Peterson et al. (2023) outline a broad ethics agenda for imminent research on psychedelic agents for Alzheimer’s disease and related dementias (AD/ADRD) by acknowledging the therapeutic promise of...

There is a growing resurgence in the study of psychedelic medicines for the treatment of mental health and substance use disorders. However, certain early investigations are marred by questionable research methods, abuses against research participants, and covert Central Intelligence Agency financial involvement. The purpose of this study was to understand how and to what extent people of colour and other vulnerable populations, specifically, individuals who were incarcerated or incapacitated due to mental health issues, were exploited during the (...) first wave of psychedelic research in the USA. To do so, we reviewed available empirical publications according to current ethical standards. Variables of interest included race and ethnicity of participants, population vulnerability, drug administration conditions, informed consent and undue influence. Our findings draw attention to the history of research abuses against people of colour in Western psychedelic research. In light of these findings, we urge a call-to-action to current psychedelic researchers to prioritise culturally inclusive and socially responsible research methods in current and future studies. All data relevant to the study are included in the article. (shrink)

Psychedelics require cross-cultural, interdisciplinary study, and we were happy to see a contribution from the field of medical anthropology. Such a study holds the promise of characterizing the ways in which psychedelics are situated in contemporary societies, both within and beyond research and clinical contexts. Here, we offer some friendly criticism of the target article by Noorani while also highlighting various points of agreement and looking ahead to future research in this field.Noorani’s article is structured around an organizing (...) theme of “containment.” The term is not formally defined, but functions more as a poetic metaphor, allowing the author to explore various ways in which psychedelics... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Section on Psychedelics Research and TreatmentDominic SistiAgainst a backdrop of post-pandemic malaise, diseases of despair, and a fragmented mental health care system, psychedelics have enjoyed a resurgence of interest as powerful psychotherapeutic agents and as catalysts of personal growth. The true power of these substances—some of which are considered sacramental by Indigenous peoples—has been shrouded for half a century by cultural mythology, political propaganda, (...) and misuse. From about 1940 to 1970, psychedelics including psilocybin and LSD were studied and used by clinicians to treat a range of psychiatric disorders from alcoholism and depression in adults to "autistic schizophrenia" in children.In June 1971, the Nixon administration's racist and illiberal War on Drugs inaugurated what was essentially a total ban on psychedelics. Society was robbed of half a century of scientific progress, and one can only speculate how differently our society might now function, and how many people might have been spared the trauma of mental illness and incarceration. Thankfully, it appears the time has arrived for psychedelic medicines to be decriminalized and included again in the pharmacopeia.In June 2023, a group of psychedelic researchers, therapists, bioethicists, Indigenous scholars, and advocates met at the Banbury Conference Center at Cold Spring Harbor Laboratory. There, this interdisciplinary group discussed several pressing ethical issues in psychedelics research and treatment that continue to [End Page 114] challenge the field. The aim of this meeting was to develop a bioethical framework for the use of psychedelics in mainstream medical settings. That is, how should psychedelics be employed responsibly by everyday clinicians, including psychiatrists, psychologists, social workers, and other behavioral health-care providers? This special section offers a sampling of three topics in psychedelic bioethics raised by the Banbury group, several of whom appear as coauthors.In our first paper, Logan Neitzke-Spruill and colleagues offer an overview of explanatory models describing the therapeutic mechanisms of psychedelic substances and how each of these models generates unique ethical quandaries. Starting from molecular biology and moving to neural circuitry and networks, neurobiological models now propel contemporary scientific research into psychedelics. Knowing how these substances work on a molecular level may offer promising ways forward in the development of new molecules designed to treat serious mental illnesses and other neurologic conditions. Perhaps neuroplastic mechanisms will be harnessed to develop new therapies without necessitating a psychedelic trip—a controversial premise discussed in our third paper, by Katherine Cheung, Brian Earp, and David Yaden.Such "neuroreductionism" risks ignoring the subjective psychological and spiritual experiences of patients that appear to be pivotal in psychedelic-assisted therapy, often described as mystical and utterly transformative. At the psychological level, these substances engender a kind of vulnerability and suggestibility requiring clear ethical standards to ensure patients' psychological and physical safety. And so too, practitioners will need structural and cultural competency to recognize the spiritual or moral values that inspire patient reactions during and after their psychedelic experiences. Ethically informed psychedelic practitioners will have to navigate between disciplinary silos and explanatory models. One practical upshot is the open question of how best to train psychedelic practitioners who hold this broad set of competencies.To that end, well-trained practitioners will need to be able to disclose in some way the transformative properties of psychedelics to prepare patients for their experiences. But how does one describe the ineffable? This raises the question of how or if it is possible for patients to truly consent to the transformative experience elicited by psychedelics, often described as one of the most important experiences of a person's life. The experience might stimulate significant emotional healing, or it might be horrifying. This sounds like a problem uniquely attached to psychedelics: after all, most pharmaceuticals don't trigger changes in one's fundamental moral values, life choices, and commitments, nor are they intended to. Yet, Brent Kious, Andrew Peterson, and Amy McGuire challenge the view that the psychedelic experience is uniquely transformative and impervious to the disclosure requirements of informed consent, a bedrock of bioethics. Ultimately, the writers show how consent is possible even if the experiences are dramatically different from most medical interventions, endorsing a practical view of consent [End... (shrink)

Peterson et al. (2023) write that there’s “a rich philosophical debate on the nature of authenticity in dementia” involving the relationship of identity and autonomy. I explore this with Jaworska’s...

