Patients’ accounts of increased “Connectedness” and “Acceptance” after psilocybin for treatment-resistant depression
Six months after an open‑label trial, patients with treatment‑resistant depression reported that psilocybin shifted them from disconnection (from self, others and the world) and emotional avoidance towards increased connectedness and acceptance. This suggests psilocybin may relieve depression via mechanisms opposite to those of conventional antidepressant medications and some short‑term talking therapies.
Authors
- Robin Carhart-Harris
- David Nutt
- Rosalind Watts
Published
Abstract
Objective
To identify patients’ perceptions of the value of psilocybin as a treatment for depression.
Method
Twenty patients enrolled in an open-label trial of psilocybin for treatment-resistant depression participated in a semistructured interview at 6-month follow-up. Thematic analysis was used to identify patients’ experiences of the treatment and how it compared with previous treatments.
Results
Two main change processes were identified in relation to the treatment. The first concerned change from disconnection (from self, others, and world) to connection, and the second concerned change from avoidance (of emotion) to acceptance. A third theme concerned comparison between psilocybin and conventional treatments. Patients reported that medications and some short-term talking therapies tended to reinforce their sense of disconnection and avoidance, whereas treatment with psilocybin encouraged connection and acceptance.
Conclusions
These results suggest that psilocybin treatment for depression may work via paradigmatically novel means, antithetical to antidepressant medications, and some short-term talking therapies.
Research Summary of 'Patients’ accounts of increased “Connectedness” and “Acceptance” after psilocybin for treatment-resistant depression'
Introduction
Over the past decade there has been renewed interest in the therapeutic use of classical psychedelics, with modern clinical trials reporting promising safety, tolerability and preliminary efficacy. Watts and colleagues note that much of the recent work has concentrated on conventional symptom-based outcomes, leaving a relative paucity of qualitative investigation into the psychological mechanisms by which psychedelic-assisted treatments might work. The present study was motivated to fill that gap by exploring patients’ own accounts of their experiences following psilocybin treatment for treatment‑resistant depression (TRD), with a view to clarifying candidate psychological processes that might underlie clinical change. This paper reports a thematic, phenomenological analysis of semi‑structured interviews conducted at six months after dosing in the first modern clinical trial of psilocybin for TRD. The core research questions asked what patients experienced during dosing, how they felt in the weeks and months afterwards, what processes of change they identified, and how they compared psilocybin with prior treatments. The study is presented as a qualitative complement to forthcoming formal quantitative and neuroimaging reports from the same trial.
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Study Details
- Study Typeindividual
- Journal
- Compound
- Topics
- Authors
- APA Citation
Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R. (2017). Patients’ accounts of increased “Connectedness” and “Acceptance” after psilocybin for treatment-resistant depression. Journal of Humanistic Psychology, 57(5), 520-564. https://doi.org/10.1177/0022167817709585
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