Psilocybin at the End of Life: A Doorway to Peace

There exists an experience you can (probably) have, in a single day, that may lastingly improve your outlook on life, even if you’re in fear because the end of your life is near.  Researchers are once again using psilocybin to occasion such experiences in patients facing life-threatening illness.

Steve Ross, a psychiatrist at NYU, has written a wonderful article about it:  Psilocybin at the End of Life: A Doorway to Peace.  You may be curious to compare Ross’s contemporary snapshot with a lecture given at Harvard Divinity School by Walter Pahnke in 1968, The Psychedelic Mystical Experience and the Human Encounter with Death.

In the intervening four decades, some things have changed, presumably for the better – for example, it is no longer routine to withhold frank ‘c-word’ diagnoses and prognoses from patients.  As for making use of the potential of mystical-type experience (aka non-dual consciousness, primary religious experience) to ease a patient’s psychological distress, Rip Van Winkle’s slumber is into double overtime.

If you know of anyone who may want to participate in a study of psilocybin with cancer patients, two are now open:  the Ross team’s at NYU and a study at Johns Hopkins in Baltimore.  For the latter, need-based partial grants are available to help out-of-town volunteers with travel expenses.

 

Psilocybin and personality change

My colleagues at Johns Hopkins have a new paper out, reporting that psilocybin, the “magic mushroom” chemical, can bring about significant and lasting changes in the key personality domain called “Openness.”

My colleagues at Johns Hopkins have a new paper out, reporting that psilocybin, the “magic mushroom” chemical, can bring about significant and lasting changes in a key aspect of personality. This is big news for academic psychology:

A large body of evidence, including longitudinal analyses of personality change, suggests that core personality traits are predominantly stable after age 30. To our knowledge, no study has demonstrated changes in personality in healthy adults after an experimentally manipulated discrete event. Intriguingly, double-blind controlled studies have shown that the classic hallucinogen psilocybin occasions personally and spiritually significant mystical experiences that predict long-term changes in behaviors, attitudes and values. In the present report we assessed the effect of psilocybin on changes in the five broad domains of personality – Neuroticism, Extroversion, Openness, Agreeableness, and Conscientiousness. Consistent with participant claims of hallucinogen-occasioned increases in aesthetic appreciation, imagination, and creativity, we found significant increases in Openness following a high-dose psilocybin session. In participants who had mystical experiences during their psilocybin session, Openness remained significantly higher than baseline more than 1 year after the session.  [from the report’s abstract]

The five domains named above constitute the widely embraced Five Factor Model of personality.  Openness, the factor showing increases in the Hopkins studies, is described as curiosity, creativity, openness to unusual ideas, openness to emotion, openness to adventure, appreciation for art, and variety of experience.  Its poles are described as “inventive/curious vs. consistent/cautious.”

Surely there can be too much of a good thing: so “open” as to be awash in fantasy, for example, or continually overwhelmed by emotion.  But for more than a few of us, doesn’t a judicious increase in Openness sound appealing?

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Prejudice over Evidence? Clouded thinking about psilocybin

In an ABC news article, an expert implies that psilocybin use, over the long run, “can and will’ lead to character deterioration. If there’s any real evidence for that, please let us know. Otherwise, can we back off on the prejudice, please?

ABC News ran an article on the recent Johns Hopkins psilocybin findings.  It ends with this doozy of a quote from Dr. Daniel Angres, associate professor of psychiatry at Rush University Medical Center, who argued the use of psilocybin is “too risky”:

“Character can and will deteriorate with the use of substances that have abuse potential over the long run,” he said, “even though initially there may sometimes seem to be ‘positive personality adaptations.'”

Excuse me?  Where is the evidence that psilocybin has “abuse potential over the long run” – if by that the professor means compulsive use – or that psilocybin “can and will” lead to character deterioration?  Can Dr. Angres point to a single peer-reviewed study supporting his statement as applied to psilocybin, or to any of the classical hallucinogens?

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Mushroom Myth-conceptions, Part 2

That some hallucinogen experiences are trivial does not mean that none is profound.

Earlier, I posted some of the key findings of the Johns Hopkins psilocybin experiments and a condensation of the concerns and criticisms the research has drawn. I promised responses to some of those concerns; this is the first in that series.

Concern/criticism:  “What’s the big deal?  I took mushrooms, and my experience was neither ‘spiritual’ nor life-changing.”

This of course proves that not all hallucinogen experiences are profound, but not that none is.*

Why are some hallucinogen experiences recalled as life-transforming and others as trivial?  Likely because the trivial experiences involved a suboptimal dosage, ill-focused intentions, a suboptimal setting, or the wrong person. Or because even when all those things are right, any given experience may not be profound. But the research shows that well-screened and well-prepared people given a sufficient dose under good circumstances have a two-thirds or better chance of a profound experience, and a very small risk of real harm.
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Mushroom Myth-conceptions

Last month’s report on a Johns Hopkins study of psilocybin and spirituality, of which I’m a co-author, has drawn numerous comments on blogs and on-line news articles.  A fraction of those comments have raised questions or criticisms which I’d like to try to address.  (On the RBC, see Mark’s posts and Andy’s critique.)

For those who think that substances such as psilocybin have something valuable to offer spiritual seekers, myself included, it may be helpful to reflect upon the concerns of people less invested in the subject (“disinterested,” even).  At the same time, the exercise could help clear up misunderstandings of the research or its implications.

Here’s a condensation of the issues I’ve heard raised.  I will be taking them up one at a time in forthcoming posts.  If you’re aware of other issues, feel free to add them as comments to this post.

1.  “I took mushrooms, and my experience was neither ‘spiritual’ nor life-changing.  So what’s the big deal?” (response)

2.  The studies used volunteers with a spiritual orientation, so of course they reported spiritual experiences, and so the studies prove nothing.

3.  Hallucinogens cause hallucinations; hallucinations cannot be a source of learning, healing, or betterment.

4.  Psilocybin may cause people to adopt untrue beliefs (e.g., about the nature of ultimate reality).

5.  The substance may harm some people or cause them to harm themselves or others.

6.  An enlightening experience doesn’t necessarily lead to an enlightened life.

For a refresher on the research findings, continue reading beneath the fold.

(And many thanks to Mark and to Keith for welcoming me to the RBC.)

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