What about Psychedelics for Healthy People?

From the Series: The Psychedelic Revival

Serotonin. Image by Kelsey Brooks.

When I began research in 2010, psychedelic science was undergoing a sea change. New FDA approved clinical trials heralded the end of regulatory prohibition against clinical research with psychedelics. Phase 2 trials of MDMA for PTSD and psilocybin for end of life anxiety had opened the possibility of producing empirical evidence of the therapeutic value of these substances.

As part of my ethnographic fieldwork, I followed the network of activists, researchers, therapists, and psychedelic enthusiasts animating this broader psychedelic renaissance. These networks coalesced every few months at conferences that variously aligned psychedelics, science, drug policy, and spirituality. Presentations ran the gamut from studies on ibogaine for addiction to the neurobiology of psilocybin to spiritual exploration with ketamine. The audiences likewise intermingled people with professional and personal psychedelic interest alike: neuroscientists who headed well-funded academic labs, students like myself who were conducting research with psychedelics or researching other things but also interested in psychedelics, activists working to decriminalize drugs, nurses and therapists who attended out of a mix of professional and personal curiosity, psychonauts who were experimenting with a variety of substances and methodologies for producing chemical knowledge.

Often, after a panel presenting on the latest in clinical research with MDMA or psilocybin, when the floor was opened up to the audience, a question would arise: “I am so grateful for the research that you and your organization are conducting. But while I am excited about the work you are doing, I want to know, what about psychedelics for healthy people?” Or sometimes, “What about psychedelics for spiritual growth?”

I link the two versions of the question not only because they both inquire about an otherwise to the clinical development of psychedelics, but also because health and spiritual growth are densely entangled in discussions of the value of these substances.

More often than not, one of the panelists would reply by invoking a landmark study on psilocybin and mystical states of consciousness conducted at Johns Hopkins University (Griffiths et al. 2006). And sometimes the speaker would note other planned studies examining a connection between mystical states of consciousness and personal growth.

These exchanges, arising from the heterogeneous mix of investments that crossed paths at these conferences, point to an otherwise of the clinical development of psychedelics. In this otherwise, psychedelics are a pathway to secular-spiritual exploration through the mystical experience. However, as I want to briefly explore, this understanding is rooted in a genealogically specific understanding of a universal core mystical experience, which has a politics distinct from the clinical development of these substances.

Clinical trials produce efficacy through particular populations—treatment resistant war related PTSD, social anxiety in autistic adults, anxiety in subjects with terminal conditions. Thus, efficacy—and safety (Hendy 2019)—are always tied to a for whom. The specificity of for whom in clinical efficacy contrasts to discussions of the mystical utility of psychedelics—where the mystical experience is framed not as particular to a treatment group, but as potentially open to all.

This openness can be traced back to midcentury experiments that decoupled mystical experience from religious traditions. To return to the Johns Hopkins study, the study investigated the psychological effects of psilocybin in healthy volunteers. To evaluate mystical experiences, researchers utilized two measurements: the States of Consciousness Questionnaire (SOCQ) and the Mysticism Scale. The latter had documented cross-cultural generalizability (Hood et al. 2001), whereas the former had been used extensively to evaluate mystical experiences occasioned by drug use, and has a distinct history within experimentation with psychedelics (Pahnke 1969; Richards, Grof et al. 1972; Richards, Rhead et al. 1977). Despite the different disciplinary histories, both scales take their framework directly from the work of philosopher of religion Walter Stace on a universal core mystical experience (Stace 1961; Pahnke 1963; Hood 1975). Stace, working in the legacy of William James, argued that mystical experiences were not subjective emotional states, but rather perceptions, which followed naturalist principles; as such those perceptions could be analyzed to separate the content of the experience from their interpretation. In other words, while the interpretation might be rooted in religious tradition, there was a core experience that existed both separate from and across cultures.

