Psychedelics, Psychotherapy and Mysticism

 

By Anna Lutkajtis

Recent research suggests that the positive therapeutic effects of psychedelics are related to their ability to induce a mystical experience. For example, in a trial of psilocybin for treatment-resistant depression, Roseman, Nutt and Carhart-Harris (2018) found that having a mystical-type experience predicted positive clinical outcomes. Further, a study by Griffith et al. (2011) found sustained positive changes in attitudes, mood, and behaviour in volunteers who took psilocybin. In this study, 83% of participants who had a psilocybin occasioned mystical experience rated it as the single most, or among the five most, spiritually significant experiences of their life (at a 14 month follow-up this number was even higher at 94%). Even more recently, a large scale survey by Davis et al. (2020, p. 1) found that psychedelic entity experiences were rated by respondents as “among the most meaningful, spiritual, and psychologically insightful lifetime experiences, with persisting positive changes in life satisfaction, purpose, and meaning attributed to the experiences.”

These findings are not particularly surprising given that mystical experiences (both psychedelic and non-psychedelic) have frequently been associated with positive after effects. For example, Wulff (2014, p. 375) writes:

“Although a profound sense of fatigue may immediately follow a mystical experience, and the knowledge or insight that defines it proves impossible to recapture, there remains the joyful impression of having encountered a higher reality and discovered new truths. Ordinary concerns recede in importance or appear in a new light, and new beliefs and values take the place of old ones. Some experients report feeling an intensified love and compassion for others, and many say that life as a whole has taken on new meaning.”

Mystical experiences have been reported by religious and non-religious people around the world and throughout history. Within religious traditions mystical experiences are given specific meaningful religious interpretations, however, even for non-religious people mystical experiences are often reported as being profoundly spiritual and meaningful. Despite this, mystical experiences have been largely ignored by mainstream psychology and psychiatry. Why has this been the case?

Mysticism and Medicine: A Serious Image Problem

Historically, there seems to have been a bias against mysticism in psychiatry and psychology. Traditionally, the mental health field has tended to view mystical states as symptoms of mental illness, rather than paths to mental wellness. This historical bias against mysticism stems from a bias towards religion and spirituality in general, and has been mainly informed by the personal opinions and clinical experience of a handful of highly influential figures. For example, Pargament et al. (2013, p. 5) write:

“Some leading psychological figures, such as Freud and Skinner, go beyond skepticism to antagonism toward religion and spirituality, equating religious practices with pathology and discouraging psychologists from supporting this purportedly defensive way of life. Albert Ellis (1986), founder of Rational Emotive Therapy, had this to say: ‘Obviously, the sane effective psychotherapist should not … go along with the patient’s religious orientation, for this is equivalent to trying to help them live successfully with their emotional illness.’”

Sigmund Freud (1856 – 1939) – who never had a mystical experience himself – theorised that mystical experiences were based on pre-rational and primitive experiences. For example, Freud hypothesised that the mystical feeling of ‘oneness’ could have its basis in the experiences of a newborn infant whose ego has not yet separated from the world around them (e.g. Kripal 2007, p. 257). For a time, Freud’s thinking was highly influential in psychiatry and as a result, mystical states were generally considered to be unreal and inconsequential. For example, Kripal (2007, pp. 137-138) argues that in the 1960s, people who showed “deep and positive interests in various altered states of consciousness and energy” were routinely dismissed by the Freudian-influenced medical establishment as being mentally ill. Similarly, in early psychedelic research the states induced by psychedelics such as LSD, mescaline and psilocybin were initially thought to simply simulate a temporary pathological psychosis (although this view was soon recognised as limited and inadequate; Garcia-Romeu and Richards 2018, p. 2).

‘Diabolical Mysticism’

Psychiatry’s unenthusiastic attitude towards mysticism also stems from the fact that mystical beliefs and experiences are frequently a feature of psychosis. For example, Koenig (2007) notes that in the United States, approximately 25-39% of people with schizophrenia and 15-22% of those with bipolar disorder have religious delusions. Such delusions may contain mystical content, such as the belief that one is in contact with God or has special knowledge regarding the meaning of the universe. As a result, in psychiatry mysticism has generally been equated with psychopathology, and a person’s mystical experiences are not usually explored in a clinical setting as it is believed that this may exacerbate or deepen delusional beliefs.

Interestingly, it was the well-known philosopher and psychologist, William James (1842 – 1910) who may have played a key role in equating mysticism with psychopathology. Although not a mystic himself, James was sympathetic to mysticism and he argued that mystical states were both real and of “paramount importance” (James 1902, p. 328). He argued:

“Our normal waking consciousness, rational consciousness as we call it, is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different … No account of the universe in its totality can be final which leaves these other forms of consciousness quite disregarded” (James 1902, p. 335).

