LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model
In a randomized, double‑blind, placebo‑controlled crossover study of 24 healthy volunteers given 50 μg LSD, the drug produced psychosis‑like aberrant salience, increased suggestibility and robust mystical and ego‑dissolution experiences, with aberrant salience strongly correlating with mystical experiences and ego‑dissolution. The authors propose that mystical experiences may link the psychosis model and the therapeutic model of psychedelics, suggesting psychedelic‑assisted therapy could benefit from fostering meaning‑laden mystical states.
Authors
- Fernanda Palhano-Fontes
- Luiz Tófoli
- Amanda Feilding
Published
Abstract
Background
For a century, psychedelics have been investigated as models of psychosis for demonstrating phenomenological similarities with psychotic experiences and as therapeutic models for treating depression, anxiety, and substance use disorders. This study sought to explore this paradoxical relationship connecting key parameters of the psychotic experience, psychotherapy, and psychedelic experience.
Methods
In a randomized, double-blind, placebo-controlled, crossover design, 24 healthy volunteers received 50 μg d-lysergic acid diethylamide (LSD) or inactive placebo. Psychotic experience was assessed by aberrant salience (Aberrant Salience Inventory, ASI), therapeutic potential by suggestibility (Creative Imagination Scale, CIS) and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ; Mindful Attention Awareness Scale, MAAS; Experiences Questionnaire, EQ), and psychedelic experience by four questionnaires (Altered State of Consciousness Questionnaire, ASC; Mystical Experiences Questionnaire, MEQ; Challenging Experiences Questionnaire, CEQ; Ego-Dissolution Inventory, EDI). Relationships between LSD-induced effects were examined.
Results
LSD induced psychedelic experiences, including alteration of consciousness, mystical experiences, ego-dissolution, and mildly challenging experiences, increased aberrant salience and suggestibility, but not mindfulness. LSD-induced aberrant salience correlated highly with complex imagery, mystical experiences, and ego-dissolution. LSD-induced suggestibility correlated with no other effects. Individual mindfulness changes correlated with aspects of aberrant salience and psychedelic experience.
Conclusions
The LSD state resembles a psychotic experience and offers a tool for healing. The link between psychosis model and therapeutic model seems to lie in mystical experiences. The results point to the importance of meaning attribution for the LSD psychosis model and indicate that psychedelic-assisted therapy might benefit from therapeutic suggestions fostering mystical experiences.
Research Summary of 'LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model'
Introduction
Since its discovery, LSD has been studied both as an experimental model of psychosis and as a therapeutic agent, creating a longstanding paradox in psychedelic research. Wießner and colleagues summarise similarities between psychedelic and psychotic phenomenology (altered perception, self and time, impaired cognition, magical thinking) and highlight aberrant salience—the inappropriate assignment of importance to stimuli or internal representations—as a central mechanism proposed in schizophrenia research that may underpin hallucinations and delusions. On the therapeutic side, the authors emphasise suggestibility (responsiveness to suggestions) and mindfulness (intentional moment-to-moment attention) as candidate mechanisms by which psychedelics may facilitate clinical change; prior work had shown that several psychedelics can increase suggestibility and that compounds such as psilocybin and ayahuasca can enhance mindfulness-related capacities, but the effects of LSD on mindfulness had not been examined. This study set out to test whether LSD at a low dose (50 µg) would increase aberrant salience (testing the psychosis model) and increase suggestibility and mindfulness (testing the therapy model), and to examine how those changes relate to the subjective psychedelic experience. The investigators hypothesised that LSD would increase aberrant salience, increase suggestibility and mindfulness, and produce positive correlations among LSD-induced changes in aberrant salience, suggestibility, mindfulness, and dimensions of the psychedelic experience (e.g. mystical experiences, ego-dissolution).
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Study Details
- Study Typeindividual
- Journal
- Compounds
- Topics
- Authors
- APA Citation
Wießner, I., Falchi, M., Palhano-Fontes, F., Feilding, A., Ribeiro, S., & Tófoli, L. F. (2023). LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model. Psychological Medicine, 53(4), 1151-1165. https://doi.org/10.1017/S0033291721002531
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