Anxiety Disorders

Embedding existential psychology within psychedelic science: reduced death anxiety as a mediator of the therapeutic effects of psychedelics.

This literature review and hypothesis paper (2019) proposes that the enduring improvements in well-being following psychedelic therapy are mediated by a reduction in death anxiety. It integrates existential psychology with psychedelic science to suggest that addressing this fundamental anxiety is central to the therapeutic process.

Authors

  • Samuel Moreton

Published

Psychopharmacology
meta Study

Abstract

Psychedelic therapies can engender enduring improvements in psychological well-being. However, relatively little is known about the psychological mechanisms through which the salutary effects of psychedelics emerge. Through integrating extant research on psychedelics with contemporary existential psychology, we present a novel hypothesis that reduced death anxiety may be a key mechanism underpinning the therapeutic effects of psychedelics. In developing this hypothesis, we also provide a complimentary review of mechanisms through which psychedelics may reduce death anxiety. We conclude that an awareness of the role of death anxiety in psychopathology has the potential to guide future research into psychedelic therapies.

Available with Blossom Pro

Research Summary of 'Embedding existential psychology within psychedelic science: reduced death anxiety as a mediator of the therapeutic effects of psychedelics.'

Introduction

The paper opens by situating recent psychedelic research within an existential-humanistic framework, arguing that conventional psychopharmacology has paid insufficient attention to fundamental human needs and existential concerns such as meaning, isolation, freedom, and fears of death. Psychedelic substances—principally serotonergic compounds such as psilocybin, LSD, DMT and mescaline—are presented as pharmacological tools that can reliably produce enduring changes in connectedness, meaning and attitudes to death, changes that coincide with improvements in psychological well‑being. Despite accumulating evidence for long‑lasting benefits after psychedelic experiences, the psychological mechanisms that drive these benefits remain uncertain. Moreton and colleagues set out to integrate extant empirical and theoretical literature from psychedelic science and existential psychology to propose a novel hypothesis: reductions in death anxiety may be a key, potentially transdiagnostic, mediator of the therapeutic effects of psychedelics. The paper aims to (a) review evidence that psychedelics reduce death anxiety, (b) summarise research linking death anxiety to diverse psychopathology, and (c) outline plausible mechanisms—both direct and indirect—by which psychedelic experiences might mitigate death anxiety and thereby contribute to clinical improvement.

Expert Research Summaries

Go Pro to access AI-powered section-by-section summaries, editorial takes, and the full research toolkit.

Full Text PDF

Full Paper PDF

Create a free account to open full-text PDFs.

Study Details

  • Study Type
    meta
  • Journal
  • Topic
  • Author
  • APA Citation

    Moreton, S. G., Szalla, L., Menzies, R. E., & Arena, A. F. (2020). Embedding existential psychology within psychedelic science: reduced death anxiety as a mediator of the therapeutic effects of psychedelics.. Psychopharmacology, 237(1), 21-32. https://doi.org/10.1007/s00213-019-05391-0

References (32)

Papers cited by this study that are also in Blossom

Validation of the revised Mystical Experience Questionnaire in experimental sessions with psilocybin

Barrett, F. S., Johnson, M. W., Griffiths, R. R. · Journal of Psychopharmacology (2015)

Neuroticism is associated with challenging experiences with psilocybin mushrooms

Barrett, F. S., Johnson, M. W., Griffiths, R. R. · Personality and Individual Differences (2017)

78 cited
Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin

Carhart-Harris, R. L., Erritzoe, D., Williams, T. et al. · PNAS (2012)

The paradoxical psychological effects of lysergic acid diethylamide (LSD)

Carhart-Harris, R. L., Kaelen, M., Bolstridge, M. et al. · Psychological Medicine (2016)

253 cited
Functional connectivity measures after psilocybin inform a novel hypothesis of early psychosis

Carhart-Harris, R. L., Leech, R., Erritzoe, D. et al. · Schizophrenia Bulletin (2012)

241 cited
Neural correlates of the LSD experience revealed by multimodal neuroimaging

Carhart-Harris, R. L., Muthukumaraswamy, S., Roseman, L. et al. · PNAS (2016)

Psychedelics and the essential importance of context

Carhart-Harris, R. L., Roseman, L., Haijen, E. C. H. M. et al. · Journal of Psychopharmacology (2018)

Show all 32 references
Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance

Griffiths, R. R., Richards, W. A., Mccann, U. et al. · Journal of Psychopharmacology (2006)

