Trial PaperAnxiety DisordersAdolescentsOlder AdultsTreatment-Resistant Depression (TRD)Depressive DisordersPalliative & End-of-Life DistressSet & SettingPersonality & Trait FactorsPsilocybin

Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis

This first qualitative interpretative phenomenological analysis of 13 cancer patients receiving psilocybin-assisted psychotherapy identified consistent themes — relational embeddedness, broadened emotional range, music- and vision-mediated meaning‑making, movement from separateness to interconnectedness, and revised life priorities — alongside transient distress and integration challenges. The findings indicate psilocybin-assisted psychotherapy may be a promising treatment for psychological distress in people with cancer and highlight experiential mechanisms relevant to theory and clinical practice.

Authors

  • Gabrielle Agin-Liebes
  • Stephen Ross
  • James Guss

Published

Journal of Humanistic Psychology
individual Study

Abstract

The psychological mechanisms of action involved in psilocybin-assisted psychotherapy are not yet well understood. Despite a resurgence of quantitative research regarding psilocybin, the current study is the first qualitative study of participant experiences in psilocybin-assisted psychotherapy. Semistructured interviews were carried out with 13 adult participants aged 22 to 69 years ( M = 50 years) with clinically elevated anxiety associated with a cancer diagnosis. Participants received a moderate dose of psilocybin and adjunctive psychotherapy with an emphasis on the process of meaning-making. Verbatim transcribed interviews were analyzed by a five-member research team using interpretative phenomenological analysis. General themes found in all or nearly all transcripts included relational embeddedness, emotional range, the role of music as conveyor of experience, meaningful visual phenomena, wisdom lessons, revised life priorities, and a desire to repeat the psilocybin experience. Typical themes found in the majority of transcripts included the following: exalted feelings of joy, bliss, and love; embodiment; ineffability; alterations to identity; a movement from feelings of separateness to interconnectedness; experiences of transient psychological distress; the appearance of loved ones as guiding spirits; and sharing the experience with loved ones posttreatment. Variant themes found in a minority of participant transcripts include lasting changes to sense of identity, synesthesia experiences, catharsis of powerful emotion, improved relationships after treatment, surrender or “letting go,” forgiveness, and a continued struggle to integrate experience. The findings support the conclusion that psilocybin-assisted psychotherapy may provide an effective treatment for psychological distress in cancer patients. Implications for theory and treatment are discussed.

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Research Summary of 'Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis'

Introduction

In recent years there has been a resurgence of quantitative research into serotonergic hallucinogens, notably psilocybin, with randomized trials reporting rapid and sustained reductions in anxiety and depression among people with cancer and in treatment-resistant depression, as well as increases in openness and reports of profound spiritual or mystical experiences. Despite these controlled trials and their quantitative outcome measures, the subjective psychological mechanisms by which psilocybin-assisted psychotherapy produces change remain underdeveloped. Prior qualitative work on psychedelic experiences exists but largely concerns recreational use, non‑comparable populations, non-Western ceremonial contexts, or different compounds; rigorous qualitative studies of serotonergic hallucinogens in clinical treatment settings are rare. Belser and colleagues set out to generate hypothesis‑forming, phenomenological data on how participants make sense of their experiences during psilocybin‑assisted psychotherapy. Using an interpretative phenomenological approach, they analysed semistructured interviews with a subsample of patients from an NYU Phase II double‑blind, placebo‑controlled crossover trial for cancer‑related anxiety and distress. The study aimed to characterise the form and content of participants' dosage‑session experiences, the meanings they ascribed to those experiences in context, and how those experiences related to longer‑term change.

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References (13)

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