From Despair to Hope: Psychedelics and the Pursuit of Human Flourishing

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If you've chosen to read this, you may be among the millions of people across the globe curious about the use of psychedelics as a potential intervention in addressing mental health challenges and fostering human flourishing. Some have dubbed the resurgence of interest (and the accompanying hype bubble) as a psychedelic renaissance. For all that is being said about it in academic journals, popular media, social networks, and around dinner tables, we are still at that uncomfortable place in the scientific process where we have more questions than answers. Hopefully, the nine minutes you invest in reading this piece sheds some light into the fascinating world of psychedelic-assisted therapy (or PAT) and fans an ember of knowledge in your inquisitive mind.

Start with Why.

In his acclaimed bestseller Start with Why, Simon Sinek (2011) prompts us to, well, start with why. Why psychedelics? Why now? Why are so many interested in learning more and signing up for PAT trials? Why should you care? Why did I choose this as the topic for my capstone project as a student in the Master of Applied Positive Psychology (MAPP) program at the University of Pennsylvania?

Last January 4, 2023, my phone rang with a distressed call from a close friend, a chosen brother. Nathan, on the edge of tears, struggled to find his voice. “I’m in my car, in the hospital parking lot, just came out of the doctor’s office,” his voice wavered. “I have stage IV liver cancer, and it doesn’t look good,” he declared. A pause fell between us, I took a deep breath and managed to get a few words out. “How are you holding up?” Now crying inconsolably, his response barely came through, “I am going to die.” The depth of despair and hopelessness he felt in that moment continue to resonate with me, even as I set down these words.

 As Nathan’s voice shook with fear, he revealed the dire impact of the grim prognosis. His desperate cry was a chilling testament to the profound downward spiral of pain and suffering that terrible news can generate, especially for those whose agency, along with life itself, ruthlessly vanishes without warning. The heartbreaking episode left an indelible mark on me. It strengthened my conviction to play a part in reducing the psychological suffering of others faced with life-threatening diagnoses, their loved ones, and anyone who endures intense mental distress.

Our Toolbox Needs More Tools.

Nathan’s battle with an incredibly challenging diagnosis not only underscores the urgent necessity for groundbreaking methods to deal with severe mental distress but also casts light on a growing need at a much larger scale. There is a global mental health crisis, and more treatment options are needed. As of 2019, an estimated one in eight (970 million) people around the world is living with a psychological disorder (WHO, 2023). Despite public and private organizations’ efforts to tackle this crisis, the pervasiveness of psychopathologies continues to escalate. Amid these challenges, widely accepted psychotherapeutic approaches such as cognitive behavioral therapy can be practical but are often costly and time-consuming (Knapp & Wong, 2020).

 Recent research underscores the potential value of PAT for treating mental illness. For instance, a meta-analysis of six randomized controlled trials found that participants who took a single dose of LSD in combination with alcohol use disorder treatment were twice as likely to decrease their alcohol misuse compared to those in the control groups (Krebs & Johansen, 2012). Another recent study shows that psychedelic users report higher psychological strengths, higher well-being, and less distress than non-users (Brasher et al., 2023). On July 1, 2023, Australia became the first nation to legally allow the prescription of MDMA and psilocybin for specific mental health conditions (Hunt, 2023), and the U.S. Food and Drug Administration is signalling the impending approval of the same substance for the treatment of post-traumatic stress disorder (PTSD; Bedi et al., 2023).

Although many remain skeptical because more research is needed, the evidence supporting psychedelics as a powerful instrument to fast-track progress in therapeutic settings continues to mount. Thus, PAT can potentially become a valuable tool in the toolbox to address the growing epidemic by accelerating progress through cognitive, emotional, somatic, and spiritual breakthroughs.

What are Psychedelics?

Psychedelics have been and continue to be used in various settings for healing, personal growth, spiritual practice, creative inspiration, and recreation, among many other purposes. The term psychedelic derives from the Greek words for “mind-manifesting,” reflecting the drugs’ ability to provoke profound shifts in consciousness (Nichols, 2016). Given their spiritual significance in some cultures, these substances are also sometimes referred to as entheogens (from the Greek “becoming divine within”), denoting their capacity to inspire spiritual, mystical, religious, or self-transcendent experiences (Godlaski, 2011).

Today, the word is used in a wide-ranging manner. It encompasses traditional plant medicines and manufactured substances, such as dimethyltryptamine or DMT (a component of ayahuasca), psilocybin (derived from so-called magic mushrooms), mescaline (found in the peyote cactus), ibogaine (discovered in a shrub native to West Africa), lysergic acid diethylamide (LSD), ketamine, and 3,4-methylenedioxy-methamphetamine (MDMA) —the latter two are technically classified as a dissociative and an empathogen, respectively. Recent research suggests that psychedelics stimulate alterations in cognition (Carhart-Harris et al., 2012), affect (Griffiths et al., 2016), and perception (Nichols et al., 2017). Likewise, these substances can produce sensory alterations (Nichols, 2016), heightened emotions (Barrett et al., 2020), a changed perception of time (Carhart-Harris & Nutt, 2017), and can lead to experiences of egolessness, self-dissolution, or a feeling of oneness with the cosmos (Lebedev et al., 2015; Nour et al., 2016; Tagliazucchi et al., 2016). These events are also referred to as self-transcendent experiences (STEs).

