own
society, and Native American Church worshippers consumed
peyote to foster indigenous resistance to North American
colonialism. In the 1960s, psychedelics were taken to
experience a mystical union that users claimed fostered a
sense of universal love, but anthropologists have also
described Amazonian societies that used them in rituals to
prepare for violent intergroup conflict.”
Roseman and Karkabi—in a sequel paper to Roseman et al.
(2021)—made similar critical observations regarding politically
pluripotent dynamics while studying ayahuasca groups in which
Israeli and Palestinians drink together in rituals organized by
Israelis. While the collective experience of “oneness”and
interconnectedness can create strong social bonds between
Israelis and Palestinians, it does not necessarily produce more
equality and justice. The “irony in harmony”is that too much
focus on harmony can bypass political tensions, and so stabilize
the hegemonic structures in which Israelis subjugate Palestinians.
When harmony is the main goal of the status quo, any mention of
injustice can be silenced to prevent disharmony. Prosocial effects
and increased group cohesion are not inherently just, and can
sometimes be in service of hierarchies, unequal social structures,
and violence. Yet, the authors also identify unique revelatory
events which momentarily rupture the harmony of the ritual by
revealing agonizing visions of Palestinian trauma which are not
aligned with the hegemonic Israeli narrative. Such events can
ignite a liberative procedure in which the subjects attempt to
change the social structure. The authors argue that such
revelatory events can ignite resistance towards the status-quo
and can activate the subject with revolutionary hope, acting
towards a more egalitarian structure.
Recognition of cultural and social influences on
psychedelics’mechanisms of action reveals a complexity of
mechanisms that raise caution with oversimplified and hyped
claims about psychedelics. Studying psychedelics only through
the dominant paradigms in psychiatry and psychology ignores
many of their functions. While integrating psychedelics into
such paradigms is necessary for their mainstream acceptance,
this comes with a risk that psychedelics will be assimilated into
these paradigms instead of changing them, and consequently
restricting psychedelic practices and the science of psychedelics.
The simplified mainstream narratives ignore broader
knowledge and perspectives about psychedelic use and
mechanism of action. The seemingly controversial argument
that psychedelics’therapeutic efficacy is dependent on
suggestibility, social context, and cultural priors challenges
traditional psychopharmacological views. But for anyone
who seeks universal scientifictruthsaboutpsychedelics,
these might be their principal mechanism of action, a non-
specificamplification of context, which is strongly related
to sociality, especially interpersonal relations and cultural
setting.
Novel theoretical orientations that incorporate
biopsychosocial notions are therefore required. Lepow et al.
presents these here in a testable hypothesis in which
psychedelics induce a critical period plasticity that “remove
the brakes on adult neuroplasticity, inducing a state similar to
that of neurodevelopment.”It is suggested that this enhanced
sensitivity to environmental input and increased relearning
capacity are then utilized in the therapeutic procedure to
create enduring effects.
Future studies need to expand beyond conventional clinical
research into process-oriented research, such as examining how
mediating variables produce different outcomes, and reporting
clinical case studies. The extrapharmacological complexity of
psychedelic effects means that evidence-based medicine has its
(double-)blind spots, as it provides us with controls to eliminate
the very conditions that psychedelics exploit—the interpersonal
dynamics and placebo and expectancy effects.
This can miss the underlying mechanism of
psychosociotheraputic processes engaged or released by
psychedeics. Therefore, another potential research avenue into
psychedelic sociality is cultural-controlled trials (Wallace, 1959)
which experimentally examine cultural differences in trial
outcomes. Such trials can even incorporate biological
measures such as oxytocin levels to assess how context
influences the most basic sociopharmacological dynamics.
Other studies can investigate interpersonal dynamics as
introduced in this Research Topic in Wagner on evaluating
MDMA couples therapy.
To conduct biopsychosocial psychedelic research,
interdisciplinary collaborations are encouraged. Such
collaborations are healthy for psychedelic research, but more
crucially, they might impact science at large. In the current state
of academic affairs, biologists, psychologists and social scientists
are studying the same human without clearly communicating
their findings to each other. Psychedelic research can serve as a
glue that integrates interdisciplinary knowledge on mind, body
and culture, and so reveal what is unique about humans.
Author contributions
LR was invited by Frontiers to develop a Research Topic and
he invited MW to join the project. MW proposed the Research
Topic of “Psychedelic Sociality”and they together developed the
proposal. KP and EF were subsequently invited to join the
project.
Conflict of interest
The authors declare that the research was conducted in the
absence of any commercial or financial relationships that could
be construed as a potential conflict of interest.
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Roseman et al. 10.3389/fphar.2022.979764

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