The ethical value—and to some scholars, necessity—of providing trial patients with post-trial access (PTA) to an investigational drug has been subject to significant attention in the field of research ethics. Although no consensus has emerged, it seems clear that, in some trial contexts, various factors make PTA particularly appropriate. We outline the atypical aspects of psychedelic clinical trials that support the case for introducing the provision of PTA within research in this field, including the broader legal status (...) of psychedelics, the nature of the researcher-therapist/participant relationship, and the extended time-frame of the full therapeutic process. As is increasingly understood, the efficacy of psychedelic-assisted psychotherapy is driven as much by extrapharmacological elements and the cultural therapeutic container as by the drug itself. As such, we also advocate for a refocusing of attention from post-trial access to a broader concept encompassing other elements of post-trial care. We provide an overview of some of the potential post-trial care provisions that may be appropriate in psychedelic clinical trials. Although the World Medical Association’s Declaration of Helsinki calls on researchers, sponsors, and governments to make provisions for post-trial access, such provision may feel impracticable or out-of-reach within psychedelic trials that are already constrained by a high resource demand and significant bureaucratic burden. We show how conceiving of post-trial provision as an integral site of the research process, and an appropriate destination for research funding, will serve to develop the infrastructure necessary for the post-legalisation psychedelic medicine ecosystem. (shrink)

Abstractabstract:Recent clinical trials of psychedelic drugs aim to treat a range of psychiatric conditions in adults. MDMA and psilocybin administered with psychotherapy have received FDA designation as "breakthrough therapies" for post-traumatic stress disorder (PTSD) and treatment-resistant depression (TRD) respectively. Given the potential benefit for minors burdened with many of the same disorders, calls to expand experimentation to minors are inevitable. This essay examines psychedelic research conducted on children from 1959 to 1974, highlighting methodological and ethical flaws. It (...) provides ethics and policy recommendations for psychedelics research involving children and adolescents, including recognizing that the psychedelic experience is an ineffable one that makes informed proxy consent for parents, guardians, and others especially challenging. Psychedelic experiences are associated with novel benefits and risks, such as significant personality changes, shifts in fundamental values, and possible re-exposure to traumatic memories. These effects may alter the process of personality development in minors. Recommendations for ethically sound psychedelics research in minors include strict adherence to eligibility criteria, including a comprehensive family and individual psychiatric, substance use, and trauma history. An age-appropriate assent process that includes considerations related to the use of therapeutic touch should be developed. In addition, oversight by data safety monitoring boards and patient and family advocates, coupled with the adoption of pharmacoequity best practices, will help to ensure safety and fairness of psychedelics research in children. (shrink)

The resurgence of psychedelic research has brought with it unique ethical considerations, including the role of personal psychedelic experience among facilitators. Some have argued that personal ps...

Background Psychedelic medicine is a rapidly growing area of research and policy change. Australia recently became the first country to legalize the prescription of psychedelics and serves as a case study of issues that may emerge in other jurisdictions. Despite their influence as a stakeholder group, there has been little empirical exploration of psychedelic researchers’ views on the development of psychedelic research and the ethical concerns. Methods We thematically analysed fourteen interviews with Australian psychedelic (...) researchers. Results Three themes were constructed from the data: 1) coming out of the shadow of the 1960s, 2) challenges and affordances in engaging stakeholders, and 3) growing pains in innovation and translation. Conclusion The results illustrated tensions arising from the rapid growth of psychedelic research from a small group of dedicated individuals with a similar worldview, to a multi-interest, regulated industry. Participants’ experiences and viewpoints were influenced by the history of psychedelic research, and this was met with an overarching concern for protecting the field from premature discontinuation, as well as maximizing potential positive impacts. Targets for stakeholder collaboration and initiatives to support responsible innovation in psychedelics include equitable access, sustainable industry involvement, productive research agendas, responsible reporting of evidence, and risk-taking within the relative safety of clinical trials. (shrink)

Eating disorders are debilitating diseases that have twin impacts on the body and mind and are associated with a number of physiological and psychological comorbidities (Blinder, Cumella, and Sanathara 2006; Casiero and Frishman 2006), including increased suicide risk (Arcelus et al. 2011; Lipson and Sonneville 2020). In addition, eating disorders are growing in prevalence (Gilmache et al. 2019) and impact women at much higher rates than men (Bearman, Martinez, and Stice 2006), especially in adolescence (Spriggs, Kettner, and Carhart-Harris 2021). Anorexia (...) nervosa (AN) is a particularly devastating eating disorder, with one of the highest mortality rates of any psychiatric disorder (Sullivan 1995). Despite the severity of the condition, current treatments for AN are limited in their efficacy (Khalsa et al. 2017). Based on the growing body of evidence demonstrating the short-term and long-term efficacy of psychedelic-assisted psychotherapy for the treatment of other mental illnesses, I argue that research into psychedelic-assisted psychotherapy for AN should be funded. (shrink)

In the last decade alone, a growing body of preliminary evidence suggests that classic psychedelics (CPs) can rapidly and durably ameliorate symptoms and cognitive deficits associated with depression. However, the mechanisms by which CPs work in the brain are not well understood. Rodent translational research, in which experimental findings from rodents are translated to humans, is fundamental in achieving this goal. This chapter focuses on a representative subset of human and rodent studies investigating CPs for depression, including the various (...) lines of research that have been initiated to understand how they work. Our aim is to show that in addition to epistemic challenges that scientists face in translating findings from rodents to humans, there is also mismatch between experimental approaches used to investigate CPs in humans and rodents. We thus show current experimental practices are not conducive to mechanistic discovery. We end with a set of positive proposals to expedite the drive to translate CPs into effective treatments for depression. -/- Keywords: classic psychedelics, psychiatry, clinical trials, collaboration, extrapolation, major depressive disorder, open science, philosophy of science, rodent models, scientific practice, translation, validity . (shrink)

A pressing philosophical problem is how to respond to the existential, anxiety and disenchantment resulting from a naturalistic worldview that eschews transcendent foundations for meaning and value. This problem is becoming more urgent as the popularization of neuroscientific findings renders a disenchanted conception of human beings ever more vivid, compelling, and widespread. I argue that the study of transformative experiences occasioned by classic psychedelic drugs such as lysergic acid diethylamide and psilocybin may reveal the nature of a viable practical (...) solution to this problem. Despite the apparent centrality of nonnaturalistic metaphysical apprehensions to psychedelic transformation, findings from psychedelic research suggest that key elements of psychedelic or “entheogenic” spirituality are consistent with naturalism. These include disruption to neurocognitive mechanisms underpinning the sense of self, and consequent experiences of self-transcendence and of the decoupling of attention from personal concerns. This liberation of attention can result in the availability of broader perspectives and the development of wonder and appreciation for life. (shrink)

Exceptionalism in bioethics generally refers to the idea that a particular medical development or intervention warrants special consideration, either ethically or legally, given its unique features...

