The Radical Ideas of Psychedelic Research 2.0: Pt. 1
Bringing us back to wholeness in more ways than one.
I explore science, spirituality, consciousness, the transpersonal, and more weird stuff in my book: Order here, or wherever books are sold.
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** This is a two-part series. Part 2 will be published next month. **
PT. 1
I find myself in the middle of a cute cosmic joke where the book I didn’t want to write won an award for Best Spiritual Book. Me, the person who used to scoff at others when they uttered anything at all religious or spiritual. Man, the Universe is weird.
My book is partly a story about how I began to reintegrate the pieces of myself that I had broken off. This got me thinking about parts, wholeness, and interconnectedness. Oh, and I also went to the MAPS Psychedelic Science conference in Denver, so I naturally also have psychedelics on my mind. So, let’s get into it.
We love to break things down into parts, especially in science. We use this reductionist method to compartmentalize and better understand how things work. This has worked out pretty well.
Enter psychedelic research 2.0. While the resurgence in psychedelic research has been interesting, I feel like we might finally be seeing the truly revolutionary potential of this movement to reveal our flawed ways of thinking and to catalyze new paradigms.
Especially around reductionism and separation.
Let’s talk about four radical ideas that psychedelic research is bringing around the ways we view scientific research and personal healing by showing us how everything is interconnected. (Two of the ideas will be saved for the next issue…)
The basic outline of a research study looks like this:
Study participant comes into the lab.
They do informed consent and take an array of validated psychological surveys that try to break down this complex person into a series of numbers.
They perform some experimental task or receive a treatment.
They head out to live the rest of their lives.
We scientists take the wholeness of this person’s life and narrow it down to one moment in time: the therapeutic/experiment moment. Within that moment, we isolate the ‘effect’ we are looking for by controlling for things we aren’t looking for, like placebo effects, the biopsychosocial phenomenon that are often comparable to treatment-specific effects.1 We control for them so we can identify what’s due to the treatment and what’s due to placebo – which could be the result of a particular environment, personal characteristic, or social dynamic.
We assume the variables are independent from each other and do not interact, such as assuming that the body is separate from the mind and that treatment can be separated from the context in which it is delivered. In other words, no matter what’s going on psychologically with you or what context the treatment is given, the treatment should work.
By breaking things up in this way, we assume we can just add them up to make the whole. But, psychedelic research has revealed that the total is not the sum of the parts – it’s greater. Psychedelic effects are known to be exceedingly susceptible to “set and setting,” or the person’s mindset going into the experience and the environment where they trip. If you’re in a bad place psychologically, or have the trip in a threatening, unsafe environment, then the odds are good that your trip won’t be the magical mystery tour that you’re hoping for. This is because it turns out that we can’t separate body from mind or treatment from context. These factors are interconnected and affect each other.
That’s common psychonaut knowledge, but new research is backing this up. As just a few examples, recent research has shown that trips taken in “anti-septic” environments tend to predict anxious reactions2 and comfortable trip environments increase a sense of interconnectedness.3 When spiritual support is added to treatment, better outcomes are seen for various measures, such as interpersonal closeness, life meaning and death transcendence.4 Environment and context matter. (BTW, there was already evidence for this even before psychedelic research 2.0: e.g. expecting to do better on antidepressants causes you to do better on antidepressants5,6 (see this paper for examples)
These variables can’t be thrown away. They are interactive and synergistic. So, radical idea #1: Stop thinking it’s just the drug that matters. Let’s leverage the placebo effect by recognizing the importance of it all. Incorporate rituals. Set intentions. Have a spiritual statue for the trip. It all matters and can increase healing. It’s not “all in your mind” — I mean, it is in your mind, but your mind is not the baby bird we’ve made it out to be; it’s more like an eagle, a hawk, or even a pteradactyl. You get the picture.
Radical idea #2: The treatment/experiment moment is not what heals the person. Despite how we define it, the treatment/experiment moment is not actually a discrete moment in time that can be separated from the rest of your experience. Things you experience before and after do influence the treatment/experiment. Experiments rarely take into consideration much of what you do beforehand. This is true for science, but also for medicine. Western healthcare is delivered and viewed in parts, too, with doctor visits, prescriptions, and follow-up – not to mention mind and body – all being separate. Psychedelic research is obliterating this idea.
With psychedelic psychotherapy research, we are seeing the emphasis on how important preparation (pre-trip) and integration (post-trip) are for the entirety of the healing process. Days in advance of treatment, participants must undergo preparation in order to have the right mindset and feel safe and comfortable in the session. This includes getting comfortable with the practitioner and establishing the patient-practitioner relationship (which, btw, is important for other treatment outcomes, like depression scores being 3x more likely to be influenced by the psychiatrist than by the patient’s medications (!!!)).7,8 Integration is vital and indispensable in helping the patient make sense and meaning of their experience, which some believe is what really heals. Have you ever sat down with your physician to discuss the meaning of your current health journey – the idea is laughable in Western medicine, right? Who has time for that? But that kind of integrated care could bolster healing.
In addition to preparation, the kind of content you consume beforehand matters for treatment. A recent study found that the media a patient consumes before a psychedelic treatment can “imprint” in their psyche, show up in their trip, and alter the trip and therapeutic outcomes, for example by reducing mystical-emotional qualities.9 One patient had been trading Disney pins on social media for many hours per day prior to one trip and described the trip as being “hijacked” by Disney imagery that prevented her from reaching deeper healing truths. When she eliminated this habit before the next trip, she got what she intended for the therapeutic session – better outcomes on depression scores. (This is a good reminder that what you consume seeps into your mind and lingers, whether you’re conscious of it or not.)
So, what comes before and after the treatment/experiment moment are interwoven and inseparable from the outcome. The threads of time weave together to create a braid of treatment. Psychedelic treatment has demonstrated this beautifully. Let’s stop thinking it’s just the therapeutic/experiment moment that matters. What happens before and after matters, too.
Environment, context, mindset, social dynamics, pre-events, post-events, and so much more are all related to how much healing you get. I’m using psychedelic research to make this point because the field is already primed to think about ‘set and setting.’ But, this is true for all research and healthcare, and it’s time we stop acting like it isn’t.
To be continued next month….