Containment Matters: Set and Setting in Contemporary Psychedelic Psychiatry

Noorani, Tehseen

doi:10.1353/ppp.2021.0032

Cited by 31 publications

(27 citation statements)

References 26 publications

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“…25 Second, the questionnaire did not include items related to set and setting of the most insightful classic psychedelic experience, which could have been used to identify context-dependent variables related to psychological insight, health behavior, and physical health. Since previous research has found set and setting to be an important aspect of the classic psychedelic experience, 27,28 it would, therefore, be interesting to explore the contribution of these variables in future research. Third, given the cross-sectional study design, the results cannot be used to make conclusive causal inferences.…”

Section: Discussionmentioning

confidence: 99%

Classic psychedelics, health behavior, and physical health

Simonsson

Hendricks

Chambers

et al. 2022

Therapeutic Advances in Psychopharmacology

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Background: Preliminary evidence suggests that classic psychedelics may be effective in the treatment of some psychiatric disorders, yet little remains known about their effects on health behavior and physical health. Objectives: The purpose of this study was to investigate associations of lifetime classic psychedelic use and psychological insight during one’s most insightful classic psychedelic experience with health behavior and physical health. Methods: Using data representative of the US population with regard to sex, age, and ethnicity ( N = 2822), this study examined associations of lifetime classic psychedelic use and psychological insight with health behavior and physical health. Results: Lifetime classic psychedelic use was associated with more healthy tobacco-related and diet-related behavior ( β = 0.05 and 0.09, respectively). Among lifetime classic psychedelic users ( n = 613), greater Psychological Insight Questionnaire (PIQ) total scale, PIQ Avoidance and Maladaptive Patterns (AMP) subscale, and PIQ Goals and Adaptive Patterns (GAP) subscale scores were each associated with higher odds of more healthy exercise-related behavior [adjusted odds ratios (aOR) (95% confidence interval, CI = 1.38 (1.13–1.68), 1.38 (1.13–1.68), and 1.32 (1.10–1.60), respectively] and higher odds of having a healthy body mass index (BMI) [aOR (95% CI) = 1.32 (1.07–1.63), 1.36 (1.10–1.69), and 1.23 (1.01–1.50), respectively], and greater GAP subscale scores were associated with more healthy diet-related behavior ( β = 0.10). All PIQ scales were positively associated with some health behavior improvements (overall, diet, exercise) attributed to respondents’ most insightful classic psychedelic experience ( β = 0.42, 0.18, and 0.17; β = 0.40, 0.19, and 0.17; and β = 0.40, 0.15, and 0.15, respectively), but only PIQ total scale and AMP subscale scores were positively associated with alcohol-related health behavior improvements ( β = 0.13 and 0.16, respectively). Conclusion: Although these results cannot demonstrate causality, they suggest that psychological insight during a classic psychedelic experience may lead to positive health behavior change and better physical health in some domains, in particular in those related to weight management.

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Section: Discussionmentioning

confidence: 99%

Classic psychedelics, health behavior, and physical health

Simonsson

Hendricks

Chambers

et al. 2022

Therapeutic Advances in Psychopharmacology

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“…An additional limitation is the role of set and setting. It is now understood that these factors have a crucial function in safe administration of a psychedelic drug such as psilocybin (Noorani, 2021). There is evidence that researchers in the 1960s and 1970s did not properly address set and setting in trial designs (Strassman, 1984); however, the earliest clinical trial included in this review did specifically mention the importance of environment (Abramson, et al, 1965).…”

Section: Discussionmentioning

confidence: 99%

Can psilocybin be safely administered under medical supervision? A systematic review of adverse event reporting in clinical trials

Roscoe

Lozy

2022

Drug Science, Policy and Law

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This systematic review investigates whether clinical trials of psilocybin support criterion number three of the drug's schedule I designation: There is a lack of accepted safety for use of the drug or other substance under medical supervision. Data were collected by using the PubMed database and conducting a search on November 24, 2021, with the search term psilocybin and applying the clinical trial filter. Only primary reports on the sole administration of psilocybin by a medical professional were included for analysis, excluding trials wherein psilocybin was not administered, trials wherein psilocybin was exclusively co-administered with other drugs, articles that were not clinical trials, and articles that were repeat analyses of already included trials. 52 included publications were closely examined for reports of adverse events, drug tolerability, and drug safety. Zero of these articles reported psilocybin to be unsafe, while 27 of the included trials suggested that psilocybin is safe to administer under proper medical supervision.

