One of the most pressing questions in psychedelic science. Is the psychedelic “trip” essential for their mental health benefits? A recent primer in NPP – Digital Psychiatry and Neuroscience tackles this question head-on. The article deconstructs the traditional narrative that the profound, consciousness-altering effects, even transcendent experiences, are the primary driver for their healing properties. While acknowledging that mystical experiences, or effects like ego death, are confirmed to correlate with positive outcomes for users, this relationship is far from absolute, varying significantly depending on the substance.
The paper presents a more nuanced view, analysing the available statistical data, rather than relying on anecdotal accounts. For psilocybin, the subjective experience, the “trip”, seems to be a strong predictor – accounting for roughly 24% of the variance in therapeutic outcomes. For ketamine, however, the link is far less pronounced, with subjective effects only predicting around 5-10% of the perceived benefits. For MDMA, there is, in fact, no statistically significant relationship between the intensity of the individual experience and its long-term success in treating PTSD. This variance between chemicals suggests that in some contexts the “trip” may be important, but there are obviously other mechanisms at play.
An increasingly popular theory is that the therapeutic benefits are derived from biology rather than psychology. Once again, neuroplasticity is seen to be key, as well as the anti-inflammatory effects of a particular substance, as opposed to the experience itself. This links back into the research we previously discussed on non-psychoactive compounds, which may mirror the benefits of traditional psychedelics. The ultimate goal of these attempts is to properly and accurately assess how relevant the psychedelic experience really is to healing. Is it a profound side-effect that can be engineered out in future, or will we lose the true power of these substances in our efforts to blunt their immediate psychological impact?
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