Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress

Swift, Thomas Cody; Belser, Alexander B.; Agin-Liebes, Gabrielle; Devenot, Neşe; Terrana, Sara; Friedman, Harris L.; Guss, Jeffrey; Bossis, Anthony P.; Ross, Stephen

doi:10.1177/0022167817715966

Cited by 95 publications

(113 citation statements)

References 28 publications

(55 reference statements)

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“…Data from this report were collected in a completed double-blind randomized controlled trial of psilocybin-assisted psychotherapy of anxiety and depression in cancer patients (see Ross et al, 2016 ; Supplementary Methods and Supplementary Figure S1 for an overview of study design) and two studies utilizing qualitative analysis of interviews from a subset of participants in the main trial (see Belser et al, 2017 ; Swift et al, 2017 for description of emergent themes). We present quantitative as well as qualitative data collected through participant interviews, participant-completed surveys, and notes from study therapists.…”

Section: Methodsmentioning

confidence: 99%

“…To better understand participant experiences, in-depth interviews were conducted with 13 participants treated in the Ross et al (2016) trial, revealing several common themes related to the psilocybin experience ( Belser et al, 2017 ; Swift et al, 2017 ). Here, we have selected four participants from this trial ( Ross et al, 2016 ) whose psilocybin session included several of the themes reported in the published qualitative studies of patient experiences.…”

Section: Introductionmentioning

confidence: 99%

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Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy

et al. 2018

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A growing body of evidence shows that existential and spiritual well-being in cancer patients is associated with better medical outcomes, improved quality of life, and serves as a buffer against depression, hopelessness, and desire for hastened death. Historical and recent research suggests a role for psilocybin-assisted psychotherapy in treating cancer-related anxiety and depression. A double-blind controlled trial was performed, where 29 patients with cancer-related anxiety and depression were randomly assigned to treatment with single-dose psilocybin (0.3 mg/kg) or niacin in conjunction with psychotherapy. Previously published results of this trial demonstrated that, in conjunction with psychotherapy, moderate-dose psilocybin produced rapid, robust, and enduring anxiolytic, and anti-depressant effects. Here, we illustrate unique clinical courses described by four participants using quantitative measures of acute and persisting effects of psilocybin, anxiety, depression, quality of life, and spiritual well-being, as well as qualitative interviews, written narratives, and clinician notes. Although the content of each psilocybin-assisted experience was unique to each participant, several thematic similarities and differences across the various sessions stood out. These four participants’ personal narratives extended beyond the cancer diagnosis itself, frequently revolving around themes of self-compassion and love, acceptance of death, and memories of past trauma, though the specific details or narrative content differ substantially. The results presented here demonstrate the personalized nature of the subjective experiences elicited through treatment with psilocybin, particularly with respect to the spiritual and/or psychological needs of each patient.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy

et al. 2018

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“…There is mounting evidence that the positive long-term effects of psychedelic therapy are mediated by the quality of the acute psychedelic experience (44)(45)(46)(47). Qualitative interviews with patients have shown that avoidance and acceptance are often central themes of their psychedelic experiences (13,(48)(49)(50)(51), and patients commonly report transient episodes of struggle with intense aversion. These challenging experiences 1 (42,52,53) are often characterized by extreme fear or panic, and can involve frightening imagery, unsettling body sensations, and the apprehension of immediate threat.…”

Section: Avoidance and Acceptance In Psychedelic Therapymentioning

confidence: 99%

“…Applied to our model, long-term increases in acceptance and corresponding reductions in psychopathology should be especially pronounced following psychedelic experiences where operant processes engender episodes of relatively avoidance-free exposure to otherwise avoided private events, thereby enabling the revision of avoidance-related beliefs. Whereas qualitative analyses of patient interviews (13,48,49,51) are compatible with this view, quantitative studies are needed to test and further develop the proposed model. This requires that relevant aspects of the acute psychedelic experience are adequately measured.…”

Section: Implications For Research Measuring Acceptance-related Procementioning

confidence: 99%

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

et al. 2020

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The efficacy of psychedelic-assisted therapies for mental disorders has been attributed to the lasting change from experiential avoidance to acceptance that these treatments appear to facilitate. This article presents a conceptual model that specifies potential psychological mechanisms underlying such change, and that shows substantial parallels between psychedelic therapy and cognitive behavioral therapy: We propose that in the carefully controlled context of psychedelic therapy as applied in contemporary clinical research, psychedelic-induced belief relaxation can increase motivation for acceptance via operant conditioning, thus engendering episodes of relatively avoidance-free exposure to greatly intensified private events. Under these unique learning conditions, relaxed avoidance-related beliefs can be exposed to corrective information and become revised accordingly, which may explain long-term increases in acceptance and corresponding reductions in psychopathology. Open research questions and implications for clinical practice are discussed.

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“…Qualitative studies of participants in recent trials of psilocybin-assisted treatment of cancer-related anxiety and depression have provided useful insight into participants’ psilocybin experiences and the therapeutic process ( Belser et al, 2017 ; Swift et al, 2017 ). However, such qualitative studies have not yet been published for recent trials utilizing psilocybin to treat addiction.…”

Section: Introductionmentioning

confidence: 99%

Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder

et al. 2018

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After a hiatus of some 40 years, clinical research has resumed on the use of classic hallucinogens to treat addiction. Following completion of a small open-label feasibility study, we are currently conducting a double-blind placebo-controlled clinical trial of psilocybin-assisted treatment of alcohol use disorder. Although treatment effects cannot be analyzed until the study is complete, descriptive case studies provide a useful window into the therapeutic process of psychedelic-assisted treatment of addiction. Here we describe treatment trajectories of three participants in the ongoing trial to illustrate the range of experiences and persisting effects of psilocybin treatment. Although it is difficult to generalize from a few cases, several qualitative conclusions can be drawn from the data presented here. Although participants often find it difficult to describe much of their psilocybin experience, pivotal moments tend to be individualized, extremely vivid, and memorable. Often, the qualitative content extends beyond the clinical problem that is being addressed. The participants discussed in this paper experienced acute and lasting alterations in their perceptions of self, in the quality of their baseline consciousness, and in their relationship with alcohol and drinking. In these cases, experiences of catharsis, forgiveness, self-compassion, and love were at least as salient as classic mystical content. Finally, feelings of increased “spaciousness” or mindfulness, and increased control over choices and behavior were reported following the drug administration sessions. Ultimately, psilocybin-assisted treatment appears to elicit experiences that are extremely variable, yet seem to meet the particular needs of the individual.

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Cancer at the Dinner Table: Experiences of Psilocybin-Assisted Psychotherapy for the Treatment of Cancer-Related Distress

Cited by 95 publications

References 28 publications

Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy

Individual Experiences in Four Cancer Patients Following Psilocybin-Assisted Psychotherapy

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance

Clinical Interpretations of Patient Experience in a Trial of Psilocybin-Assisted Psychotherapy for Alcohol Use Disorder

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