[swores]

For some people, psychedelic use leads to mystical/spiritual/religious thinking.

But that's not the main way in which they are able to treat mental health problems, specifically not in the majority (I suspect all) actual scientific research on this subject, but also just for people using them outside medical trials.

The key thing, it seems, is that psychedelics temporarily (while you're under the influence) increase the connectivity between different neurons in the brain, and between different areas of the brain. That can help in two ways, the first of which is that some new connections can become not temporary, and keep existing for the foreseeable future. The other is that, while under the influence, those additional neuron connections allow the person to think in different ways than they normally do, to see ideas or problems from a different angle/perspective. And this difference is what allows the therapy administered at the same time as the psychedelic drug (or the self-therapy version of using a drug and then thinking about the subjects that are causing you distress in life) to potentially have a better chance of making a stronger change to how the person thinks about certain things than if the same therapy were provided without psychedelics enabling greater levels of rewiring of the brain.

[pantalaimon]

> The key thing, it seems, is that psychedelics temporarily (while you're under the influence) increase the connectivity between different neurons in the brain, and between different areas of the brain.

Couldn’t it be that this is what’s being experienced as mystical?

[swores]

When people talk about psychedelic experiences being 'mystical' (or spiritual etc.) they're normally talking about the feelings, experience, and sometimes visions of the trip itself. Strong trips really can make you feel like you've communicated with God, or with mother nature, or make you feel like all people are connected on a spiritual plane, or... whatever. They're not talking about the science of how it affects your brain.

And all the studies (that I'm aware of, at least) using psychedelics and therapy to treat mental health conditions don't use doses high enough for the kind of trips they can create those experiences - the goal is to have a strong enough effect that the brain and its thought patterns are more malleable than usual, but not so strong that the patient focussed on the trip rather than on the talking therapy.

It's definitely possible a patient could walk away from a session so impressed with its effectiveness that they describe it as magical, or even mystical meaning that it worked and they can't understand how it worked, but that's not at all what psychedelic users normally mean when using those terms.

edit: Actually, it's worth mentioning that there are other non-Western cultures using psychedelics to treat mental health issues, such as Ayahuasca ceremonies in various South American countries. I don't really know enough about these to talk about them in any detail, but I do know it's common for the people to take strong enough doses of Ayahuasca to have full, intense trips, and while I think there usually is a leader of the group who probably does some sort of conversations to help people with their trips, it's not like Western countries' talking therapy, and I suspect it's likely that some, maybe m many, people who find benefit from that sort of psychedelic experience are indeed getting it from what they experienced, thought, and felt, while tripping.

[avaldez_]

>edit: Actually, it's worth mentioning that there are other non-Western cultures using psychedelics to treat mental health issues, such as Ayahuasca ceremonies in various South American countries.

South America is non-western culture now? Lmao ok. Also, practically nobody uses Ayahuasca to treat mental health issues over here. That kinda thing is an extremely niche and small practice of usually affluent people. Ayahuasca retreats are super expensive and half of the people you see there are rich Americans looking for some anecdata to share in sites like this. Everyone else is using standard medicine and therapy.

[swores]

You're right I worded that badly, but as I acknowledged in my previous comment it's an area I know little about and only mentioned it as a known example that's not the same as the rest of what I explained.

I do however believe there are various cultures that do use ayahuasca unrelated to the sort of expensive retreats Americans might travel to.

And you're right that Western / non-Western was a poor way of explaining what I meant, but I'm not sure if there's a widely accepted good phrasing for what I meant which was really "countries or communities within countries whose cultures, including in healthcare, are more significantly unlike the cultures in Western Europe & North America than the cultural differences between countries & states within NA+EU".

In hindsight I probably should have just said "I believe there are completely different styles of psychedelic use for mental health such as with Ayahuasca but I don't know enough to say more about that"!

[bigmadshoe]

> And all the studies (that I'm aware of, at least) using psychedelics and therapy to treat mental health conditions don't use doses high enough for the kind of trips they can create those experiences - the goal is to have a strong enough effect that the brain and its thought patterns are more malleable than usual, but not so strong that the patient focussed on the trip rather than on the talking therapy.

I think you’re misinformed on this. Most modern psychedelic research is not focused on actively participating in therapy during the psychedelic experience itself. Typical doses used in trials are actually very large — verging on a “heroic dose” in some cases. E.g. see: https://bigthink.com/series/the-big-think-interview/psychede...

“My therapeutic research with psychedelics is primarily used 'psilocybin,' which is the agent in magic mushrooms. The dose we now give to patients is anywhere from 30 milligrams to 40 milligrams, which Terence McKenna, who's the famous psychedelic bard would refer to repeatedly as the "heroic dose."

[swores]

Thanks for the new info, I hadn't heard of the study you linked.

I'm sceptical of your claim that "MOST (emphasis mine) modern psychedelic research is not focused on actively participating in therapy during the psychedelic experience"

I don't have time to look into what the split between the two approaches is now days, but it's an interesting enough question that I'll definitely find some time to get my knowledge caught up in the near future. Almost certainly not fast enough for this HN thread to still be alive by the time I have, but I'll reply to you if/when I'm able to either agree that you were right or explain why wrong, in case you're interested and in case you notice when someone replies to an older comment or yours (which can be achieved with the handy HN Replies, built by a longtime HN reader, which I personally think is a great tool filling a gap that HN should have had as a default feature - https://www.hnreplies.com/ )

[bigmadshoe]

A quick scan of the literature appears to confirm this trend, also showing the increased effectiveness of a large dose, however there certainly are studies using a lower dose as you described.

E.g. https://www.sciencedirect.com/science/article/pii/S0924977X2...