In recent years, the scientific study of meditation and psychedelic drugs has seen remarkable developments. The increased focus on meditation in cognitive neuroscience has led to a cross-cultural classification of standard meditation styles validated by functional and structural neuroanatomical data. Meanwhile, the renaissance of psychedelic research has shed light on the neurophysiology of altered states of consciousness induced by classical psychedelics, such as psilocybin and LSD, whose effects are mainly mediated by agonism of serotonin receptors. Few attempts (...) have been made at bridging these two domains of inquiry, despite intriguing evidence of overlap between the phenomenology and neurophysiology of meditation practice and psychedelic states. In particular, many contemplative traditions explicitly aim at dissolving the sense of self by eliciting altered states of consciousness through meditation, while classical psychedelics are known to produce significant disruptions of self-consciousness, a phenomenon known as drug-induced ego dissolution. In this article, we discuss available evidence regarding convergences and differences between phenomenological and neurophysiological data on meditation practice and psychedelic drug-induced states, with a particular emphasis on alterations of self-experience. While both meditation and psychedelics may disrupt self-consciousness and underlying neural processes, we emphasize that neither meditation nor psychedelic states can be conceived as simple, uniform categories. Moreover, we suggest that there are important phenomenological differences even between conscious states described as experiences of self-loss. As a result, we propose that self-consciousness may be best construed as a multidimensional construct, and that “self-loss,” far from being an unequivocal phenomenon, can take several forms. Indeed, various aspects of self-consciousness, including narrative aspects linked to autobiographical memory, self-related thoughts and mental time travel, and embodied aspects rooted in multisensory processes, may be differently affected by psychedelics and meditation practices. Finally, we consider long-term outcomes of experiences of self-loss induced by meditation and psychedelics on individual traits and prosocial behavior. We call for caution regarding the problematic conflation of temporary states of self-loss with “selflessness” as a behavioral or social trait, although there is preliminary evidence that correlations between short-term experiences of self-loss and long-term trait alterations may exist. (shrink)

In this paper, we examine the case of psychedelic medicine for Alzheimer’s disease and related dementias (AD/ADRD). These “mind-altering” drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issues: the impact of psychedelics (...) on autonomy and consent; the impact of “ego dissolution” on persons experiencing a pathology of self; how psychedelics might impact caregiving; the potential exploitation of patient desperation; institutional review boards’ orientation to psychedelic research; and methods to mitigate inequity. These ethical issues are magnified for AD/ADRD but bear broader relevance to psychedelic medicine and research in other clinical populations. (shrink)

“Classic”, serotonergic psychedelic drugs such as LSD and psilocybin are the objects of renewed attention in science and psychiatry. A recent spate of research has produced evidence that psychedelics might be safe and effective adjuncts to the treatment of mood and addictive disorders, agents of positive psychological change in healthy subjects, and valuable tools for studying the neural mechanisms of perception and cognition. This chapter surveys three philosophical debates that have arisen in response to this “renaissance” of (...) class='Hi'>psychedelic research. The first concerns the mechanisms of psychedelic-assisted psychotherapy (“psychedelic therapy”): How, exactly, does psychedelic administration in controlled conditions cause lasting psychological benefits? The second concerns the implications of psychedelic research for the philosophy of mind: Does psychedelic evidence show that there can be conscious mental states lacking all forms of self-consciousness? The third concerns the epistemic status of the psychedelic state: Is it possible that certain kinds of knowledge, or other epistemic benefits, could be gained by undergoing a psychedelic experience? (shrink)

An emerging body of research suggests that psychedelic experiences can change users’ religious or metaphysical beliefs. Here I explore issues concerning psychedelic-induced belief change via a critique of some recent arguments by Wayne Glausser. Two scientific studies seem to show that psychedelic experiences can convert atheists to belief in God, but Glausser holds that academic and popular discussions of these studies are misleading. I offer a different analysis of the relevant findings, attempting to preserve the insights (...) of Glausser’s critique while setting the record straight on some important points. For one thing, the studies provide stronger evidence for atheist deconversion than Glausser allows. For another, Glausser’s arguments against the “Metaphysical Belief Theory” of psychedelic therapy involve scientifically dubious claims and inferences. Finally, in evaluating this theory, we ought to focus on its strongest version, which posits belief shifts from metaphysical naturalism to non-naturalism, rather than from atheism to classical monotheism. (shrink)

Recent scientific research into the therapeutic potential and mechanisms of psychedelic drugs raises intriguing and hitherto largely unexplored philosophical questions. A brief overview of the relevant science is given before addressing these questions. It is argued that psychedelic transformation is a distinctive psycho- pharmacological intervention because its mechanism of action ineliminably involves conscious mental representations, and thus is more transparent to the subject than the mechanisms of other drug therapies. This argument connects with issues in the philosophy (...) of (cognitive) scientific explanation. It is also argued that transformative psychedelic experiences may well confer three distinct kinds of epistemic benefits: knowledge by acquaintance of the subject's psychological potential, knowledge by acquaintance of the meta-physical nature of the (sense of) self, and revitalized capacities for the acquisition of modal knowledge. Non-naturalistic metaphysical and epistemological claims abound in psychedelic circles; thus, it is important to realize that psychedelics may yield naturalistically acceptable epistemic benefits. (shrink)

It has been hypothesized that psychedelic experiences elicit lasting psychological benefits by altering narrative selfhood, which has yet to be explicitly studied. The present study investigates retrospective reports (n = 418) of changes to narrative self that participants believe resulted from, or were catalysed by, their psychedelic experience(s). Responses to open-ended questions were analysed using inductive and deductive thematic coding and interpreted within agent-centred approaches to development and well-being. Themes include decentred introspection, greater access to self-knowledge, positive shifts (...) in self-evaluation processes, greater psychological and behavioural autonomy, and enhanced connectedness with others and the world. While this explorative qualitative study offers some initial support for the explanation that changes to narrative self are a cornerstone of psychedelics' therapeutic and transformative potential, methodological and recruiting limitations preclude the ability to make objective claims and generalizations. Future scientific research is necessary to further elucidate this hypothesized mechanism. (shrink)