The SOCQ was used in a variety of experiments to connect the mystical experience with psychedelics. I would argue that this questionnaire became one of the techniques through which the psychedelic and the mystical came to co-articulate each other in the latter half of the twentieth century. The SOCQ originated as the Psychedelic Experience Questionnaire (PEQ), and was developed by Walter Pahnke (1963) as part of his doctoral research at Harvard University. While Stace was examining the writings of mystics from a range of religious traditions, Pahnke hypothesized that the same structure of experience could be elicited from the drug psilocybin in divinity students. After his doctoral experiment, Pahnke continued to revise and refine the questionnaire with his collaborator William Richards. When the SOCQ eventually landed back in the Johns Hopkins study, the question was not about a mystical experience in divinity students, but in healthy volunteers, who regularly participated in spiritual or religious activities, a much broader population.

Clinical trials for PTSD and end of life anxiety are not just developing the therapeutic efficacies of psychedelics (Sanabria and Hardon 2017); they are also developing an empirical case for the value of these substances. Thus, the chemical politics of the empirical project connects a variety of actors that support these substances—the therapists, psychonauts, researchers, and activists. But the clinical development is also developing these substances through pathologies that delineate for whom access will be legal. When audience members ask after the spiritual and healthful applications of these substances, they not just asking after a different empirical trajectory for demonstrating the value of these substances, they are also asking after different parameters for inclusion, one in which access has a much broader for whom attached. The FDA has approved Phase 3 studies with MDMA and psilocybin. And while this next phase could take several years, the closer that potential approval gets, the more it is possible that the chemical politics animating research will become fractured by tensions around these issues of for whom psychedelics will be legal.

References

Griffiths, R. R., W. A. Richards, U. McCann, and R. Jesse. 2006. “Psilocybin Can Occasion Mystical-Type Experiences Having Substantial and Sustained Personal Meaning and Spiritual Significance.” Psychopharmacology 187, no. 3: 268–83.

Hendy, Katherine. 2019. “MDMA Is Not Ecstasy: The Production of Pharmaceutical Safety through Documents in Clinical Trials.” Medical Anthropology Quarterly. Online ahead of print, October 1.

Hood, Ralph W. Jr., Nima Ghorbani, P. J. Watson, Ahad Framarz Ghramaleki, Mark N. Bing, H. Kristl H. Davison, Ronald J. Morris, and W. Paul Williamson. 2001. “Dimensions of the Mysticism Scale: Confirming the Three‐Factor Structure in the United States and Iran.” Journal for the Scientific Study of Religion 40, no. 4: 691–705.

Hood, Ralph W. 1975. “The Construction and Preliminary Validation of a Measure of Reported Mystical Experience.” Journal for the Scientific Study of Religion 14, no. 1: 29–41.

Pahnke, Walter Norman. 1963. “Drugs and Mysticism: An Analysis of the Relationship between Psychedelic Drugs and the Mystical Consciousness: A Thesis.” PhD diss., Harvard University.

Pahnke, W. N. 1969. “Psychedelic Drugs and Mystical Experience.” International Psychiatry Clinics 5, no. 4: 149–62.

Richards, William, Stanislov Grof, Albert Kurland, and Louis Goodman. 1972. “LSD-Assisted Psychotherapy and the Human Encounter with Death.” Journal of Transpersonal Psychology 4, no. 2: 121–50.

Richards, William A., John C. Rhead, Francesco B. Dileo, Richard Yensen, and Albert A. Kurland. 1977. “The Peak Experience Variable in DPT-Assisted Psychotherapy with Cancer Patients.” Journal of Psychoactive Drugs 9, no. 1: 1–10.

Sanabria, Emilia, and Anita Hardon. 2017. “Fluid Drugs: Revisiting the Anthropology of Pharmaceuticals.Annual Review of Anthropology 46: 117–32.

Stace, Walter Terrance. 1961. Mysticism and Philosophy. London: McMillan.