Psychedelics, Mystical Experience, and Therapeutic Efficacy: A Systematic Review

Summary & key facts

This paper reviewed 12 studies that tested whether a 'mystical experience' during psychedelic therapy is linked to getting better symptoms. The mystical experience means things like feeling boundless, losing your usual sense of self, and feeling deeply connected to everything. About 10 of the 12 studies found that stronger mystical experiences were associated with bigger improvements in problems such as depression, cancer-related distress, and substance use. But most studies were small, not very diverse, and about half were open-label, which can make results less reliable. The authors say larger, more diverse, and better-controlled studies are needed to understand when mystical experiences help and how to reduce any related anxiety.

Key facts:

• The review looked at 12 studies that used psilocybin, ayahuasca, or ketamine in therapy settings.
• A mystical experience was described by researchers as feelings like oceanic boundlessness, ego dissolution, and universal interconnectedness.
• About 10 out of the 12 studies found a significant link between having a mystical experience and later symptom improvement.
• The clinical problems studied included depression, cancer-related distress, and substance use disorder.
• About half of the studies were open-label, meaning participants and researchers knew what treatment was given, which can introduce bias.
• Many studies had small numbers of people and lacked diversity in gender, race, ethnicity, education, and socioeconomic background.
• The authors recommend future studies with larger and more diverse groups and randomized designs to get more reliable answers.
• Researchers also want more detailed work on what makes mystical experiences stronger and how to keep their benefits while reducing anxiety that can come with them.

Abstract

The mystical experience is a potential psychological mechanism to influence outcome in psychedelic therapy. It includes features such as oceanic boundlessness, ego dissolution, and universal interconnectedness, which have been closely linked to both symptom reduction and improved quality of life. In this review, 12 studies of psychedelic therapy utilizing psilocybin, ayahuasca, or ketamine were analyzed for association between mystical experience and symptom reduction, in areas as diverse as cancer-related distress, substance use disorder, and depressive disorders to include treatment-resistant. Ten of the twelve established a significant association of correlation, mediation, and/or prediction. A majority of the studies are limited, however, by their small sample size and lack of diversity (gender, ethnic, racial, educational, and socioeconomic), common in this newly re-emerging field. Further, 6 out of 12 studies were open-label in design and therefore susceptible to bias. Future studies of this nature should consider a larger sample size with greater diversity and thus representation by use of randomized design. More in-depth exploration into the nature of mystical experience is needed, including predictors of intensity, in order to maximize its positive effects on treatment outcome benefits and minimize concomitant anxiety. Systematic Review Registration: PROSPERO, identifier CRD42021261752.

Topics

Chemical synthesis and alkaloids Neurotransmitter Receptor Influence on Behavior Psychedelics and Drug Studies

Categories

Clinical Psychology Psychology Social Sciences

Tags

Anxiety Clinical psychology Distress Psychiatry Psychology Psychotherapist

Substances

Ayahuasca Ketamine Psilocybin

Conditions & symptoms

Addiction Anxiety Depression Addiction or harmful habbits Sadness or low mood