This article proposes a different aesthetic state of Gilles Deleuze’s crystal-image defined as ‘psychedelic crystal’, a formation of the crystalline regime in light of the contemporary revival of scientific research exploring the healing potentialities of hallucinogenic drugs. The proposition of the psychedelic crystal occurs between Deleuze’s crystals of time, the therapeutic dimension of psychedelics, and Siegfried Kracauer’s concept of redemption (as salvation) through the cinematic medium. What lies in the middle of this encounter is a shared understanding (...) of media – films as media; drugs as media – as holding a curative influence: to resume an affirmative potentiality for life and to restore a belief in the (physical and psychical) world. The film-philosophical dimension of the psychedelic crystal, developed specifically through an engagement with Jan Kounen’s Blueberry (2004) as case study, sees cinema with the potential to reanimate our mental and physical reality, especially when in relation to traumatically repressed, dissociated or repeated memory formations – thus looking at certain film aesthetics as a mind-revealing, mind-expanding and mind-healing technology which can be considered as intrinsically entangled with the current revival of therapeutic practices of psychoactive substances. As a proposition, the psychedelic crystal discloses a potential dimension of the psychedelic frontier of healing which transversally embraces the transdisciplinary gamut of film-philosophy, film theory and psychedelic research. (shrink)

Background: Psychedelics are known for their powerful mental effects due to the activation of 5HT-2A receptors in the brain. During the 1950s and 1960s, research was conducted on these molecules until their criminalization. However, their clinical investigation as therapeutic tools for psychiatric disorders has revived the deontological ethics surrounding this subject. Questions arise as research on their therapeutic outcome becomes a reality. We aim to explore deontological ethics to understand the implications of psychedelics for the clinician, patient, and (...) society. Results: A total of 42 articles were considered for this review. Methods: A methodological search of psychedelic studies from 2017 to 2022 was conducted in PubMed, Scopus, EBSCOhost, and ScienceDirect to address the deontological ethics of clinical psychedelic use. Conclusion: Psychedelics need to be culturally contextualized, epistemic harm minimized and represented to ensure informed consent. Open data and commissions are needed to ensure safe and equal distribution. (shrink)

Recent clinical trials show that psychedelics such as LSD and psilocybin can be given safely in controlled conditions, and can cause lasting psychological benefits with one or two administrations. Supervised psychedelic sessions can reduce symptoms of anxiety, depression, and addiction, and improve well-being in healthy volunteers, for months or even years. But these benefits seem to be mediated by "mystical" experiences of cosmic consciousness, which prompts a philosophical concern: do psychedelics cause psychological benefits by inducing false or implausible beliefs (...) about the metaphysical nature of reality? This book is the first scholarly monograph in English devoted to the philosophical analysis of psychedelic drugs. Its central focus is the apparent conflict between the growing use of psychedelics in psychiatry and the philosophical worldview of naturalism. Within the book, Letheby integrates empirical evidence and philosophical considerations in the service of a simple conclusion: this "Comforting Delusion Objection" to psychedelic therapy fails. While exotic metaphysical ideas do sometimes come up, they are not, on closer inspection, the central driver of change in psychedelic therapy. Psychedelics lead to lasting benefits by altering the sense of self, and changing how people relate to their own minds and lives-not by changing their beliefs about the ultimate nature of reality. The upshot is that a traditional conception of psychedelics as agents of insight and spirituality can be reconciled with naturalism (the philosophical position that the natural world is all there is). Controlled psychedelic use can lead to genuine forms of knowledge gain and spiritual growth-even if no Cosmic Consciousness or transcendent divine Reality exists. Philosophy of Psychedelics is an indispensable guide to the literature for researchers already engaged in the field of psychedelic psychiatry, and for researchers-especially philosophers-who want to become acquainted with this increasingly topical field. (shrink)

One recent development in epistemology, the philosophical study of knowledge, is the notion of ‘epistemic innocence’ introduced by Bortolotti and colleagues. This concept expresses the idea that certain suboptimal cognitive processes may nonetheless have epistemic (knowledge-related) benefits. The idea that delusion or confabulation may have psychological benefits is familiar enough. What is novel and interesting is the idea that such conditions may also yield significant and otherwise unavailable epistemic benefits. I apply the notion of epistemic innocence to research on (...) the transformative potential of psychedelic drugs. The popular epithet ‘hallucinogen’ exemplifies a view of these substances as fundamentally epistemically detrimental. I argue that the picture is more complicated and that some psychedelic states can be epistemically innocent. This conclusion is highly relevant to policy debates about psychedelic therapy. Moreover, analysing the case of psychedelics can shed further light on the concept of epistemic innocence itself. (shrink)

In recent years, researchers in the “psychedelic renaissance” have been reinvestigating the therapeutic potential of psychedelic compounds for conditions like post-traumatic stress disorder, clinical anxiety/depression, and addiction. Each of these has treatment-resistant cases, sometimes decades in the making, but studies employing psychedelics to address them are yielding impressive results. Given the evolving legal situation around these substances as well as corporate investment in them, their availability and appeal promise to increase. The question facing Christians is: How do these (...) developments impact the theological significance of psychedelics as a broader phenomenon? This paper argues that since the population standing to benefit from these treatments is likely to include Christians, a thoughtful and rigorous response is necessary. The inquiry proceeds by analyzing some of the pertinent research, showing the insufficiency of previous Christian responses, and considering some hurdles and objections before issuing a call to theologize on this timely and important cultural moment. (shrink)

