“Did you feel that ‘all is One’?”
“Did you experience something profoundly sacred and holy?”
“Did you feel as if you were outside time and space?”
While these questions might sound best fit for a late-night campfire, they’re actually part of the toolkit used by researchers to understand the experiences of patients undergoing treatment with psychedelic drugs.
In part one of this two-part series, we looked at the tools scientists use to measure, dissect and analyze the mystical states of patients undergoing psychiatric treatment with psychedelics like LSD and “magic mushrooms.”
Spiritual-like experiences could be the key behind the therapeutic value of these drugs, currently projected as a new paradigm in mental health treatment.
But, while mysticism and psychedelics have become historically intertwined, some researchers think it’s time to draw a line between hard science and metaphysical belief.
Mysticism In Psychedelic Medicine: A Bone Of Contention
As one could naturally predict, the introduction of mystical concepts in an area of scientific research has not gone unnoticed.
The mystical experiences that psychedelics induce have triggered an ongoing debate around how these experiences are framed, and whether they should be taken seriously by researchers working with scientific rigor.
Dr. Matthew W. Johnson, a psychedelics researcher at Johns Hopkins University, wrote in a recent article that the rise of psychedelic medicine brings with it the risk of scientists and clinicians imposing their own religious or spiritual beliefs into their practice.
“For today’s psychedelic scientists and clinicians, frameworks of concern are likely to resemble a loosely held eclectic collection of various beliefs drawn piecemeal from mystical traditions, Eastern religions, and indigenous cultures, perhaps best described by the term “new age,” wrote Johnson.
The researcher states that, in alignment with best practices of clinical psychology, clinicians working with psychedelics should be extremely careful not to introduce mystical concepts that are not supported by empirical science.
In a paper published last May, University of Amsterdam researchers James W. Sanders and Josjan Zijlmans warned that the use of the “mystical experience questionnaire” described in part one of this series invites participants in psychedelic research trials “to interpret their experience through the framework of mysticism.”
They fear that, by using the “mystical experience construct,” researchers are providing participants with a particular terminology and framework with which to illuminate their own psychedelic experiences.
Additionally, they argue that the inclusion of mystical concepts in psychedelic research risks damaging the credibility of psychedelic science as a whole.
“We are concerned that use of the mysticism framework creates a ‘black box’ mentality in which researchers are content to treat certain aspects of the psychedelic state as beyond the scope of scientific inquiry,” say the researchers.
Sanders and Zijlmans advocate for new theories around psychedelics, grounded purely in scientific explanations. In their view, the “unitive” feelings that arise with the intake of psychedelics (best described as feeling oneself as part of a larger whole) could be the result of a psycho-pharmacological disruption to beliefs about one’s own separation from the environment.
Why Do Psychedelics Induce A Mystical State In The First Place?
For over 23 years the Beckley Foundation has co-sponsored dozens of studies into psychedelics. One of their most prominent ones, done in collaboration with Imperial College London, looked at the brains of people under the effects of psychedelics through fMRI imaging.
This study shed light into how the chemical action of psychedelics can trigger feelings of awe, traceable to a neurological level.
Psychedelics have an ability to turn down the “repressive activity” of the default mode network, explains Amanda Feilding, founder and director of Beckley. It has been proposed that this brain network can be matched to what Freud called “the Ego.”
One study with LSD and another with psilocybin showed “a decreased supply of blood to the center of the default mode network under the psychedelic experience.”
“So this controlling, repressive mechanism, which kind of makes I, I and makes one able to control one’s behavior, is turned down. And when that happens, all the centers of the brain tend to communicate more with each other,” said Feilding.
This allows a “sudden flowering of communication” between the different parts of the brain.
In Feilding’s view, the mystical experience is an endogenous state of mind which happens on rare occasions, much more often to children. Children live in a constant state of neuroplasticity that is much more akin to the psychedelic state than the adult state of mind.
By decreasing blood flow to the brain’s default mode network, verbal planning and egocentric behavior are lessened.
“That, together with the right mindset, can spill into a feeling of unity with nature or the universe and awe and the sense of beauty and eternity,” says Feilding.
Is The Mystical Experience Necessary For The Success Of Psychedelics Medicine?
Regardless of one’s philosophical position around the realness of subjective spiritual experiences, the therapeutic aspect of the mystical experience in psychedelics remains a bone of contention.
Jonhs Hopinks researcher Dr. Albert Garcia-Romeu says that, while the mystical experience can help facilitate positive therapeutic outcomes, it’s not a necessary condition for the formation of new insights that can lead to progress in psychedelics-assisted psychotherapy.