However, James differentiated between two different types of mysticism; ‘religious mysticism proper’ (which generally had positive effects) and ‘diabolical mysticism,’ which he equated with psychopathology:

“In delusional insanity, paranoia, as they sometimes call it, we may have a diabolical mysticism, a sort of religious mysticism turned upside down. The same sense of ineffable importance in the smallest events, the same texts and words coming with new meanings, the same voices and visions and leadings and missions, the same controlling by extraneous powers; only this time the emotion is pessimistic: instead of consolations we have desolations; the meanings are dreadful; and the powers are enemies to life” (James 1902, pp. 368-369).

 

While diabolical mysticism is only one half of mysticism, it is the half that has been given the most attention in Western psychology and medicine. This makes sense given that people who have entirely positive mystical experiences are unlikely to seek professional help. However it does create an unbalanced and negatively skewed picture of the mystical experience. While mysticism certainly has a shadow side, in modern Western psychology and medicine the focus on diabolical mysticism has been excessive – to the point where mystical experiences that may be healthy and even ‘normal’ have been pathologised.

The Sacred / Secular Divide

In a recent article on the use of psilocybin for depression, Roseman et al. (2018, p. 2) argue that the term ‘mystical’ is problematic in itself “as it suggests associations with the supernatural that may be obstructive or even antithetical to scientific method and progress.”

Indeed, modern psychology and psychiatry are based on secular humanistic and scientific understandings of the human condition and their focus is on the personal and the interpersonal – not the spiritual or otherworldly. So far, no mainstream secular mental health paradigm has managed to include the personal, interpersonal and spiritual/mystical within a single framework. Spirituality has achieved some legitimacy in psychological research (for example, research studies that demonstrate the positive impact that religion and spirituality can have on people’s mental health) but very little of this research has made its way into applied practice. Transpersonal psychology, which has attempted to integrate spirituality and mystical experiences into clinical practice, has been criticised for lacking scientific rigor and has never been fully accepted into the mainstream.

It is also possible that part of the reluctance among psychologists to integrate spirituality into clinical practice may come from the personal biases of clinicians themselves. Pargament et al. (2013, p. 5) note that in the United States for example, psychologists as a group are considerably more skeptical about the validity of a ‘sacred dimension’ than the general population.

Mysticism and Psychedelic Psychotherapy

Regardless of the reason, the fact remains that mystical and spiritual matters have largely been neglected in mainstream mental health care and most clinicians report minimal or no training in dealing with them. This has resulted in what some scholars have termed ‘spiritual illiteracy’ and ‘spiritually avoidant care’ (Saunders et al. 2010; Vieten et al. 2013).

However, despite this history of skepticism and avoidance, we are currently in the midst of a ‘psychedelic renaissance’ – a new era of psychedelic research that will have significant implications for the role of the mystical experience in the treatment of mental health conditions. Given the growing interest in psychedelic-based interventions and the probability that psychedelics such as psilocybin will soon be used as a mainstream mental health treatment, clinicians are likely to be faced with a new and unusual phenomenon: patients who have mystical experiences induced by their psychotherapeutic treatment.

This calls for a major paradigm shift in mental health care. Up until now, psychologists and psychiatrists may have been able to avoid religion and spirituality in practice, however given the sometimes overwhelmingly mystical nature of the psychedelic experience this approach seems unlikely to be able to continue.

Going forward we need a new approach to the mystical experience – one that rehabilitates its overly negative reputation and recognises the personal and clinical value of psychedelic-induced mystical experiences. Regardless of whether psychedelic mystical experiences are ontologically ‘real,’ these experiences do have real and meaningful treatment outcomes and deserve the attention and respect of clinicians.

 

About the writer: 

Anna Lutkajtis is a postgraduate student from Sydney, Australia. Her research focuses on
mysticism, the dark night of the soul and the healing potential of altered states of consciousness. She is particularly interested in the relationship between mental illness and spirituality, mystical experiences, and how traditional contemplative and spiritual practices have been integrated into modern Western psychology. Her PhD project is focused on psilocybin and healing.

Don’t Stress About the Simulation

By  Dr Sam Douglas

I’ve seen a bit of talk in psychedelic spaces lately about the possibility that we might be living in a simulation. From Descartes’s evil demon that perfectly deceives our senses, to Putnam’s Brains in Vats (BIVs) to Bostrom’s post-human computer simulation, a lot of ink has been spilled debating the idea that the world and our place in it might not be anything like the picture our everyday senses give us. 

For some, psychedelic or other mystical experiences can unsettle our confidence that reality is as it seems. I’m not here to say that the alternate realities or higher dimensions people perceive during psychedelic experiences actually exist or not. But I am going to argue that there is an important sense in which it doesn’t matter. 

Here’s an adaptation of Hilary Putnam’s thought experiment about disembodied brains in vats. I’ve changed it to apply to simulations (because everyone knows that’s way cooler), but the argument works either way.