Psychedelic Harm Reduction and Integration (PHRI) is a transtheoretical and transdiagnostic clinical approach to working with patients who are using or considering using psychedelics in any context. The ongoing discussion of psychedelics in academic research and mainstream media, coupled with recent law enforcement deprioritization of psychedelics and compassionate use approvals for psychedelic-assisted therapy, make this model exceedingly timely. Given the prevalence of psychedelic use, the therapeutic potential of psychedelics, and the unique cultural and historical context in (...) which psychedelics are placed, it is important that mental health providers have an understanding of the unique motivations, experiences, and needs of people who use them. PHRI incorporates elements of harm reduction psychotherapy and psychedelic-assisted psychotherapy, and can be applied in both brief and ongoing psychotherapy interactions. PHRI represents a shift away from assessment limited to untoward outcomes of psychedelic use and abstinence-based addiction treatment paradigms and toward a stance of compassionate, destigmatizing acceptance of patients' choices. Considerations for assessment, preparation, and working with difficult experiences are presented. (shrink)

Psychedelics are experiencing a renaissance in clinical research. In recent years, an increasing number of studies on psychedelic-assisted treatment have been conducted. So far, the results are promising, suggesting that this new (or rather, rediscovered) form of therapy has great potential. One particular reason for that appears to be the synergistic combination of the pharmacological and psychotherapeutic interventions in psychedelic-assisted treatment. But how exactly do these two interventions complement each other? This paper provides the first account of (...) the interaction between pharmacological and psychological effects in psychedelic-assisted treatment. Building on the relaxed beliefs under psychedelics (REBUS) hypothesis of Carhart-Harris and Friston and the contextual model of Wampold, it argues that psychedelics amplify the common factors and thereby the remedial effects of psychotherapy. More precisely, psychedelics are assumed to attenuate the precision of high-level predictions, making them more revisable by bottom-up input. Psychotherapy constitutes an important source of such input. At best, it signalizes a safe and supportive environment (cf. setting) and induces remedial expectations (cf. set). During treatment, these signals should become incorporated when high-level predictions are revised: a process that is hypothesized to occur as a matter of course in psychotherapy but to get reinforced and accelerated under psychedelics. Ultimately, these revisions should lead to a relief of symptoms. (shrink)

Recent scientific research suggests that altered states of consciousness induced by classic psychedelic drugs can cause durable psychological benefits in both healthy and patient populations. The phenomenon of ‘psychedelic transformation’ has many philosophically provocative aspects, not least of which is the claim commonly made by psychedelic subjects that their transformation is centrally due to some kind of learning or knowledge gain. Can psychedelic experiences really be a source of knowledge? From the vantage point of philosophical (...) materialism or naturalism, a negative answer is tempting because psychedelic subjects often claim drug-facilitated knowledge of non-natural, transcendent realities. This fact, combined with common conceptions of these drugs as ‘hallucinogenic’ or ‘psychotomimetic’, invites the conclusion that claims of epistemic benefit from psychedelic experience are uniformly false. However, several recent proposals have been made in the literature about naturalistically acceptable epistemic benefits that might arise from psychedelic use. In this chapter I review these proposals, classifying them in accordance with standard epistemological categories, and discuss the arguments for and against them. I also offer some suggestions for future research. (shrink)

Research on psychedelic medicines is experiencing a revival. Some clinicians, scientists, and ethicists believe that psychedelics are so different from other treatments that they warrant special consideration in how they are researched, regulated, commercialized, and administered. Others argue that psychedelic medicines show clinical potential, but they should be treated like other medical interventions. In other words, identical standards should apply. This article analyzes whether psychedelic medicines warrant special consideration from a regulatory and ethical perspective.

Psychedelic-Assisted Psychotherapy is being investigated as a treatment for a range of psychiatric illnesses. Current research suggests that the kinds of subjective experiences induced by psychedelic compounds play key roles in producing therapeutic outcomes. To date, most knowledge of therapeutic psychedelic experiences are derived from psychometric assessments with scales such as the Mystical Experience Questionnaire. While these approaches are insightful, more nuanced and detailed descriptions of psychedelic-induced changes to subjective experience are required. Drawing on recent (...) advancements in qualitative methods arising from the interdisciplinary field of phenomenological psychopathology, we propose a systematic and comprehensive investigation into how Psychedelic-Assisted Psychotherapy alters subjective experience. This research program aims to characterise the nature of therapeutic psychedelic experiences by drawing on concepts from philosophical phenomenology. Such characterisations should, moreover, contribute to our understanding of the mechanisms of psychedelic therapy, the role of integration therapy, and related philosophical debates. (shrink)

Psychedelic-assisted Psychotherapy combines the use of psychedelic compounds, such as psilocybin, with psychotherapy. PAP has shown some promise as a novel treatment for Major Depressive Disorder, and empirical research suggests that its efficacy turns on the altered states induced by psychedelic compounds. In this paper we draw on the literature of phenomenology to explain the therapeutic potential of psychedelic experiences. Svenaeus characterises mental illness as a form of suffering that entails three distinct but related experiences (...) of alienation or “unhomelike being-in-the-world”: illness suffering, which relates to embodiment; existential suffering, which relates to self-narratives, and political suffering, which relates to social relationships. Ratcliffe further characterises the experience of MDD in phenomenological terms as a loss of pre-intentional possibility that manifests as excessive noematic feeling in the experience of embodiment, restrictive narratives in the construction of self, and disconnectedness in experience of the social world. We contend that PAP ameliorates the suffering associated with MDD by inducing and consolidating a state of broadened pre-intentional possibility—one that entails sudden, profound and enduring changes in embodiment, self-narratives, and social experience. We argue further that this phenomenological account is consistent with a bio-psycho-social model of mental health and illness, and we frame it as an argument supporting the plausibility of recent claims about treatment success. This helps to justify ongoing future empirical research in this setting. (shrink)

Within recent years, an increasing number of people and researchers in the Global North have become interested in psychedelic substances and their therapeutic application. While much of the current media attention and research effort mainly concentrate on the therapeutic potential and actions of the individual's acute psychedelic experience, this article explores the user-perceived, therapeutic dynamics of psychedelics in a more long-term perspective by charting the lived experiences and practices of ‘integration’ among psychedelic users in Denmark. Based (...) on ethnographic fieldwork from November 2020 to June 2021, I offer a dual typology of self-related integration as narrative and experiential-somatic. Combining the two, I argue that psychedelic integration in contemporary Denmark can be viewed as a processual self-transformation of the users' experiential orientation where understandings and/or modes of being from the acute psychedelic experience are woven into, prolonged, and/or embodied in their everyday existence. (shrink)

