Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation

Abstract

Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy's (ACT's) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.

Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness

“…Experiences of psychedelic ceremonies have been consistently reported as positive, valuable, and in many cases associated with health improvements by both novice and regular participants ( Barbosa et al, 2009 ; Loizaga-Velder and Verres, 2014 ). Furthermore, in line with the current results, previous observational studies on psychedelic ceremony participants have found increased wellbeing ( Bouso et al, 2012 ; Uthaug et al, 2018b ; Spriggs et al, 2020 ), creative divergent thinking ( Kuypers et al, 2016 ; Mason et al, 2019 ), cognitive flexibility and mindfulness-related capacities ( Soler et al, 2016 ; Soler et al, 2018 ; Murphy-Beiner and Soar, 2020 ; Zeifman et al, 2020 ), as well as reduced abuse of alcohol and other addictive drugs ( Doering-Silveira et al, 2005 ). It is worth noting that absolute change (ΔWEMWBS = 5.7 in the current sample vs. 2.8 reported in Haijen et al, 2018 ) and effect size (d = 0.62 vs. d = 0.4, reported in Roseman et al, 2019 ) for post-psychedelic wellbeing increase were approximately 2 and 1.5 times higher in the current study than in a structurally similar sample that considered naturalistic psychedelic use unrestricted to ceremony settings, suggesting that psychedelics used in guided, collective environments may on certain occasions provide an added advantage for the prevention and treatment of mental health problems.…”

Psilocybin as a Novel Pharmacotherapy for Treatment-Refractory Anorexia Nervosa

“…Similarly, Carhart-Harris et al (2018) reported reduced suicidal ideation at 6 months follow-up in TRD patients treated with psilocybin [105]. Zeifman et al (2020) found that individuals with mild to very severe depression had significant reductions in suicidal ideation 4 weeks following psilocybin [36].…”

“…Acutely, psilocybin increases spirituality [7,8,[26][27][28], emotional empathy [29,30], creative thinking [30,31], optimism, happiness, mindfulness [32], insightfulness [33], motivation [34], memory recovery [35], acceptance of, and connectedness to, others [35,36], and induces ego dissolution/personality change (i.e. collapse of rigidified identity) [37] and emotional breakthrough experiences [38].…”

“…Helping AN patients to process the traumatic memories that contribute to AN onset, as well as their extreme fear associated with food and weight gain, would clearly be of long-term benefit. Emotional detachment and inability to re-experience trauma memories may benefit from the increase in emotional empathy [30] and memory consolidation effects induced by psilocybin [35,36].…”

Uncovering psychological mechanisms mediating the effects of drugs: some issues and comments using the example of psychedelic drugs

“…A number of recent publications have explored the possible psychological mechanisms through which classic psychedelics might have effects on final outcomes such as depression and anxiety (Davis et al 2020 ; Roseman et al 2018 ; Zeifman et al 2020 ), well-being (Roseman et al 2019 ), positive mood (Forstmann et al 2020 ), narcissism (van Mulukom et al 2020 ), or partner violence (Thiessen et al 2018 ). Such work may be informative and important for understanding and maximizing the therapeutic potential of some of these substances.…”