  1. If you’re in a simulation, then you don’t have hands.
  2. You don’t know that you’re not in a simulation.
  3. Therefore, you don’t know that you have hands.

Is the conclusion worth really worrying about though?

For everyday purposes, probably not, since the only doubt you have about your hands is unrelated to the everyday experience of your hands. Imagine someone in a Matrix-style scenario, whose simulated body has lost its hands in a simulated accident, while their real body still has them. Would this person be comforted to be told that it’s OK because they ‘really’ have hands? How about the psychedelic version, where it’s fine because there’s no such thing as physical hands and we’re really all made from vibrations or something? I wouldn’t be very impressed in either case. Why? Because my lack of possibly illusory hands is more important to my everyday life than my ‘real’ ones, and the suffering that this causes me is most definitely real.

This fits with other ideas around what might be illusory. Our selves, the ‘I’ that is separate from the world, might be an illusion, and yet suffering occurs regardless (or possibly because of the illusion). Can you be wrong about physical injury being the cause of your pain? Yes. Can you be wrong about whether you had the experience of pain? That’s much less clear, and still hotly debated. 

Of course, I’ve assumed any simulation we are in is perfect in the sense that, unlike Neo’s experience of the Matrix, there is nothing in what we perceive that gives us reason to think that the world around us is not what it seems. For those not familiar with BIV and deceiving demon scenarios, this is normal – we would hardly worry about whether we were in a simulation if we could tell the difference between it and reality. 

This is where psychedelic experience complicates the philosophy a little.

Maybe we have been allowed to peek behind the curtain and see aspects of reality that are normally hidden from us. Even if you don’t buy that (and I’m not saying you should), at the very least psychedelics show that how we perceive the world and ourselves is not set in stone. Having experienced this, the ‘illusion’ may no longer feel as perfect as it once did. 

But before people rush off and try to observe their way out of this philosophical quandary by taking the express train to hyperspace (where legal) and telling everyone that Descartes should have just smoked some Changa instead of sulking in an oven for three days, we need to put the brakes on.

If seeing reality as different causes you to think that maybe your everyday perceptions aren’t ‘real’, then why would you think that any perceptions were trustworthy? Psychedelics show that we can’t always trust our perceptions. But this applies just as much to any places or entities people perceive during these experiences. Maybe all the things we perceive are real. Maybe none of them are. The point is, no matter how much acid you take, you can’t perceive your way out of the fact that our perceptions might not be perfect.

Where to from here?

You could abandon observation and try to philosophise a solution. Or, you could lean into it, pragmatically accept that some things are uncertain and get on with your life. I can’t tell you how this choice would be for you, but from my own experience I know what helps me sleep at night, and it’s not trying to prove that I have hands by using pure reason. This pragmatism means that even though you can’t say for sure that things like motor vehicles ‘really’ are what they seem, you should stay out of their way. Your perceptions of moving objects are the culmination of millions of years of evolution, and even if you think reality is ultimately different, they are worth paying attention to. 

But we should also pay attention to what we can be surer of. Experiences might not reflect reality, and the self might be illusory, but the experiences themselves are real. Importantly, the joy or suffering you experience is real. Doubly important is the fact that it’s real for everyone else too. So maybe the way forward is to not sweat the small stuff of whether the world is as it seems and take heart from the idea that if we cause joy and alleviate suffering, we’re doing something real, whether we’re in a simulation or not. 

 

Psychedelic Medicine: Will it lead to reform in Australia

By Sam Douglas

Psychedelic Medicine: Will it lead to reform in Australia

 

It seems every day there’s another news story about researchers being given permission to investigate the therapeutic potential of psychedelics. Venture capitalists and investors are increasingly aware of the financial potential too as they seek to maximise returns through first mover advantage. Awesome! We’ll have legalised or at least decriminalised psychedelics in no time, right? Sorry to burst your bubble, but, no. The medical-psychedelic movement, or I should say, the medical-psychedelic-business movement in Australia may not deliver non-medical legalisation or even decriminalisation.

In the US, medical cannabis undoubtedly helped smooth the way for recreational legalisation in the states where it has occurred. Depending on the state, the list of conditions that would allow a cannabis prescription was quite long, and the process of getting & filling that prescription was achievable for large numbers of people. Medical access has led to recreational access. It should be no surprise that psychedelic decriminalisation has the greatest support in places that have followed this path, such as Colorado (especially Denver) and California.

But medical cannabis in Australia is a very different beast. Here, despite estimates that up to 100,000 people are self-medicating with illicitly sourced product, and that up to 500,000 could benefit, the number of prescriptions written has been quite small (though growing rapidly). The barriers to patient access are so problematic that our Senate is undertaking an inquiry into this very issue.