The nascent for-profit psychedelic industry has begun to engage in corporate practices like funding scientific research and research programs. There is substantial evidence that such practices from other industries like tobacco, alcohol, pharmaceuticals and food create conflicts of interest and can negatively influence population health. However, in a context of funding pressures, low publicly funded success rates and precarious academic labor, there is limited ethics guidance for researchers working at the intersection of clinical practice and population health (...) as to how they should approach potential financial sponsorship from for-profit entities, such as the psychedelic industry. This article reports on a reflective exercise among a group of clinician scientists working in psychedelic science, where we applied Adams’ (2016) PERIL (Purpose, Extent, Relevant harm, Identifiers, Link) ethical decision-making framework to a fictionalized case of corporate psychedelic financial sponsorship. Our analysis suggests financial relationships with the corporate psychedelic sector may create varying degrees of risk to a research program’s purpose, autonomy and integrity. We argue that the commercial determinants of health provide a useful framework for understanding the ethics of industry-healthcare entanglements and can provide an important population health ethics lens to examine nascent industries such as psychedelics, and work toward potential solutions. (shrink)

This book looks at the possible research and clinical applications of psychedelic substances. Instead of considering the experiences one can have with psychedelics or their uses in psychotherapy, this book views psychedelics' implications for a number of topics "coming over the psychedelic horizon," so to speak.

ABSTRACT:Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative (...) experiences involve either the acquisition of knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes. (shrink)

Psychedelic or ecodelic medicines (e.g., psilocybin, ayahuasca, iboga) for the care and treatment of addiction, post‐traumatic stress disorder, cancer, cluster headaches, anxiety, and depression have surged to the forefront of discussions about mental health in the US, leading to the emergence of well‐capitalized biotech companies offering multimillion‐dollar IPOs. Venture capital website Pitchbook reports “continuing investor interest and growing acceptance of what until recently was seen as a fringe area of medicine.” As scholars, activists, and practitioners who have been healed (...) by these medicines and applaud the recent wave of decriminalization after a long, strange trip of mass incarceration and widespread dangerous misinformation, we look forward to a culture that makes these medicines available in a safe and affordable way that respects the lineages of the knowledges that are essentially and not accidentally bundled with these plants—Indigenous and counterculture wisdoms for whom these medicines were never “fringe,” but always foundational. In place of corporadelia's pursuit of standardization, we emphasize the care and wisdom of the Indigenous and countercultural teachings—traditions that have made psychedelics available to the emerging corporate/research partnership in the first place. These knowledge traditions offer foils to the ongoing translation of university peer‐reviewed research into market copy, technical articles, and IPOs, and the concomitant emergence of psychedelic pundits. In particular, we examine instances where prominent researchers have overstated the findings of existing clinical trials in public‐facing representations of the field. We argue that these corporate priorities and tactics are being aided by a new wave of psychedelic “thought leaders” who seek to delegitimize non‐hierarchical approaches to knowledge production and community support within a psychedelic commons. While prominent psychedelic psychiatrists and behaviorists are focused on rooting out and transforming individual habits of mind, we argue that there is another, latent potential for psychedelics to draw attention to—and transform—the invisible, hegemonic infrastructures and ideologies that subtly naturalize and perpetuate deeply unequal societies. (shrink)

In this opinion piece we propose the investigation of psychedelic-assisted psychotherapy for the treatment of body dysmorphic disorder (BDD). BDD is a psychiatric disorder characterised by appearance-based preoccupations and accompanying compulsions. While safe and effective treatments for BDD exist, non-response and relapse rates remain high. Therefore, there is a need to investigate promising new treatment options for this highly debilitating condition. Preliminary evidence suggests safety, feasibility, and potential efficacy of psychedelic treatments in disorders that share similar psychopathological mechanisms (...) with BDD. Drawing on this evidence, as well as on relevant qualitative reports and theoretical proposals, we argue that it would be worthwhile to conduct a phase 2a study aimed at assessing the safety and feasibility of psychedelic-assisted psychotherapy in BDD. We also offer some suggestions for how future research ought to proceed. (shrink)

Recent research offers good reason to think that various psychedelic drugs—including psilocybin, ayahuasca, ketamine, MDMA, and LSD—may have significant therapeutic potential in the treatment of various mental health conditions, including post-traumatic stress disorder, depression, existential distress, and addiction. Although the use of psychoactive drugs, such as Diazepam or Ritalin, is well established, psychedelics arguably represent a therapeutic step change. As experiential therapies, their value would seem to lie in the subjective experiences they induce. As it is the only (...) way for trainee psychedelic therapists to fully understand their subjective effects, some have suggested that firsthand experience of psychedelics should form part of training programs. We question this notion. First, we consider whether the epistemic benefits offered by drug-induced psychedelic experience are as unique as is supposed. We then reflect on the value it might have in regard to the training of psychedelic therapists. We conclude that, absent stronger evidence of the contribution drug-induced experiences make to the training of psychedelic therapists, requiring trainees to take psychedelic drugs does not seem ethically legitimate. However, given the potential for epistemic benefit cannot be entirely ruled out, permitting trainees who wish to gain first-hand experience of psychedelics may be permissible. (shrink)

