The use of psychedelics in treating all manner of mental illnesses has been a hot topic in recent years. Scientists at prestigious institutions such as Johns Hopkins, New York University, the University of New Mexico, and Imperial College in London have conducted small but rigorous and controlled studies which have shown the immense potential of psilocybin therapy in dealing with depression, anxiety, and addiction. These studies have led to numerous books exploring the history and medical potential of psychedelics to change and heal the mind, most notably best-selling American author Michael Pollan’s “How To Change Your Mind.”
As momentum has built, a number of jurisdictions have decriminalized the cultivation and possession of psilocybin (the active ingredient in “magic mushrooms”), notably the major American cities of Oakland, California and Denver, Colorado. 2020 will also see voters in Oregon and California decide on whether to legalize the substance throughout their states. Many psychologists, physicians, and people afflicted with mental illnesses are eager to take advantage of the benefits offered by this remarkable plant. As Mr. Pollan puts it:
a single psilocybin trip guided by trained professionals has the potential to relieve “existential distress” in cancer patients; break addictions to cigarettes, alcohol, and cocaine; and bring relief to people struggling with depression. Psychiatry’s current drugs for treating these disorders are limited in their effectiveness, often addictive, address only symptoms, and can come with serious side effects. Thus, the prospect of psychedelic medicine is raising hopes of a badly needed revolution in mental health care.
How Is Psilocybin Therapy Conducted?
While there isn’t currently an established model for psilocybin treatment, most of the studies conducted thus far have patients use the substance in a controlled environment, supervised by a psychologist who guides them through the experience. The Imperial College study on depression offered patients a 25-milligram capsule of psilocybin, which is a substantial dose. They were placed in a room with a bed, surrounded with flowers and candles, and guided through traumas, significant past events, and formative memories.
A study at the University of New Mexico on psilocybin treatment for alcohol addiction offered participants four weeks of traditional psychotherapy, before giving them a dose of psilocybin in a quiet, comfortable room with male and female “co-therapists.” In this study, the therapists did little more than direct patients to “turn their attention inward” and go where their minds took them. This was followed by four more weeks of psychotherapy, another psilocybin session, and a final bout of traditional therapy.
As one participant noted, his experience wasn’t focused on his dependence on alcohol, but rather on the stresses, guilt, and happiness which his relationship with family members created. His recovery wasn’t motivated by a desire to avoid alcohol, but rather by the prospect of improving his relationships with loved ones. He reported being effortlessly abstinent for months afterward, before beginning to drink moderately once again but with “a conscientiousness he had never experienced with alcohol before.” Two years after the study his drinking remained under control, and he had repaired his marriage and relationships with his children.
Why Does Psilocybin Therapy Work?
While many countries are accelerating research into psilocybin therapy, no one is exactly sure why the treatment has proven to be so effective. Nonetheless, there are a number of compelling theories as to why it works. Serotonin is often cited as one possible key to the effects of psilocybin, as the substance causes “downregulation” of the serotonin system, which can result in reduced impulsivity and improved mood. But changes to serotonin typically last for just one week, so the longer-term benefits of the treatment must derive from a different source.
Michael Bogenschutz, the lead investigator in the University of New Mexico alcohol trial, posits the view that exposure to psychedelics and oneirogenics can create a phenomenon that mirrors the long-tail effects of PTSD. As he puts it:
“there’s a whole process that happens when a toxic memory is seared into the brain. The only physical effect is probably light hitting the eyes. It’s the meaning made of that memory, and the brain and body’s reaction to the meaning, that can cause lasting damage. So if there are experiences that are so toxic and so horrible that they can cause physical and psychological damage, it’s not a crazy idea that there are some experiences that are so positive, so beneficial that they can have a healing effect.”
Other researchers point to the concept of “ego death” that has long been associated with psychedelics. Robin Carhartt-Harris, a researcher at Imperial College, notes that psilocybin reduces activity in the brain’s “default mode network”, a collection of brain regions and neurotransmitters that are believed to construct an independent self and place it at the center of perceptions and experiences. Psychedelics help individuals to pay less attention to the self, breaking down walls and facilitating connections. Since many depressed and addicted people are plagued with a deep and abiding sense of isolation from others, this can feel like a dramatic escape from a mental prison. Many of the participants in these studies reported that psilocybin dramatically reduced their sense of alienation.
Another theory is that the therapy increases neuroplasticity, changing and reshaping neurons in the brain. This remodeling of cells is the basis of all learning, and substances like psilocybin and ibogaine have been proven to improve neuroplasticity. Addiction, anxiety, trauma, and depression can create negative changes in brain chemistry, as the mind learns to take pleasure or stress from external cues. Psilocybin seems to help restore the brain to a pre-addicted state.
A Word Of Caution
While psilocybin therapy has shown immense promise to heal mental wounds, we would strongly recommend restricting its use to a clinical setting. There are physical and psychological risks that go hand in hand with the benefits of psychedelic therapies, and in many jurisdictions, you can be arrested and incarcerated for use or possession of these substances. Michael Pollan notes that in all societies that used psychedelic substances, ranging from the Amazon to ancient Greece, they were always used with “deliberateness and care.” He writes that these substances “were not taken alone but usually in a group under the direction of an elder or shaman familiar with the mental territory, and they were used only on certain occasions, surrounded by ritual and with a clear intention. There was nothing casual about it.” All would be wise to maintain this level of caution as they experiment with their immense potential.
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