James Hawkins, Medical psychotherapist

Published in JHH 19.1 – Integrative Medicine

‘A person is a spatially and temporally limited piece of what we call the ‘universe’.

He experiences himself and his feelings as separated from the rest, an optical illusion of his consciousness. The pursuit of liberation from this bondage is the only object of real religion.’

Albert Einstein

Research studies and academic reviews on psychedelics are emerging all the time. Searching in my own personal database today turns up more than 950 papers, mostly published in the last five years. I also regularly contribute to a Psychedelic Health Professionals (PHP) Network newsletter which gives details of a further four recently published psychedelic research articles every week. As Guy Goodwin, Oxford emeritus professor of psychiatry, has commented. ‘Remedicalising psilocybin and related drugs is the most interesting project in contemporary psychiatry’.

I am trained as a medical doctor and as a psychotherapist. I went to university in the late 1960s, so it’s no surprise that I’m intrigued by the re-emergence and therapeutic potential of psychedelics. I have written and lectured a good deal about these topics – see for example on my own website at goodmedicine.org.uk>good knowledge>psychedelics or on the Psychedelic Health Professionals site at psychedelicnetwork.org.uk>lectures-and-tutorials. Over two years ago, I helped found the PHP Network and we’re currently in the process of setting ourselves up as an educational charity. Do visit the PHP website for information about a wealth of opportunities we provide including the free weekly newsletter, podcasts, journal clubs, a linked book club, orientation/integration groups, supervision, lectures and also (legal) psilocybin retreats in the Netherlands.

However, what I would like to focus on here is something a bit more specific – the potential synergy between psychedelics and meditation. I will do this through two articles. This first one looks at the fascinating research developing in this area. In the second article, due to appear in the next issue of JHH, I will talk a bit about my own personal exploration of this synergy. I hope these two rather different lenses will complement each other in helpful ways.

So first here is a fairly brief look at current research in this area. At the moment, the most clearly identified predictor of good long-term outcome after psychedelic use in healthy subjects is the depth of the mystical or peak experience they have while taking the substance (Elsey, 2017; McCulloch et al, 2022). The recent paper Psychedelic experiences and mindfulness are associated with improved wellbeing (Qui & Minda, 2021) comments, ‘The current study aims to examine the relationship between psychedelic use, mindfulness, and multi-faceted wellbeing as an outcome. Hierarchical regression was used to quantify these associations on a large sample of people (N = 1219), who engage in both meditation practices and psychedelic use. These results show that both mindfulness and mystical experiences each predict substantial increases in wellbeing. Psychedelics were found to be an important moderator of mystical experience to explain improvements in wellbeing.’ In another study, Pedersen and colleagues (Pedersen et al, 2021) interviewed 50 psychedelic users and wrote – ‘we document how they draw on archetypical mystical narratives, comprising three key dimensions: (1) the transcendence of time and space; (2) deep euphoria; and (3) the perception of being at one with “a larger whole”.’ Both one’s personal tendency to ‘absorption’ and the ‘porosity’ of one’s background sociocultural beliefs contribute to the quality of these experiences (Payne et al, 2021).

There are a whole series of good recent articles about the similarities and differences between meditation and psychedelics (Qui & Minda, 2021; Payne et al, 2021: Eleftherious & Thomas, 2021; Garland & Fredrickson, 2019; Millière et al, 2018; Simonsson & Goldberg, 2022; Geere et al, 2021) and I am aware of five papers that have explored potential synergies between these approaches more directly (Azhari et al, 2020; Smigielski, Kometer et al, 2019; Dakwar et al, 2019; Griffiths et al, 2018; Grabski et al, 2021). The Azhari, Dakwar and Grabski studies report on improved substance use disorder outcomes through combining mindfulness-based approaches with ketamine, while both the Griffiths and the Smigielski papers used psilocybin to augment meditation outcomes.

The 2018 study Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors by Roland Griffiths and colleagues at John Hopkins was a ground-breaker in this field (Griffiths et al, 2018). The paper’s abstract reads: ‘Psilocybin can occasion mystical-type experiences with participant-attributed increases in wellbeing. However, little research has examined enduring changes in traits. This study administered psilocybin to participants who undertook a program of meditation/spiritual practices. Healthy participants were randomized to three groups (25 each): (1) very low-dose (1 mg/70kg on sessions 1 and 2) with moderate-level (“standard”) support for spiritual-practice (LD-SS); (2) high-dose (20 and 30mg/70kg on sessions 1 and 2, respectively) with standard support (HD-SS); and (3) high-dose (20 and 30mg/70kg on sessions 1 and 2, respectively) with high support for spiritual practice (HD-HS). Psilocybin was administered double-blind and instructions to participants/staff minimized expectancy confounds. Psilocybin was administered 1 and 2 months after spiritual practice initiation. Outcomes at 6 months included rates of spiritual practice and persisting effects of psilocybin. Compared with low-dose, high-dose psilocybin produced greater acute and persisting effects. At 6 months, compared with LD-SS, both high-dose groups showed large significant positive changes on longitudinal measures of interpersonal closeness, gratitude, life meaning/purpose, forgiveness, death transcendence, daily spiritual experiences, religious faith and coping, and community observer ratings. Determinants of enduring effects were psilocybin-occasioned mystical-type experience and rates of meditation/spiritual practices. Psilocybin can occasion enduring trait-level increases in prosocial attitudes/behaviors and in healthy psychological functioning.’

