In a follow-up study to the NYU trial, “Patient Experiences of
Psilocybin-Assisted Psychotherapy,” published in the Journal of
Humanistic Psychology in 2017, Alexander Belser, a member of the NYU
team, interviewed volunteers to better understand the psychological
mechanisms underlying the transformations they experienced. I read the
study as a subtle attempt to move beyond the mystical experience
paradigm to a more humanistic one and at the same time to underscore
the importance of the psychotherapist in the psychedelic experience.
(Note the use of the term “psilocybin-assisted psychotherapy” in the title;
neither of the papers in Psychopharmacology mentioned psychotherapy
in its title, only the drug.)
A few key themes emerged. All of the patients interviewed described
powerful feelings of connection to loved ones (“relational embeddedness”
is the term the authors used) and, more generally, a shift “from feelings of
separateness to interconnectedness.” In most cases, this shift was
accompanied by a repertoire of powerful emotions, including “exalted
feelings of joy, bliss, and love.” Difficult passages during the journey were
typically followed by positive feelings of surrender and acceptance (even
of their cancers) as people’s fears fell away.
Jeffrey Guss, a coauthor on the paper and a psychiatrist, interprets
what happens during the session in terms of the psilocybin’s “egolytic”
effects—the drug’s ability to either silence or at least muffle the voice of
the ego. In his view, which is informed by his psychoanalytic training, the
ego is a mental construct that performs certain functions on behalf of the
self. Chief among these are maintaining the boundary between the
conscious and the unconscious realms of the mind and the boundary
between self and other, or subject and object. It is only when these
boundaries fade or disappear, as they seem to do under the influence of
psychedelics, that we can “let go of rigid patterns of thought, allowing us
to perceive new meanings with less fear.”
The whole question of meaning is central to the approach of the NYU
therapists,* and is perhaps especially helpful in understanding the
experience of the cancer patients on psilocybin. For many of these
patients, a diagnosis of terminal cancer constitutes, among other things, a
crisis of meaning. Why me? Why have I been singled out for this fate? Is
there any sense to life and the universe? Under the weight of this
existential crisis, one’s horizon shrinks, one’s emotional repertoire
frankie
(Frankie)
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