Peak experiences and the afterglow phenomenon: When and how do therapeutic effects of hallucinogens depend on psychedelic experiences?

Abstract

Interest in the therapeutic potential of psychedelic substances has recently resumed. During an early phase of human psychedelic research, their therapeutic application in different pathologies had been suggested, and the first evidence for efficacy was provided. The range of recent clinical applications of psychedelics spans from cluster headaches and obsessive-compulsive disorder to addiction and the treatment of fear and anxiety in patients suffering from terminal illness, indicating potentially different therapeutic mechanisms. A variety of approaches in psychotherapy emphasize subjective experiences, such as so-called peak experiences or afterglow phenomena, as differentially mediating therapeutic action. This review aims to re-evaluate earlier and recent concepts of how psychedelic substances may exert beneficial effects. After a short outline of neurophenomenological aspects, we discuss different approaches to how psychedelics are used in psychotherapy. Finally, we summarize evidence for the relationship between subjective experiences and therapeutic success. While the distinction between pharmacological and psychological action obviously cannot be clear-cut, they do appear to contribute differently from each other when their effects are compared with regard to pathologies.

Psychedelics

“…Other studies examined the use of psychedelics to treat anxiety and depression, schizophrenia, and even autism (e.g., Bender, 1966). A review of psychedelicassisted therapy was recently published (Maji c et al, 2015).…”

The Ibogaine Experience: A Qualitative Study on the Acute Subjective Effects of Ibogaine

“…Their psychometric properties could be improved by new items and validated for different languages and substances (Bouso et al 2016). There are also epistemic limitations in the assessment of subjective effects, and a metaphoric terminology might prove useful to assess these experiences (Maji c et al 2015), which is where the present study might offer valuable insights. By investigating the physical and psychological aspects of the immediate experience, we extracted categories of effects that can be used to improve the assessment of the subjective effects of ibogaine and other psychedelics.…”

How does it feel to be on psilocybin? Dose-response relationships of subjective experiences in humans

“…The obtained results do not necessarily apply to the general population or to psilocybin administration in a recreational or less controlled setting. Lastly, the study of subjective experiences depends on introspection and is more challenging to assess than other physiological parameters, especially because these experiences often go beyond the previously experienced epistemic range [92,93].…”