Nor has it, thus far, led to many changes in the criminalised status of cannabis. The structure of medical cannabis access schemes in Australia seem to be as restrictive as possible. Cynically, I suspect this is so politicians can pose with the families of children suffering from otherwise untreatable epilepsy, but not have to entertain any serious change to the status quo. If, as some people think, cannabis law reform is a precondition for psychedelic law reform, then Australia is a very long way behind other jurisdictions.

Yes, there are some NGOs associated with psychedelic medicine doing great work supporting research and advocating for medical access. But it’s worth noting that some of the highest profile NGOs in this area publicly state that they do not support changing the law, except for medical use. Yes, some proponents may talk openly about medicalisation leading to legalisation. But if you pay attention, this happens a lot less than it used to. And yes, some of these people privately support law reform efforts. But talk is cheap, private conversations doubly so.

When anyone talks up the future of psychedelic medicine, we need to ask them what this future will actually look like, specific to where we are. Will it be like our medical cannabis situation, where the vast bulk of people who could make use of it can’t, where the product is often overpriced and inferior, and that non-medical possession and all cultivation (except in the ACT) is still a criminal offence?

Except it could be more restrictive than that. Even if you could get through all the hoops to access your standardised dose of synthetic medical psychedelic, restricting its use to supervised clinical settings might mean that you never even take the substance outside the building, let alone in an environment of your choosing.

Sure, if scientists are successful in removing the ‘trip’ from the beneficial effects of psychedelics, then it might be less restrictive. You’ll get your prescription and take the expensive patented drug that ‘fixes’ you – gets you back to being a good little worker/consumer who doesn’t make a fuss about why society is such a dumpster-fire of sadness, anger and dysfunction.

I hope you’ll excuse me if I find such scenarios underwhelming.

None of this is to say that these advances are inherently bad, and that the companies, NGOs and researchers pursuing them are not doing something worthwhile. In my experience talking to people interested in psychedelics, it’s clear that there are many people in the community who have a deep need for new approaches to mental health and want to access these therapies legally. As awareness grows, this will only increase. I have enough experience of anxiety and depression in myself and those close to me, that I am fully aware of the limitations of existing treatments and why sufferers are demanding something better.

But businesses will generally only seek to reform laws to the extent that they will profit from such changes. Companies responsible for the manufacture of codeine and fentanyl don’t, as far as I’m aware, lobby to decriminalise the cultivation of opium poppies. Nor is it clear that corporations seeking to profit from medical cannabis are particularly interested in governments letting people grow their own, even for medicinal purposes. If our government gives psychedelic businesses a choice between a highly restrictive regulatory regime or no access at all, we can reliably predict how they will react.

Here is the future we could be heading for in Australia, if we don’t step up:

Those who are sick enough, and can navigate the bureaucratic hurdles, might eventually be able to get into a clinic for psychedelic therapy. The companies who make and supply medical psychedelics to these facilities will make billions of dollars. Researchers who don’t say anything too radical in public will still get their grants. And well-connected NGOs and their political allies will pat each on the back, signalling their virtue by doing photo-ops with carefully selected patients.

You, however, will still face legal consequences and risk your career for growing or picking psilocybin mushrooms. You’ll be treated as a criminal for having some squares of paper that are vastly less likely to kill you than a bottle of spirits or a packet of paracetamol. If you buy a pill, you’ll never be 100% sure of the ingredients or potency. You’ll still run the gauntlet of unreliable sniffer dogs at festivals and train stations and be forced to endure the violation of being unlawfully strip-searched by police if one indicates on you. Every day will be a reminder that your autonomy, religious freedom and cognitive liberty matter less than corporate profit and social conformity.

I don’t know about you, but I want something more than that, for all of us.

If you want to openly use ayahuasca or huachuma because they’re integral to your spirituality or religion. If you want to be able to trip responsibly in a safe place with good friends & family. If you want to dance the night away with a pill that has a precise and appropriate amount of MDMA in it. If you want to see the world differently, and don’t want to beg a doctor for permission to do so. If you’d like our laws about what’s illegal to possess and grow to be informed by actual research on risk and harm, rather than historical prejudice and the moral cowardice of politicians. If you think the war on drugs has failed and want it to end.

If you want any of these things, then you need to understand that the businesses, organisations and researchers around psychedelic medicine are not automatically going to give them to you.

If any changes to how psychedelics are treated under the law are going to happen – or even have a chance of happening – it will be through political and social actions. Break stereotypes. Change the minds of those around you. Write to politicians and respond to parliamentary inquiries. Educate yourself about which political parties will really support change and vote accordingly. Find like-minded people and get organised to do all this and more.

This will be hard. Look at the effort it’s taken to get cannabis law reform this far in Australia. And I’d be lying if I said that this will definitely work – the reality is that sometimes truth and fairness don’t always win.
But we owe it to ourselves, and each other, to try.