I Want What They're Having
New research on psychedelics show they're more than just a trippy good time.
Hi all! Just a brief logistical note as the newsletter transitions to me from Erica Rex. I will be writing about my personal take on the Psychedelic Renaissance and related topics. Those of you who have been subscribed for a while may already be quite familiar with the landscape of psychedelics and research into psychedelic substances, but some of the new readership may not be all caught up. So, bear with us, please! I’ll aim to keep the tempo of two newsletters per month. Whatever subscription structure Erica had set up for the newsletter will remain in place, but paid subscriptions appreciated to cover the cost of research (e.g. journal subscriptions, etc). Enjoy!
- Mona (@monasobhaniphd)
One of my college roommates once told me, “You should never do psychedelics. You’ll totally flip out.” She wasn’t wrong (at the time). I consider myself a type A person and much prefer to take my environment predictable and controllable, thank you very much. That’s why I chose science – neuroscience to be precise – as a career, because if we understand components, we can better control outcomes.
In 2020, in the midst of an existential-crisis-slash-spiritual-awakening (that’s a story for another time), I found myself directed to the scientific literature on psychedelics. The person who recommended the reading thought I would be interested in the perceptions one can have while on a psychedelic trip — perceptions that could be interpreted as mystical or spiritual. I had misgivings this would set my passion aflame, so I set aside, maybe, fifteen minutes to dig into the topic.
But, after locating and reading some of the very recent research being conducted on psychedelic substances, I was absolutely blown away. Days – and many matcha lattes – later, I was still captivated and immersed in the scientific papers detailing how psilocybin – the psychoactive ingredient found in some hallucinogenic mushrooms – improved symptoms of anxiety and depression. Not only had there been a good amount of new research conducted, but the results were extraordinary. To be clear, although I’m a neuroscientist, it wasn’t the neuroimaging results (i.e. the technique used to measure the function and structure of the brain using magnetic resonance imaging (MRI)) that impressed me.
Since completing my dissertation, which had been based on my own neuroimaging work, I had become unimpressed with, and uninterested in, neuroimaging’s ability to provide truly meaningful information or understanding about human behavior. The sample sizes were too small, the variance too high, the analyses too simplistic. The same brain regions were implicated in practically every study, making me wonder if we were truly making any serious progress in understanding the brain. Personally, it is still unclear to me (from an individual perspective) how knowing, for example, that my amygdala is active when I’m watching a beloved horror movie, meaningfully contributes to my human experience.
Instead, here’s what caused me to perk up with attention at the promise of psychedelics, and why:
How quickly, and how long, psychedelics worked: Anxiety and depression symptoms improved after just a few psychedelic-assisted therapy sessions, as soon as within one day and lasted for up to six months (1-7).
Why is this impressive? Anxiety and depression can be very difficult to treat, and treatment outcomes have severe limitations. In particular, it can take a while to see the effects of standard treatments for depression, with time frames for psychotherapy varying widely and antidepressant medications taking days to months to work – if at all (8). Only about 54% of people show improvement after using an antidepressant medication (9–12) and 62% show improvement after psychotherapy (9,13–15). In the studies examining psilocybin and depression, a majority of the participants (~60-80%) had immediate and lasting effects from just a few sessions. That’s huge. Of course, more long-term studies are needed to see how the effects hold over time, but it’s still noteworthy.
How significant and meaningful the experience seemed to be for participants: A majority (~70-80%) of the participants reported the psychedelic experience as being one of the most spiritually significant or personally meaningful experiences of their lives, with some comparing the meaningfulness of the experience to the birth of a first child or death of a parent (16).
The fact that I didn’t know, at the time, what a mystical or spiritual experience was, or what it precisely entailed, did not stop me from being impressed. I thought psychedelics were just a groovy time. I did not realize they could elicit deep personal transformation through the experience of feeling unity and interconnectedness with all people and things, a sense of sacredness, feelings of peace and joy, a sense of transcending normal time and space, and ineffability — aka a spiritual/mystical experience. But what was more interesting was…
That the mystical experience of the psychedelic trip mediated therapeutic improvement. In other words, the stronger the mystical experience, the greater the reduction of anxiety and depression symptoms, and other clinical outcomes (6,7,17–19).
How could this work? One explanation is that psychedelics could be rewiring the brain in such a way that the brain areas involved in anxiety and depression get adjusted. But since there are no known precise and consistent neural correlates for anxiety or depression, it’s hard to say. Neuroplasticity may be the underlying mechanism for therapeutic improvement, but it could also partly be due to a psychological reframing, a flip in perspective – or something else. Not every experience, after all, needs to be accompanied by MRI-measurable differences in the human brain to cause meaningful behavior change.
How much the psychedelic experience changed the participants and their lives. Participants displayed significant changes to some aspects of personality, such as openness (20), and reported positive changes in attitudes about life and self, positive behavior, as well as increased spirituality (16,20,21).
Personality is considered to be a rather stable constellation of traits, and witnessing drastic personality changes from a behavioral intervention, especially a short one, is practically unheard of in behavioral research. In other words, it had to be quite the experience to cause such an unusual change. The fact that just a few sessions of psychedelic intervention facilitated positive changes in behavior, as well as attitudes about life and self, is also rather incredible as behavior and attitudes are notoriously difficult to alter.
So… suddenly I was very interested in psychedelics! Not only did the psychedelic experience (in conjunction with therapy) appear to be a promising therapeutic for anxiety and depression, but also a formidable force for positive, impactful, and profound personal change.
The deep personal and spiritual meaning the patients brought with themselves out of the trips is … not nothing. Does it tie directly back to a rewired neural network? We truly do not know. But does it matter? Of course, for the sake of general knowledge, it matters. For the sake of healing and transformation, however, I don’t think it does. It feels strangely traitorous to say such a thing as a neuroscientist, because we are always focused on mechanism, mechanism, mechanism.
But, frankly, I’m so over pure neural mechanisms as explanations for behavior.
We shouldn’t solely focus on mechanistic and biological explanations for human behavior because humans are astronomically complex. It is an assumption that every factor that contributes to a behavior is coded in the human brain (or body) and can be identified through current day measurement. Are we sure that every aspect of our minds, and the ways we think, have neural (or bodily) correlates? Only time will tell if this assumption is true or not. In the meantime, we need biopsychosocial – and probably spiritual – models for why we behave the way we do. Researchers/practitioners of the body are rarely taught about the mind or brain and vice versa, but we need a combination of these fields to truly understand humans and life.
During the period of time when I stumbled on this new research, I was feeling disenchanted with life. The participants of the psychedelic research studies seemed to come out of their experiences dazzled and having found new meaning to life.
I wanted what they were having.
So, I decided to take a trip to find out… an acid trip. I’ll tell you about it in the next newsletter.