This is such an interesting and helpful paper that is well worth reading in full. The authors concluded, ‘Psilocybin was administered in the context of undertaking a non-sectarian program of meditation and other spiritual practices that emphasized integration of spiritual values in daily life. The study showed robust interactive positive effects of psilocybin dose and added support for spiritual practices on a wide range of longitudinal measures at 6 months including … (the previously mentioned self-reported changes as well as) … rating of participants by community observers. Analyses suggest that the determinants of these effects were the intensity of the psilocybin-occasioned mystical experience and the rates of engagement with meditation and other spiritual practices.’ The researchers also noted, ‘Overall, these results suggest that both mystical experience (induced by high dose psilocybin) and spiritual practices (involving meditation) contribute to positive outcomes, with mystical experience making a substantially greater contribution.’ This is worth noting – that beneficial outcomes seemed particularly due to psychedelic-induced mystical experiences with meditation practice providing additional but less significant contributions.

The other currently reported study that particularly speaks to this potential meditation/psychedelic overlap involved giving psilocybin or placebo to experience meditators on day four of a five-day mindfulness retreat (Smigielski, Kometer et al, 2019). The researchers noted that, ‘Compared with placebo, psilocybin enhanced post-intervention mindfulness and produced larger positive changes in psychosocial functioning at a 4-month follow-up, which were corroborated by external ratings, and associated with magnitude of acute self-dissolution experience.’ They also highlighted that ‘Meditation seems to enhance psilocybin’s positive effects while counteracting possible dysphoric responses’. Associated functional MRI scans were reported in a further paper (Smigielski, Scheidegger et al, 2019) where the authors wrote, ‘The analysis of functional connectivity identified psilocybin related and mental state-dependent alterations in self-referential processing regions of the default mode network (DMN). Notably, decoupling of medial prefrontal and posterior cingulate cortices, which is thought to mediate sense of self, was associated with the subjective ego dissolution effect during the psilocybin-assisted mindfulness session. The extent of ego dissolution and brain connectivity predicted positive changes in psychosocial functioning of participants 4 months later.’

And this overlap between psychedelics and meditation is not just about ego dissolution. The experience of awe (wonder, reverence) seems to be of real importance too (van Mulukom et al, 2020; Chen & Mongrain, 2020; van Elk et al, 2019; Hornsey et al ,2018; 2019; Hendricks, 2018). Other significant benefits of both psychedelics and mindfulness include compassion for self and others (Yela et al, 2020; Fauvel et al, 2021; Kamboj et al, 2018; Elsey et al, 2021) and increased value-directed activities (Donald et al, 2020; Teixeira et al, 2022).

There is so much more I could write about overlapping meditation/psychedelic research, but what I would like to do in a linked paper in the next edition of JHH is to share some personal experience. I very much agree that, ‘The plural of anecdote is not data’ but sometimes personal experiences and qualitative studies can act as scouts scoping out the countryside and suggesting territory that might later be worth exploring further both by individuals and by the slower moving heavy artillery of randomised and other formal research trials. In the next paper I will comment on five areas: first, and a bit more fully, how I personally have found psychedelics and meditation enhance each other; then second the value of trying different settings/activities when using psychedelics; third the question of whether one trips with a sitter or friend or group or alone; fourthly the potential helpfulness of using some form of recording device to make notes during the trip; and fifthly a brief discussion of ways I have found helpful for personal integration.

Meanwhile, do visit the Psychedelic Health Professionals Network website for more on emerging research as well as links to a variety of other resources, including orientation/integration groups, supervision, journal clubs, links to talks and (legal) psilocybin retreats in the Netherlands.

References

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Chen SK & Mongrain M (2020) Awe and the interconnected self. The Journal of Positive Psychology, 16(6) 770–778.

Dakwar E, Nunes E, Hart C et al (2019) A single ketamine infusion combined with mindfulness-based behavioral modification to treat cocaine dependence: A randomized clinical trial. Am J Psychiatry, 176(11) p. 923–930.

Donald J, Bradshaw E, Ryan R et al (2020) Mindfulness and its association with varied types of motivation: A systematic review and meta-analysis using self-determination theory. Personality and Social Psychology Bulletin, 46(7) 1121–1138.

Eleftheriou ME & Thomas E (2021) Examining the potential synergistic effects between mindfulness training and psychedelic-assisted therapy. Frontiers in Psychiatry, 12(1330).

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