Placebo response theory and set and setting theory are two fields which examine how non-biological factors shape the response to therapy. Both consider factors such as expectancy, preparation and beliefs to be crucial for understanding the extra-pharmacological processes which shape the response to drugs. Yet there are also fundamental differences between the two theories. Set and setting concerns itself with response to psychoactive drugs only; placebo theory relates to all therapeutic interventions. Placebo theory is aimed at medical professionals; set and setting theory is aimed at professionals and drug users alike. Placebo theory is primarily descriptive, describing how placebo acts; set and setting theory is primarily prescriptive, educating therapists and users on how to control and optimize the effects of drugs. This paper examines how placebo theory and set and setting theory can complement and benefit each other, broadening our understanding of how non-biological factors shape response to drugs and other treatment interventions.
Set and setting is a term which refers to the psychological, social, and cultural parameters which shape the response to psychedelic drugs. The concept is considered fundamental to psychedelic research and has also been used to describe nonpharmacological factors which shape the effects of other agents such as alcohol, heroin, amphetamines, or cocaine. This paper reviews the history and evolution of the concept of set and setting from the 19th-century Parisian Club des Hashischins, through to 1950s psychotomimetic research on nondrug determinants of psychopharmacology, the use of extra-drug techniques by psychedelic therapists of the 1950s, and the invention of the concept of set and setting by Leary. Later developments and expansions on the concept of set and setting are discussed, and the term of collective set and setting is suggested as a theoretical tool to describe the social forces which shape individual set and setting situations. The concept of set and setting, it is argued, is crucial not only for psychedelic research but also for advancing drug research and developing more effective drug policy.
Past research has demonstrated to the ability of psychedelics to enhance suggestibility, and pointed to their ability to amplify perception of meaning. This paper examines the existing evidence for the meaning-enhancing properties of psychedelics, and argues that the tendency of these agents to enhance the perception of significance offers valuable clues to explaining their reported ability to stimulate a variety of therapeutic processes, enhance creativity, and instigate mystical-type experiences. Building upon previous research, which suggested the potential role of psychedelic meaning-enhancement in enhancing placebo response, the paper explores the mechanisms by which the meaning-amplifying properties of psychedelics might also play a role in enhancing creativity, as well as in effecting mystical-type experiences. The wider social and public-health implications of this hypothesis are discussed, and suggestions are made as to the various ways in which scientific understanding of the meaning-enhancing properties of psychedelics might be advanced and utilized.
Set and setting is a fundamental concept in the field of psychedelic drug research, which points to the profound dependence of psychedelic effects on psychological, social, and cultural factors. Santo Daime is a Brazilian religion that makes elaborate use of ordering principles, techniques, and symbology to shape and direct the effects of the hallucinogenic brew ayahuasca. This paper systematically explores the tapestry of, inter alia, symbolic, social, cultural, psychological, aesthetic and musical elements that participate in the shaping of the psychedelic experience in the context of the Santo Daime ayahuasca religion. The methodically rich under the hood description of the mechanics of entheogenic initiation within the Santo Daime tradition provides a template for future studies of the role of context in psychedelic experimentation.
How historical, social, and cultural forces shaped the psychedelic experience in midcentury America, from CIA LSD experiments the Harvard Psilocybin Project. Are psychedelics invaluable therapeutic medicines, or dangerously unpredictable drugs that precipitate psychosis? Tools for spiritual communion or cognitive enhancers that spark innovation? Activators for one's private muse or part of a political movement? In the 1950s and 1960s, researchers studied psychedelics in all these incarnations, often arriving at contradictory results. In American Trip, Ido Hartogsohn examines how the psychedelic experience in midcentury America was shaped by historical, social, and cultural forces—by set (the mindset of the user) and setting (the environments in which the experience takes place). He explores uses of psychedelics that range from CIA and military experimentation to psychedelic-inspired styles in music, fashion, design, architecture, and film. Along the way, he introduces us to a memorable cast of characters including Betty Eisner, a psychologist who drew on her own experience to argue for the therapeutic potential of LSD, and Timothy Leary, who founded the Harvard Psilocybin Project and went on to become psychedelics' most famous advocate. Hartogsohn chronicles these developments in the context of the era's cultural trends, including the cold war, the counterculture, the anti-psychiatric movement, and the rise of cybernetics. Drawing on insights from the study of science, technology, and society, he develops the idea of LSD as a suggestible technology, the properties of which are shaped by suggestion. He proposes the concept of collective set and setting, arguing that the historical and sociocultural context of midcentury America offered a particular set and setting—creating the conditions for what he calls the American trip.
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