Psychedelics can facilitate psychological growth in a number of ways that don’t touch on the metaphysical.
“That can include insights into one’s personal life and life history, relationships, as well as just biological factors like feelings of increased mood and energy and reduced negative affect,” says Garcia-Romeu.
Psychedelics have the potential to trigger positive psychological change through their ability to induce “pivotal mental states.” These have recently been defined by researchers Ari Brouwer and Robin Carhart-Harris as “transient, intense hyper-plastic mind and brain states, with exceptional potential for mediating psychological transformation.”
“Psychedelics hijack the same neurochemical mechanisms that are engaged during, and likely exist for, situations where a hyper-plastic state and associated psychological change is felt as needed,” say the researchers.
They propose that the mechanisms underlying these states have evolved to aid rapid and deep learning in situations of existential threat or crisis for the ultimate purpose of catalyzing psychological change when circumstances demand it.
Still, Garcia-Romeu adds that there have been statistically significant correlations found between how people rate on the mystical experience questionnaire and their psychological improvements.
He’s confident that if clinicians can learn to wield those experiences skillfully in a therapeutic or clinical setting, the result can bring immensely valuable tools for psychological healing.
What Do Regulators And For-Profit Actors Think About Mysticism?
While multiple psychedelic substances are currently undergoing dozens of clinical trials with the aims of receiving approval for their use in psychiatric treatment, the safety and efficacy of these substances receives far more attention than the contents of the experiences they induce.
For a regulating body like the FDA, researchers aiming to put a psychedelic drug and treatment through the clinical research pipeline only need to prove two things: that the drug (and its associated protocols) are safe, and that they work successfully at treating the indication they’re after.
The FDA has no particular interest in what happens in the mind of a patient experiencing a psychedelic trip, as long as their condition improves without substantial side effects.
“They don’t care because to them, the question is, ‘does it work or does it not work?’ And ‘is it safe or is it unsafe?’ And we have plenty of data to show that it’s safe,” says Johns Hopkins’ Garcia-Romeu.
As a host of publicly-listed companies dive deeper into psychedelics research, investigation becomes crystallized in the areas needed to pass regulatory approval. For some companies in the field, the mystical experience of psychedelics could be an unnecessary byproduct in a path towards revenue generation.
“People that are trying to develop this commercially will want to minimize all the psychotherapy and all these things because they’re very expensive, relatively speaking: they’re labor intensive,” says Dr. Charles Raison, a researcher studying psychedelics at the Usona Institute and Emory University.
The way psychedelics-assisted psychotherapy is being proposed today, patients would need to take these drugs in a safe environment, with professional supervision, and pre and post-experience follow-ups. This whole process could put the cost of each psychedelic session in the hundreds of dollars.
Raison says there’s a number of commercial entities that are beginning to look at ‘how close can we get to just giving psychedelics in a safe room, and that’s it.”
“How important are those experiences, really? How far down the road do we need to go to help them happen versus, you know, cost effectiveness?,” he wondered in an interview.
Some companies in the field, including Boston-based Delix Therapeutics, are taking it one step further, looking into the possibility of chemically altering psychedelic compounds to only produce a neuroplastic effect, without causing hallucinations.
With this model in mind and several drug candidates, Delix has raised $70 million and aims to take its candidates through clinical trials.
Chief Innovation Officer David E. Olson explains that on a biological level, all antidepressants promote the growth of neurons in a key brain region known to regulate mood, reward, and fear.
“Psychedelics —as well as non-hallucinogenic analogs of psychedelics that we call psychoplastogens—, are particularly good at promoting this type of neuroplasticity.”
However, Olson still defends the valuable role of psychotherapy in the context of psychedelic medicine. In his view, psychotherapy will always improve treatment responses, whether that treatment is a psychedelic or an SSRI antidepressant.
“Patients will definitely be helped by psychedelic-assisted therapy, but given the constraints associated with in-clinic administration, only a limited number of patients will benefit from this approach,” he said.
“The drug-only approach is simply more scalable, so I think that psychiatry needs both options in order to maximize the number of patients who can be helped.”
Several other companies are currently working on altering psychedelic substances to produce diverse effects that could either maximize, minimize or alter a patient’s mystical journey with the drug.
As the space of medicinal psychedelics grows, their clinical applications are also likely to branch out, leaving always some room for those who believe in the therapeutic power of inducing spiritual experiences in patients.
“I do think that society would be better if it introduced an element of the spiritual,” concludes Beckley Foundation’s Amanda Feilding.