Flourishing through Self-Transcendent Experiences.

Abraham Maslow and Viktor Frankl argue that self-transcendence, going beyond individual boundaries and connecting with others and the world around us, is how we reach our ultimate potential and find meaning in life. Maslow (2014) defined self-transcendence as pushing past the needs of the self to attend to the well-being of others and feeling part of something greater (e.g., altruism, spirituality, and the pursuit of the greater good). In other words, as positive psychology trailblazer, Chris Peterson (2006), so brilliantly summarized it: Other people matter. Frankl (1985) believed that we find meaning through our actions (doing something significant), our experiences (loving someone), and our attitudes (making sense of even the most difficult experiences).

A STE refers to a state where we go beyond our ordinary self or everyday reality. STEs can occur in different contexts, and their intensity can vary significantly (Yaden et al., 2017). They can be spontaneous or induced through awe, mindfulness, flow, religion, sensory deprivation, near-death experiences, and, of course, psychedelics, among many other things (Garcia-Romeu et al., 2015; Yaden et al., 2017). While growing agreement exists on the conceptual definition of STEs, the psychological process, characteristics, and outcomes remain highly debated.

Researchers describe the phenomenology of STEs as involving physical sensations (e.g., warmth, connectedness, lightness), perceptual changes (e.g., egolessness, timelessness), and cognitive and affective shifts (e.g., love, compassion, forgiveness, joy, freedom, and wonder) (Garcia-Romeu et al., 2015). STEs are often ineffable (transcend language), making it challenging to study using qualitative methodologies. Despite the difficulties in observing STEs, numerous scales indicate that they are primarily associated with beneficial outcomes. They have been linked to positive emotions and well-being (Keltner & Haidt, 2003; Van Cappellen & Rimé, 2014), altruism and pro-social behavior (Saroglou et al., 2005; Van Cappellen et al., 2016), perspective-taking and empathy (Yaden et al., 2017), increases in life satisfaction (Van Cappellen et al., 2013), constructive changes in unhealthy behaviors (Kang et al., 2018), and reduced depression, anxiety, and stress (Griffiths et al., 2016). The effects of psychedelic induced self-transcendent experiences (PI-STEs) on typically stable mental constructs suggest that PAT may induce lasting belief alterations (Lebedev et al., 2015; Lyons & Carhart-Harris, 2018; MacLean et al., 2011; Pokorny et al., 2017; Schmid & Liechti, 2018; Watts et al., 2017).

Change your Beliefs. Change your Life. Change the World.

Beliefs are how we make sense of the world (Crum & Clifton, 2023). They play a crucial role in our capacity to flourish. Moreover, the real-world outcomes produced by the stories we tell ourselves reinforce and strengthen those stories in a self-perpetuating cycle (Crum & Clifton, 2023). For example, constructive views about our intelligence and abilities usually translate into increased attention and effort, which in turn increases the likelihood of achieving positive outcomes that further reinforce these beliefs.

Sound familiar? Fredrickson’s (2013) broaden and build theory argues that positive beliefs and emotions expand cognitive and behavioral flexibility, enhancing personal resources and resilience and facilitating a self-sustaining cycle of personal growth. Additionally, individuals with high self-efficacy—those who believe they can perform well—are more agentic and likely to view difficult tasks as something to be mastered, to remain optimistic when facing adversity, and to recover from setbacks (Bandura, 2001). Conversely, destructive beliefs can lead to a downward spiral of poor performance and decreased engagement (Walton & Wilson, 2018). Because these deeply ingrained stories profoundly impact mental and physical health outcomes, exploring how to manipulate them using PI-STEs could be immensely valuable.

PI-STEs, in combination with expert mental health support or coaching, may allow individuals to test, challenge, and reconsider negative beliefs, opening the door to embracing more adaptive perspectives. For instance, a seminal study using PAT with psilocybin showed increased optimism, quality of life, and meaning in individuals with life-threatening cancer, suggesting a potential shift in their worldviews (Griffiths et al., 2016). PAT using MDMA has also shown meaningful reductions in PTSD symptom severity, with participants reporting changes in their beliefs about themselves and their trauma (Feduccia & Mithoefer, 2018). Another study found a positive relationship between prior use of psychedelics and shifts toward panpsychism, the idea that all matter has consciousness, which is correlated to reduced feelings of existential isolation and an increased sense of connectedness (Timmermann et al., 2021). These empirical findings, among many others, highlight the profound alterations in beliefs that PI-STEs may catalyze, establishing an opportunity to learn more about the intricacies of these processes.