In the historical context of a crisis in biological psychiatry, psychedelic drugs paired with psychotherapy are globally re-emerging in research clinics as a potential transdiagnostic therapy for treating mood disorders, addictions, and other forms of psychological distress. The treatments are poised to soon shift from clinical trials to widespread service delivery in places like Australia, North America, and Europe, which has prompted ethical questions by social scientists and bioethicists. Taking a broader view, we argue that the ethics of (...) psychedelic therapy concerns not simply how psychotherapies are different when paired with psychedelic drugs, but how psychedelic therapies shape and are shaped by different values, norms, and metaphysical commitments. Drawing from the published literature and interviews with seven psychedelic therapists working in clinical trials in the United States, Germany, Switzerland, and Australia, this article opens the black box of the treatments to consider the values and informal debates currently animating the therapies. Considering questions of patient autonomy, mechanisms of therapeutic action, and which therapies are best suited to pair with psychedelic substances, we examine the ethics of psychedelic therapy as an emergent form of life. To bring this form of life out in fuller relief, we conclude by comparing and contrasting it with ayahuasca use in Amazonian shamanism. (shrink)

hroughout medieval Christianity, religious works of art emerged to illustrate the teachings of the Bible for the largely illiterate population. What, then, is the significance of the psychoactive mushrooms hiding in plain sight in the artwork and icons of many European and Middle-Eastern churches? Does Christianity have a psychedelic history? -/- Providing stunning visual evidence from their anthropological journey throughout Europe and the Middle East, including visits to Roslyn Chapel and Chartres Cathedral, authors Julie and Jerry Brown document the (...) role of visionary plants in Christianity. They retrace the pioneering research of R. Gordon Wasson, the famous “sacred mushroom seeker,” on psychedelics in ancient Greece and India, and among the present-day reindeer herders of Siberia and the Mazatecs of Mexico. Challenging Wasson’s legacy, the authors reveal his secret relationship with the Vatican that led to Wasson’s refusal to pursue his hallucinogen theory into the hallowed halls of Christianity. -/- Examining the Bible and the Gnostic Gospels, the authors provide scriptural support to show that sacred mushrooms were the inspiration for Jesus’ revelation of the Kingdom of Heaven and that he was initiated into these mystical practices in Egypt during the Missing Years. They contend that the Trees of Knowledge and of Immortality in Eden were sacred mushrooms. -/- Uncovering the role played by visionary plants in the origins of Judeo-Christianity, the authors invite us to rethink what we know about the life of Jesus and to consider a controversial theory that challenges us to explore these sacred pathways to the divine. (shrink)

Beginning with a review of Michael Pollan's latest book about the renaissance of research into the use of psychedelics to treat addiction, depression, and end-of-life anxiety, this essay considers wisdom and insight that might be gained by examining the psychedelic practices of primitive people. Pollan finds that almost all who begin using psychedelics to treat the ill eventually come to the conclusion that they should be made available for the broader purpose of 'the betterment of well people'. By (...) considering both scientific and spiritual perspectives on these compounds, the book offers insight into the toxicity not only of our mental environment, but at the same time our relationship to fellow humanity and Mother Nature. However, Pollan does not consider what is perhaps the greatest source of wisdom regarding the pharmacological potential of psychedelics: primitive societies who have long incorporated these compounds into their ways of being. By casting anthropological accounts of primitive psychedelic practices against those of contemporary research, this essay seeks to deepen enquiry into the pathologies of modern personhood as they bear upon the ecological crisis, together with the potential value of entheogens for understanding and responding to these problems. (shrink)

Psychedelic experiences are often compared to “transformative experiences” due to their potential to change how people think and behave. This study empirically examines whether psychedelic experiences constitute transformative experiences. Given psychedelics’ prospective applications as treatments for mental health disorders, this study also explores neuroethical issues raised by the possibility of biomedically directed transformation—namely, consent and moral psychopharmacology. To achieve these aims, we used both inductive and deductive coding techniques to analyze transcripts from interviews with 26 participants in (...) class='Hi'>psychedelic retreats. Results indicate that psychedelic experiences can constitute transformative experiences. Twenty participants reported experiences or insights that were seemingly inaccessible or impossible to attain if not for the psychoactive effects of psychedelics. All participants besides one reported some change in identity, values, beliefs, desires, and behavior—changes in behavior being the most common. Participants also reported feeling capable deciding to use psychedelics in part due to information seeking prior to their retreats. Finally, several participants reported an enhanced capacity for enacting changes in their lives. Our results underscore both the importance of subjective embodiment to transformation and the role of transformative agency in shaping outcomes of the psychedelic experience. We examine our results relative to neuroethical issues and advocate for centering the person in psychedelic research and neuroethical inquiry about psychedelics to avoid pitfalls associated with psychedelics’ potential as moral psychopharmacological agents. (shrink)

Psychedelic treatments, particularly 3,4-methylenedioxymethamphetamine (MDMA)-assisted and psilocybin-assisted therapies, have recently seen renewed interest in their clinical potential to treat various mental health conditions. Clinical trials for both MDMA-assisted and psilocybin-assisted therapies have shown to be highly efficacious for post-traumatic stress disorder and major depression. Recent research trials for psychedelic-assisted therapies (PAT) have demonstrated that although they are resource-intensive, their effects are rapid-acting, durable and cost-effective. These results have generated enthusiasm among researchers seeking to investigate psychedelic therapies (...) in active-duty service members of the US military, particularly those with treatment refractory mental health conditions. At the same time, psychedelics remain in early stages of clinical investigation, have not yet achieved regulatory approval for general clinical use and may confer unique psychological and neurobiological effects that could raise novel ethical considerations when treating active-duty service members. Should psychedelics achieve regulatory approval, military relevant considerations may include issues of access to these treatments, appropriate procedures for informed consent, confidentiality standards, and possible unanticipated mental health risks and other psychological sequelae. A service member’s deployability, as well as their ability to return to full military duty following PAT, may also be of unique concern. The authors argue that MDMA-assisted therapy currently represents a promising treatment that should be more rapidly investigated as a clinical therapy for service members while still taking a measured approach that accounts for the many military-specific uncertainties that remain. (shrink)

Chris Letheby, Jaipreet Mattu, and Eric Hochstein try to put an end to the “mysticism wars,” by which they mean the battle between psychedelic researchers who hold that mystical concepts ought to be employed in attempts to describe and understand psychedelic experiences and those who do not hold this. Letheby, Mattu, and Hochstein side with the former and do so on the grounds that (as they put it), “there are no good reasons to abandon mystical concepts in (...) class='Hi'>psychedelic science, and plenty of good reasons to keep them.” At bottom, they contend that critiques of the pro-mystical-concepts view can be solved via clarifying concepts and recognizing basic (though significant) distinctions. And though they grant that mystical concepts may one day be superseded in the science of psychedelics, they maintain that this should not occur on the basis of a misplaced conceptual critique, as is (they maintain) the present-day critique of the pro-mystical-concepts view. (shrink)

