The acute subjective effects of psychedelics are responsive to users’ expectations and surroundings (i.e., “set and setting”). Accordingly, a great deal of thought has gone into designing the psychosocial context of psychedelic administration in clinical settings. But what theoretical paradigms inform these considerations about set and setting? Here, we describe several historical, sociological influences on current psychedelic administration in mainstream European and American clinical research settings, including: indigenous practices, new age spirituality from the 1960s, psychodynamic/psychoanalytic approaches, and cognitive-behavioral approaches. We consider each of these paradigms and determine that cognitive-behavioral therapies, including newer branches such as acceptance and commitment therapy (ACT), have the strongest rationale for psychedelic-assisted psychotherapy going forward. Our primary reasons for advocating for cognitive-behavioral approaches include, (1) they avoid issues of cultural insensitivity, (2) they make minimal speculative assumptions about the nature of the mind and reality, (3) they have the largest base of empirical support for their safety and effectiveness outside of psychedelic therapy. We then propose several concepts from cognitive-behavioral therapies such as CBT, DBT, and ACT that can usefully inform the preparation, session, and integration phases of psychedelic psychotherapy. Overall, while there are many sources from which psychedelic psychotherapy could draw, we argue that current gold-standard, evidence-based psychotherapeutic paradigms provide the best starting point in terms of safety and efficacy.
This study investigates the lived-experience of spiritual life in contemporary USA, India, and China. A qualitative coding frame was constructed based on participant responses to open-ended questions regarding spirituality. Qualitative analysis was facilitated by the use of Dedoose, a mixed methods software. The exploratory approach of this study takes on a cross-culturally comparative lens, and has two primary questions: (1) What are the universal aspects of lived spirituality across cultures, and (2) How does culture shape spiritual experience (e.g., typology and prevalence)? A total of 6112 participants (41% women, mean age of 29 years, range 18–75 years) were recruited, and analysis was conducted on a subset of 900 participants. The primary thematic categories derived by content analysis included religion (religious traditions, religious conversion, religious professionals, religious figures “theophany,” and religious forces “heirophany”), contemplative practice (meditation, mindful movement, prayer, and rituals), ancestors (ancestral worship, dreams about ancestors, and general mention of ancestors), natural world (animals, and nature), and metaphysical phenomena. Metaphysical categories were further parsed apart to include extrasensory perception (telepathy, clairvoyance, precognition, realistic dreams, and intuitive impressions), psychokinesis, survival hypothesis (near death experiences, out of body experiences, and apparitional experiences), and faith and energy healing (recovery/remission of illness, and spiritual practitioners). Explanatory factors for similarities and differences across groups, and the origins of spirituality, are discussed.
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