“Revealing the Soul”: Psychedelics and the Future of Mental Health Care

By Kaylee Davis

Image courtesy of Pixabay

In 1956, the psychiatrist Humphry Osmond coined the term “psychedelic.” In correspondence with Aldous Huxley, Osmond made the suggestion with the following rhyme: "To fathom Hell or soar angelic/ Just take a pinch of psychedelic." In combining the Greek words psyche (meaning “mind or soul”) and deloun (meaning “to make visible or reveal”), Osmond described the effect psychedelic substances, specifically LSD, have on the mind. While Osmond and other pioneers of the psychedelic movement during the 1950s and 60s had their work cut short by the Controlled Substances Act of 1970, research and interest in the use of psychedelics for treatment of mental illnesses have both increased in the last decade. (Carhart-Harris and Goodwin, 2017) Specifically, ayahuasca and psilocybin have become of particular interest in the treatment of Major Depression, especially depression that is otherwise treatment-resistant (Liechti, 2017; Palhano-Fontes et al., 2019; Roseman, Nutt and Carhart-Harris, 2018; Ross et al., 2016; Watts et al., 2017). This increase in interest, I argue, is a result of an urgent need for spiritual insight and meaning, which cannot be ignored when perusing research on the benefit of psychedelic drugs for mental illnesses.

Ayahuasca vine.
Image courtesy of Appolo, Flickr

To appreciate this need, we need not go further than the tremendous growth in popularity of ayahuasca (a hallucinogen made from boiling the vines of Banisteriopsis caapi and other Amazonian plants) in the US in the past few years, at least in Silicon Valley and Manhattan. But Americans are not just drinking this sacred brew in small circles in the US. They are traveling to its home country of Peru, all the way to the Amazonian forests, seeking shamans to help them on a journey of self-exploration, spiritual growth, and emotional (and even physical) healing (Winkelman, 2010, p. 10). Several days before the “trip,” those undertaking the ayahuasca experience follow a restricted diet and refrain from other indulgences such as sex. After ingesting the muddy herbal liquid, an intense experience ensues. Similar to Osmond’s description of “fathom[ing] Hell or soar[ing] angelic,” the experience of ayahuasca (and other psychedelics) is said to be painful to most—past memories and trauma arise—yet at the same time, many report having a profound feeling of connectedness and acceptance (Watts et al., 2017).

The neural correlates of these psychedelic experiences are still largely a mystery. Research on the subject is still in its infancy but is quickly growing. Similar to the conventionally used antidepressants (i.e. selective serotonin reuptake inhibitors—SSRIs), it is well established in the scientific literature that psychedelics target the brain’s serotonergic system. However, the mechanisms by which psychedelics act as agonists in this system differ greatly from that of SSRIs—specifically, psychedelics act as 5-HT2A serotonin receptor agonists to induce the characteristic states of altered consciousness (Carhart-Harris and Goodwin, 2017; Celanda et al., 2004; Carhart-Harris et al., 2018; Mahapatra and Gupta, 2017). Furthermore, new research on the neurological effects of psychedelics is pushing the boundaries of our understanding of neurobiology. For instance, the “ego dissolution” (i.e. the loss of a sense of self) and the feeling of connectedness with the world that accompanies psychedelic experiences are thought to be a result of increased global functional connectivity in the brain (Tagliazucchi et al., 2016; Carhart-Harris, et al., 2016; Atasoy et al., 2017).

More research is needed to gain a fuller understanding of these mechanisms and their connection to phenomenological states. However, even if we did have a solid neuroscientific understanding of how psychedelics help “normalize” the brain to non-depressive (or other mental) states, there is an intrinsic value in a spiritual and psychosocial understanding of mental illness and mental health. As ethicist Erik Parens would argue, when we try to reduce spiritual and psychosocial phenomena into neuroscientific and medical terms, we make a “category mistake”—“construing non-medical (or life or human) problems as medical problems, [aka] construing normal human variations as pathological” (Parens, 2011, p. 2). These experiences of an expansion of consciousness, of the connection with the wider world, and, in a sense, of transcending our sense of individual self that a psychedelic encounter engenders is the very form of “spiritual insight” that we crave.

Image courtesy of Pixabay

In most Western societies, it is no great revelation to say that our religious convictions are in decline (and the US is not an exception, especially among Millennials; Rousseau, 2014, p. 477). Thus, devoid of organized religion, “spirituality” becomes an individual process of discovering meaning and developing a relationship with (or, at least, experiencing) “a fundamental, nonmaterial aspect of the universe” (Mohandas, 2008, p. 64). But with no organized religious conviction to stand on, there is little foundation on which to build this relationship with the nonmaterial (i.e. the spiritual). Thus, using psychedelics such as ayahuasca in healing mental illness cannot be as simple a fix as taking aspirin for a headache. The real value of acute psychedelic events comes in “exploring a range of non-ordinary states. [The psychedelic experience] unlocks a door; how far one ventures through the doorway and what awaits one in the realms beyond largely is dependent on non-drug variables” (Richards, 2008, p. 190). In other words, for the full healing effects of psychedelics to take place requires psychological work after the acute experience. Luckily, some researchers have already realized this, even going so far to recommend a specific complementary psychotherapy (namely, Acceptance and Commitment Therapy; Watts et al., 2017, p. 555; Carhart-Harris and Goodwin, 2017, p. 2110).

In the ritual surrounding an ayahuasca encounter described above, “conscious access to the process of symbolization [are] shaped by songs, stories, and mythological worlds that structure [the user’s] visions.” In effect, “these prepare the patients for the experiences, and enable them to assimilate effects through collective motifs, rather than be flooded with unconscious personal material” (Winkelman, 2014, p. 8). Thus, if in research and treatment we strip the psychedelic experience from the creative aspect of the healer, shaman, or guide, I fear that we will lose a necessary component of the original healing tradition—specifically, the spiritual aspect that allows users to integrate their experience into their daily lives (Carhart-Harris et al., 2018). While we do not have to adopt every aspect of the traditional ayahuasca ceremony (or that of other traditional psychedelic substances), when we research and, eventually, use psychedelics in clinical settings we must do so with a holistic understanding of the human psyche.

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Kaylee Davis graduated from Hendrix College with a BA in Philosophy in 2018. She is currently a student in MA Bioethics program at Emory Univerisity. She plans to pursue a career in medicine after graduating from the program, with a focus on integrative family medicine.

References

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Davis, K. (2019). “Revealing the Soul”: Psychedelics and the Future of Mental Health Care. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2019/05/revealing-soul-psychedelics-and-future.html.