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“…Coined by Zinberg (1984), numerous studies have theorised that set and setting can significantly affect clinical outcomes in psychedelic sessions (Gukasyan & Nayak, 2021, Noorani, 2021, Carhart-Harris et al, 2018b. Set refers to the mindset of the participant; their personality, expectations, and intentions (Zinberg, 1984).…”

Section: Set and Settingmentioning

confidence: 99%

“…Additionally, the right setting can provide safety and confidentiality, making the user more comfortable and possibly strengthening the therapeutic alliance (Gukasyan & Nayak, 2021). Noorani (2021) states that the ideal setting for a psychedelic experience is a 'living room-like setting', in which the environment is welcoming, neutral, and comfortable, rather than clinical. MDMA studies have particularly taken setting into account, and sessions are often in comfortable, quiet and neutrally-furnished rooms with relaxing music (Krediet et al, 2020, Mithoefer et al, 2016.…”

Section: Set and Settingmentioning

confidence: 99%

“…This was particularly for cases where the psychedelic substance was mixed with alcohol or stimulants and where users had improper set and setting. Numerous studies have demonstrated that set and setting can significantly impact the outcome of a psychedelic session and therefore is important to take into consideration prior to use (Gukasyan & Nayak, 2021, Noorani, 2021, Carhart-Harris et al, 2018b. This is discussed in depth in Chapter…”

Section: Nz Has a Whole Bunch Of People Using It [Mdma] And Only A Ch...mentioning

confidence: 99%

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Journey To The Centre Of The Mind: Psychedelic Treatment of Mental Health in Aotearoa

Lutyens¹

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<p>Examining participants’ experiences self-medicating with LSD, psilocybin, and MDMA, this exploratory study sought to determine whether psychedelics have a future in New Zealand mental health treatment. This thesis employed a mixed-methods approach to data collection, by collecting broad-brush quantitative data via a Qualtrics survey, which then informed the qualitative data collection method of semi-structured interviews. Braun and Clarke’s (2006) steps of thematic analysis identified key themes from the interview transcripts, including the New Zealand environment, the success of the psychedelic treatment, and the creation of the ‘self-therapist’. There appears to be a robust, underground psychedelic community that offers participants support and knowledge around safe psychedelic use Congruent with international research, study participants reported successful, long-lasting effects of LSD, psilocybin and MDMA, with minimal adverse effects (Bird et al., 2021, Davis et al., 2020, Griffiths et al., 2008, Muttoni et al., 2019). The challenge of accessing legal, conventional mental health treatment meant that participants used psychedelics to craft their own safe treatment method, paying particular attention to set and setting. Overall, participants advocated for psychedelic legalisation in New Zealand and proved to be a valuable source of knowledge for future drug policy. Analysing these results, this study concluded that New Zealand’s prohibition of psychedelics fails to prevent individuals from seeking out these substances. Instead, it perpetuates societal and internal stigma and causes individuals to be wary of talking about their psychedelic-treated mental health issues. As psychedelics have been proven to be medically useful and incur minimal harm, they should be rescheduled and enabled in New Zealand drug laws, both as a form of self-medication and as an adjunct to psychotherapy. Lastly, while future research must consider psychedelics through other cultural lenses, any legalisation should be mindful of not appropriating other indigenous groups’ use of plant-based psychedelics.</p>

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Containment Matters: Set and Setting in Contemporary Psychedelic Psychiatry

Cited by 31 publications

References 26 publications

Classic psychedelics, health behavior, and physical health

Classic psychedelics, health behavior, and physical health

Can psilocybin be safely administered under medical supervision? A systematic review of adverse event reporting in clinical trials

Journey To The Centre Of The Mind: Psychedelic Treatment of Mental Health in Aotearoa

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