What do psychedelics reveal about consciousness? What impact have psychedelics had on philosophy? In this rapidly growing area of study, this is the first volume to explore the philosophy of psychedelic experience, from a range of interdisciplinary and cross-cultural perspectives. In doing so, Philosophy and Psychedelics reveals just why the place of psychedelics in our societies should not be left to medical sciences alone, as psychedelic experience opens up new perspectives on fundamental philosophical questions relating to human experience, (...) ethics, and the metaphysics of mind. Mapping a range of philosophical responses to the surge in studies into psychedelic drugs in the cognitive sciences, this go-to volume examines topics including psychedelics and the role of governance; psychedelics and mysticism; what psychedelics can tell us about dyadic thankfulness; and psychedelics as ways to gain new knowledge. Written by leading international scholars, the essays cover Western and non-Western traditions, from analytic philosophy to Zen Buddhism, and discuss a variety of hallucinogens, such as LSD, MDMA, and Ayahuasca, in order to build a much-needed bridge between the rapidly growing scientific research and the philosophy behind psychedelic experience. (shrink)

Current evidence suggests that the efficacy of psychedelic therapy depends, in part, on the character of psychedelic experiences themselves. One pronounced aspect of psychedelic experiences is alterations to the experience of time, including reports of timelessness or transcending time. However, how we should interpret such reports remains unclear, and this lack of clarity has philosophical and clinical implications. For instance, “true” timelessness may be considered antithetical to having any experience at all, and descriptions of experiences involving “timelessness” (...) are known to be diverse and of varying clinical significance. In this article, we utilize a phenomenological approach to the study of temporality to highlight ambiguities in current constructs used to assess psychedelic experiences. In doing so, we advance some preliminary phenomenological accounts of psychedelic therapy’s mechanisms of action, such as psychedelic temporality acting as a kind of counterpoint for depressive temporality. We conclude by outlining how a dedicated phenomenological research program can provide a nuanced map of psychedelic temporality, guiding future research in a manner that addresses both philosophical and clinical ambiguities. (shrink)

The Western world is experiencing a resurgence of interest in the therapeutic potential of psychedelics, most of which are derived from plants or fungi with a history of Indigenous ceremonial use. Recent research has revealed that psychedelic compounds have the potential to address treatment‐resistant depression and anxiety, as well as post‐traumatic stress disorder and addictions. These findings have contributed to the decriminalization of psychedelics in some jurisdictions and their legalization in others. Despite psychedelics’ opaque legal status, numerous companies (...) and individuals are profiting from speculative investments with few, if any, benefits accruing to Indigenous Peoples. In this paper, we suggest that the aptly named “psychedelic renaissance,” like the European Renaissance, is made possible by colonial extractivism. We further suggest that Indigenous philosophical traditions offer alternative approaches to reorient the “psychedelic renaissance” towards a more equitable future for Indigenous Peoples, psychedelic medicines, and all our relations. (shrink)

A Study of Perennial Philosophy and Psychedelic Experience, with a Proposal to Revise W. T. Stace’s Core Characteristics of Mystical Experience ©Ed D’Angelo 2018 -/- Abstract -/- According to the prevailing paradigm in psychedelic research today, when used within an appropriate set and setting, psychedelics can reliably produce an authentic mystical experience. According to the prevailing paradigm, an authentic mystical experience is one that possesses the common or universal characteristics of mystical experience as identified by the philosopher (...) W. T. Stace in his 1960 work Mysticism and Philosophy. Stace’s common characteristics of mystical experience are the basis for the Hood Mysticism Questionnaire, which is the most widely used quantitative measure of mystical experience in experimental studies of psychedelic experience. In this paper, I trace the historical roots of Stace’s common characteristics of mystical experience back to Christian Neoplatonism and apophatic theology, and I trace those, in turn, back to Plato’s concept of the Good and to Aristotle’s concept of God as active intellect. I argue that Stace’s common characteristics of mystical experience are not universal or culturally invariant but are the product of a specifically Christian religious and moral tradition that has its roots in ancient Greek metaphysics. My paper concludes with a revised list of common characteristics of psychedelic experience that is a better candidate for a list of invariant structures of psychedelic experience than Stace’s common characteristics of Christian mystical experience. (shrink)

Serotonergic (or “classic”) psychedelics have struck many researchers as raising significant philosophical questions that, until recently, were largely unexplored by academic philosophers. This paper provides an overview of four emerging lines of research at the intersection of academic philosophy and psychedelic science that have gained considerable traction in the last decade: selfless consciousness, psychedelic epistemology, psychedelic ethics, and spiritual/religious naturalism. In this paper, we highlight philosophical questions concerning (i) psychedelics, self-consciousness, and phenomenal consciousness, (ii) the epistemic (...) profile of the psychedelic experience; (iii) ethical concerns about the appropriate use of psychedelics; and (iv) whether spiritual or religious dimensions of psychedelic use are compatible with a naturalistic worldview. (shrink)

Recent developments regarding the pharmacology of psychoactive substances are significant for treating depressions or opioid addictions. Current theories, hypotheses, and models of drug effects assume a cause–effect narrative, which is based on a stimulus/response mechanism. These narratives prioritize effects rather than conscious experiences. In this sense, drug experiences are quickly subsumed into common categories and codes of biological determinism. If subjective experiences are in the focus of the research, it quickly becomes a link to mystical, spiritual, or transcendental narratives. (...) These classifications lead to epistemological doublets (Gadamer). In this article, psychedelic experiences of drug users are analyzed in the frame of the pharmaco-analysis by Deleuze/Guattari. These framed psychedelic experiences are interpreted by means of a non-philosophical approach through philo-fictions (Laruelle), i.e., contradictory assumptions and hyperspeculations. In this respect, the aim of this article is to bring philo-fictions in relation to psychedelic experiences and to discuss them with models of information science, quantum mechanics, new materialism, and the philosophy of immanence. The result will be an open synthesis, with the assumption of further reflections on the agency, immanence, and the wholeness of matter. (shrink)