LSD-assisted psychotherapy in patients with terminal cancer

Grof, S., Goodman, L. E., Richards, W. A. · Pharmacopsychiatry (1973)

143 cited
Psilocybin, psychological distress, and suicidality

Hendricks, P. S., Johnson, M. W., Griffiths, R. R. · Journal of Psychopharmacology (2015)

84 cited
Dreamlike effects of LSD on waking imagery in humans depend on serotonin 2A receptor activation

Kraehenmann, R. ;., Pokorny, D. ;., Vollenweider, L. ;. et al. · Psychopharmacology (2017)

138 cited
Reactions to psilocybin administered in a supportive environment

Leary, T., Litwin, G. H., Metzner, R. · Journal of Nervous and Mental Disease (1977)

Ego-dissolution and psychedelics: validation of the ego-dissolution inventory (EDI)

Nour, M. R., Evans, J., Nutt, D. J. et al. · Frontiers in Human Neuroscience (2016)

Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: a preliminary report

Osório, F. L., Sanches, R. F., Macedo, L. et al. · brazilian Journal of Psychiatry (2015)

420 cited
The fabric of meaning and subjective effects in LSD-induced states depend on serotonin 2A receptor activation

Preller, K. H., Herdener, M., Pokorny, T. et al. · Current Biology (2017)

Serotonergic hallucinogens in the treatment of anxiety and depression in patients suffering from a life-threatening disease: A systematic review

Reiche, S., Hermle, L., Gutwinski, S. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2018)

Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression

Roseman, L., Nutt, D. J., Carhart-Harris, R. L. · Frontiers in Pharmacology (2018)

Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression a SPECT study

Sanches, R. F., Osório, F. L., Dos Santos, R. G. et al. · Journal of Clinical Psychopharmacology (2016)

380 cited
Long-lasting subjective effects of LSD in normal subjects

Schmid, Y., Liechti, M. E. · Psychopharmacology (2017)

Unifying theories of psychedelic drug effects

Swanson, L. R. · Frontiers in Pharmacology (2018)

Increased global functional connectivity correlates with LSD-induced ego dissolution

Tagliazucchi, E., Roseman, L., Kaelen, M. et al. · Current Biology (2016)

DMT models the near-death experience

Timmermann, C., Roseman, L., Williams, L. et al. · Frontiers in Psychology (2018)

Psychedelic medicine: a re-emerging therapeutic paradigm

Tupper, K. W., Wood, E., Yensen, R. et al. · Canadian Medical Association Journal (2015)

Cited By (20)

Papers in Blossom that reference this study

Intact neurophysiological markers of death denial in long-term ayahuasca users

Dor-Ziderman, Y., David, J., Berkovich-Ohana, A. · Psychopharmacology (2025)

Psychedelic-assisted psychotherapy: Where is the psychotherapy research?

Aday, J. S., Horton, D. M., Fernandes-Osterhold, G. et al. · Psychopharmacology (2024)

How Do Psychedelics Reduce Fear of Death?

Letheby, C. · Neuroethics (2024)

11 cited
Meditation Trips: A Thematic Analysis of the Combined Naturalistic Use of Psychedelics With Meditation Practices

Azmoodeh, K., Thomas, E., Kamboj, S. K. · Experimental and Clinical Psychopharmacology (2023)

9 cited
Show all 20 papers
Can psychedelics enhance group psychotherapy? A discussion on the therapeutic factors

Ponomarenko, P., Seragnoli, F., Calder, A. et al. · Journal of Psychopharmacology (2023)

Right-Wing Psychedelia: Case Studies in Cultural Plasticity and Political Pluripotency

Pace, B. A., Devenot, N. · Frontiers in Psychology (2021)

Novel Treatment Approaches for Substance Use Disorders: Therapeutic Use of Psychedelics and the Role of Psychotherapy

Johnson, M. W., Gründer, G., Betzler, F. et al. · Current Addiction Reports (2021)

The ritual use of ayahuasca during treatment of severe physical illnesses: a qualitative study

Maia, L. O., Daldegan-Bueno, D., Tófoli, L.F. · Journal of Psychoactive Drugs (2020)

21 cited
Self-reported negative outcomes of psilocybin users: A quantitative textual analysis

Bienemann, B., Ruschel, N. S., Campos, M. L. et al. · PLOS ONE (2020)

57 cited

Your Personal Research Library

Go Pro to save papers, add notes, rate studies, and organize your research into custom shelves.