LSD, madness and healing: Mystical experiences as possible link between psychosis model and therapy model

Abstract

Background For a century, psychedelics have been investigated as models of psychosis for demonstrating phenomenological similarities with psychotic experiences and as therapeutic models for treating depression, anxiety, and substance use disorders. This study sought to explore this paradoxical relationship connecting key parameters of the psychotic experience, psychotherapy, and psychedelic experience. Methods In a randomized, double-blind, placebo-controlled, crossover design, 24 healthy volunteers received 50 μg d-lysergic acid diethylamide (LSD) or inactive placebo. Psychotic experience was assessed by aberrant salience (Aberrant Salience Inventory, ASI), therapeutic potential by suggestibility (Creative Imagination Scale, CIS) and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ; Mindful Attention Awareness Scale, MAAS; Experiences Questionnaire, EQ), and psychedelic experience by four questionnaires (Altered State of Consciousness Questionnaire, ASC; Mystical Experiences Questionnaire, MEQ; Challenging Experiences Questionnaire, CEQ; Ego-Dissolution Inventory, EDI). Relationships between LSD-induced effects were examined. Results LSD induced psychedelic experiences, including alteration of consciousness, mystical experiences, ego-dissolution, and mildly challenging experiences, increased aberrant salience and suggestibility, but not mindfulness. LSD-induced aberrant salience correlated highly with complex imagery, mystical experiences, and ego-dissolution. LSD-induced suggestibility correlated with no other effects. Individual mindfulness changes correlated with aspects of aberrant salience and psychedelic experience. Conclusions The LSD state resembles a psychotic experience and offers a tool for healing. The link between psychosis model and therapeutic model seems to lie in mystical experiences. The results point to the importance of meaning attribution for the LSD psychosis model and indicate that psychedelic-assisted therapy might benefit from therapeutic suggestions fostering mystical experiences.

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“…There are some potential limitations with our CEQ scale, as two items on the Insanity subscale were missing due to experimenter error. However, we observed good internal reliability for this scale, and our overall mean CEQ score and the Insanity subscale scores (for first and most recent experience) were similar to those observed in previous studies [ 32 ].…”

A neurobiological perspective on social influence: Serotonin and social adaptation

“…Similarly, a more recent study using an orally administered dose of LSD (50 μg) also found that LSD increases suggestibility. This was not correlated with other effects such as aberrant salience processing (Wießner et al, 2021). Another study (Duerler et al, 2020) found that LSD (100 μg administered orally) increased adaptation in response to social feedback but only when opinions were not too different from the participant's own.…”

LSD and creativity: Increased novelty and symbolic thinking, decreased utility and convergent thinking

“…Drawings under LSD showed unchanged colour quantity but increased colour abstractness , similar to previous observations on sharpened colours and changed colour combinations in drawings and paintings (Dobkin De Rios and Janiger, 2003; Tonini and Montanari, 1955). This might be related to psychedelic-induced visual effects (Kometer and Vollenweider, 2016; Wießner et al, 2021b), implying that subjective experiences might have been expressed by figural techniques.…”

“…These contrasting relationships suggest that symbolic thinking and ambiguity constitute a third phenomenon of increased ‘meaning’, differentially related to ‘pattern break’ and decreased ‘organization’. Meaning attribution under psychedelics is widely reported but poorly understood, being associated with psychedelic-induced symbolization, mystical experiences, creativity, psychotic-like and therapeutic effects (Hartogsohn, 2018; Leptourgos et al, 2020; Liechti et al, 2017; Masters and El Houston, 1966; Preller et al, 2017; Wießner et al, 2021b), pointing to a fundamental mechanism within the psychedelic phenomenology requiring further exploration.…”

“…This work is part of a larger study which is published elsewhere, including further information on participants, drug and procedures (Wießner et al, 2021a(Wießner et al, , 2021b.…”