Implications for psychedelic-assisted psychotherapy: functional magnetic resonance imaging study with psilocybin
In a double‑blind fMRI study of ten healthy volunteers, intravenous psilocybin increased vividness and visual imagery during positive autobiographical recollection and recruited additional visual and sensory cortical regions in the late recollection phase compared with placebo, with greater vividness predicting improved subjective wellbeing at follow‑up. The authors conclude that psilocybin may therefore be useful in psychotherapy to facilitate recall of salient memories or to help reverse negative cognitive biases.
Authors
- Robin Carhart-Harris
- David Nutt
- David Erritzoe
Published
Abstract
Background
Psilocybin is a classic psychedelic drug that has a history of use in psychotherapy. One of the rationales for its use was that it aids emotional insight by lowering psychological defences.
Aims
To test the hypothesis that psilocybin facilitates access to personal memories and emotions by comparing subjective and neural responses to positive autobiographical memories under psilocybin and placebo.
Method
Ten healthy participants received two functional magnetic resonance imaging scans (2mg intravenous psilocybin v. intravenous saline), separated by approximately 7 days, during which they viewed two different sets of 15 positive autobiographical memory cues. Participants viewed each cue for 6 s and then closed their eyes for 16 s and imagined re-experiencing the event. Activations during this recollection period were compared with an equivalent period of eyes-closed rest. We split the recollection period into an early phase (first 8 s) and a late phase (last 8 s) for analysis.
Results
Robust activations to the memories were seen in limbic and striatal regions in the early phase and the medial prefrontal cortex in the late phase in both conditions (P<0.001, whole brain cluster correction), but there were additional visual and other sensory cortical activations in the late phase under psilocybin that were absent under placebo. Ratings of memory vividness and visual imagery were significantly higher after psilocybin (P<0.05) and there was a significant positive correlation between vividness and subjective wellbeing at follow-up (P<0.01).
Conclusions
Evidence that psilocybin enhances autobiographical recollection implies that it may be useful in psychotherapy either as a tool to facilitate the recall of salient memories or to reverse negative cognitive biases.
Research Summary of 'Implications for psychedelic-assisted psychotherapy: functional magnetic resonance imaging study with psilocybin'
Introduction
Psilocybin is a classic psychedelic historically used in psychotherapy on the premise that it lowers psychological defences and facilitates emotional insight. Earlier literature and case reports describe spontaneous autobiographical recollections or "relivings" under psychedelics that resemble dream-like sequences or flashbacks, and prior work by the group found decreased resting activity in medial prefrontal cortex after psilocybin—a region thought to exert top-down inhibitory control over limbic structures. These observations motivated a hypothesis that psilocybin might facilitate access to salient personal memories via neural disinhibition of limbic and sensory systems. This study set out to test whether psilocybin augments subjective and neural responses to positive autobiographical memories. Using a placebo-controlled, within-subject cross-over design with functional magnetic resonance imaging (fMRI), the investigators compared responses to personal positive memory cues under intravenous psilocybin (2 mg) versus saline. They predicted increased activations in medial temporal and visual association regions and greater subjective vividness and emotionality of recollections under psilocybin. Positive cues were used deliberately to reduce the risk of adverse reactions during the drug state.
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Study Details
- Study Typeindividual
- Journal
- Compound
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- APA Citation
Carhart-Harris, R. L., Leech, R., Williams, T. M., Erritzoe, D., Abbasi, N., Bargiotas, T., Hobden, P., Sharp, D. J., Evans, J., Feilding, A., Wise, R. G., & Nutt, D. J. (2012). Implications for psychedelic-assisted psychotherapy: functional magnetic resonance imaging study with psilocybin. British Journal of Psychiatry, 200(3), 238-244. https://doi.org/10.1192/bjp.bp.111.103309
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