There are Risks.

Research to date suggests that classic psychedelics are among the safest psychoactive drugs due to their limited physiological impact (Schlag et al., 2022), non-addictive nature (Morgenstern et al., 1994; Shalit et al., 2019; Stone et al., 2006), and lack of association with harm to society (Nichols et al., 2017; Nutt et al., 2007). They are typically linked with low toxicity and do not appear to cause organ damage or neuropsychological deficits (Hasler et al., 2004; Nichols, 2004). For example, extensive scientific exploration has not revealed any evidence of neurotoxicity associated with LSD, mescaline, or psilocybin when ingested at standard doses (Nichols, 2016; Schlag et al., 2022). However, these substances are not without some potential adverse side effects.

Psychedelics may interact with drugs that modulate serotonin and can cause increases in pulse rate, blood pressure, and body temperature, making them unsuitable for individuals with certain pre-existing conditions, such as cardiovascular disease (Johnson et al., 2019; Schlag et al., 2022). Although bodily symptoms such as weakness, fatigue, drowsiness, headaches, nausea, dizziness, blurred vision, dilated pupils, tremors, and increased tendon reflexes may occur during dosing sessions, they are typically mild, even at doses that can produce significant STEs (Nichols, 2004; Passie et al., 2002).

Adverse psychological reactions, though rare, include Hallucinogen Persisting Perception Disorder (HPPD) and persistent psychosis, particularly in those with a history of schizophrenia or bipolar disorder (Schlag et al., 2022; Dos Santos et al., 2017). In addition, challenging experiences or “bad trips” can cause significant distress but are generally short-lived and may still lead to positive outcomes (Grof & Hofmann, 2008; McCabe, 1977). Other psychological risks include exacerbating psychopathologies in susceptible individuals (Carbonaro et al., 2016; Schlag et al., 2022). Psychedelics carry potential physical and psychological risks, and they may also offer therapeutic benefits, which accentuates the importance of additional research, careful consideration, and expert guidance in their use.

Importantly, psychedelics remain classified as Schedule I drugs under the United Nations Single Convention on Narcotic Drugs, making their use illegal in many jurisdictions (Smith & Appelbaum, 2021).

Ending with Why.

During my call with Nathan, I heard in his voice not only the pain of a physical ailment but the terror of an existential crisis and an impending end, of believing that he had no choices. If psychedelics can offer alternatives to mitigate such deep-seated fears and provide people like him with a sense of peace, then I believe we have a moral and humanitarian obligation to explore the possibilities. Research suggests that PI-STEs can be especially powerful for people facing life-threatening illnesses who often experience demoralization and a loss of dignity (Matthews & Cook, 2009; Bovero et al., 2023). Moreover, psychedelics such as psilocybin may effectively alleviate anxiety and depression by increasing optimism, quality of life, and meaning in people diagnosed with terminal cancer (Griffiths et al., 2016; Grob et al., 2011; Ross et al., 2016). We owe it to Nathan and all those struggling with mental health challenges to leave no stone unturned in our pursuit of compassionate care.

On May 4, 2023, only four months after the ominous call, Nathan died. His passing was turbulent and restless. It was filled with anguish, sadness, anger, and suffering. Despite being in treatment for months, he never had a chance to say goodbye to the people he loved. His pain, resistance to the inevitability of his diagnosis, and psychological struggle created an agonizing end-of-life experience that compromised closure for his two children, Ezer and Sara, and for all of us who loved him profoundly. I am hopeful that these words serve to advance, albeit modestly, the global conversation on the potential healing power of psychedelics.

As we reflect on the possibilities and controversies surrounding PAT, many questions remain: What personal and collective beliefs or biases might influence our views on the use of psychedelics? What are the ethical implications of these treatments? How do the potential benefits and risks weigh against each other? How does the use of these substances align with our current understanding of mental health and human flourishing? In exploring psychedelics, we are reminded that the journey toward healing and thriving is complex, rich in subtleties, and uniquely distinct for each individual.

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About the author | Jon is a strategy, operations, transformation, and organizational turnaround executive. He is the Founder & CEO of the Strongpoint Group, an independent global business advisory firm dedicated to helping organizations create their long-term business strategy and optimize their operations through a sustainability lens. He has over 20 years working across multiple industries. Jon holds a Master in Applied Positive Psychology from the University of Pennsylvania, an MBA from Cornell University, and a BA from McGill University. He also has extensive experience in highly complex negotiations, including advanced training at the Harvard Kennedy School of Government.
Jon is originally from Caracas, Venezuela and lives in Toronto, Canada, with his lifelong partner Adriana and his two kids, Charles (11) and Jacques (7). You can reach Jon via jon@strongpointgroup.ca or through LinkedIn.