Does Psychedelic Therapy Have a Transdiagnostic Action and Prophylactic Potential?

Abstract

Addressing global mental health is a major 21st-century challenge. Current treatments have recognized limitations; in this context, new ones that are prophylactic and effective across diagnostic boundaries would represent a major advance. The view that there exists a core of transdiagnostic overlap between psychiatric disorders has re-emerged in recent years, and evidence that psychedelic therapy holds promise for a range of psychiatric disorders supports the position that it may be transdiagnostically effective. Here, we propose that psychedelic therapy's core, transdiagnostically relevant action lies in its ability to increase neuronal and mental plasticity, thus enhancing the potential for change, which we consider to be a key to its therapeutic benefits. Moreover, we suggest that enhanced plasticity via psychedelics, combined with a psychotherapeutic approach, can aid healthy adaptability and resilience, which are protective factors for long-term well-being. We present candidate neurological and psychological markers of this plasticity and link them with a predictive processing model of the action of psychedelics. We propose that a model of psychedelic-induced plasticity combined with an adequate therapeutic context has prophylactic and transdiagnostic potential, implying that it could have a broad, positive impact on public health.

The Watts Connectedness Scale: a new scale for measuring a sense of connectedness to self, others, and world

“…We infer that connectedness holds transdiagnostic relevance both in relation to psychedelic therapy specifically (Kočárová et al 2021) and beyond it (Carhart-Harris et al 2018) in a similar way to other candidate transdiagnostic factors, such as psychological flexibility (Close et al 2020;Davis et al 2020a;Kashdan and Rottenberg 2010;Watts and Luoma 2020). Psychological flexibility (Hayes et al 2011;Kashdan and Rottenberg 2010) and connectedness are proposed to overlap (Watts and Luoma 2020).…”

Models of Psychedelic-Assisted Psychotherapy: A Contemporary Assessment and an Introduction to EMBARK, a Transdiagnostic, Trans-Drug Model

“…This inattention may reflect the ongoing effort to characterize PAP within the institutional bounds of Western psychiatry and psychology, which attend more exclusively to cognitive and neural phenomena. As such, beneficial outcomes of PAP treatment have been conceptualized in neuropsychological terms that omit participants’ experiences of embodiment ( Kelly et al, 2021 ; Thal et al, 2021 ), such as the “reset” of a maladaptive neural status quo ( Carhart-Harris et al, 2017 ; Carhart-Harris and Friston, 2019 ), increased psychological flexibility ( Watts and Luoma, 2020 ; Agin-Liebes et al, 2022 ), cognitive reappraisal ( Agin-Liebes et al, 2022 ), altered neural responses to affect ( Barrett et al, 2020 ), or increased neuronal and mental plasticity ( Kočárová et al, 2021 ). This centering of the brain-mind may seem unremarkable, given the prevalence of neuropsychological explanations offered by most psychotherapies.…”

N,N‐dimethyltryptamine and Amazonian ayahuasca plant medicine

“…Ayahuasca sessions could be complemented with meditation and mindfulness interventions to improve therapeutic clinical outcomes by helping to reduce anxiety and avoidant responding during the experience and help to maintain and cultivate the psychotherapeutic benefits after the experience (Barrett & Griffiths, 2018 ; Fox et al., 2016 ; Payne et al., 2021 ; Williams & Penman, 2011 ). Ayahuasca could additionally be used prophylactically and in positive psychology interventions in healthy individuals due to the many reported benefits of ayahuasca use including reduced ratings of hopelessness, improved neurocognitive function and an association with positive personality attributes (Brito‐de‐Costa et al., 2020 ; Gonzalez et al., 2021 ; James et al., 2020 ; Kočárová et al., 2021 ; Netzband et al., 2020 ).…”