- Psychedelics Panel Invited to Mainstream Healthcare Conference - March 16, 2018
Psychedelics Research at the 2018 American Psychological Association Convention
Chacruna’s goal is to help advance the understanding of psychedelics and their therapeutic potentials in society, and to support the development of scientific study of this topic. We are happy to announce an important step in this direction.
The annual convention of the American Psychological Association (APA) is one of the largest and most prominent professional psychology conferences in the world. This year, the APA will convene in San Francisco, CA, August 9–12.
The lineup will include an interdisciplinary symposium entitled Psychedelics and Psychology: New Developments in Research and Practice. These presentations will feature empirical, clinical, and cultural considerations relevant to mental health professionals and the general public, made up of an international panel of researchers who represent different aspects of this emerging field. Participants include Bia Labate, PhD, Alicia Danforth, PhD, Stanley Krippner, PhD, Clancy Cavnar, PsyD, Adele Lafrance, PhD, Gabby Agin-Liebes, PhD candidate, Adam Snider, PsyD candidate, and Cristina Magalhães, PhD.
The APA is comprised of many divisions with different emphases of research and practice. Our symposium will be hosted by Division 55, the Society for the Advancement of Pharmacotherapy, a professional organization focused on research and clinical practice integrating pharmacological treatments with psychotherapy.
The cultural meaning of various forms of psychedelics use is rapidly changing at many levels. In popular media, ayahuasca and other substances continue to gather public interest and acceptance in roles that go beyond contexts of recreational drug use. In health care, MDMA and psilocybin are most likely headed toward FDA-approval as medical treatments.
The need for training of mental health professionals in various competency areas related to psychedelics is increasingly apparent. Dialogue between psychedelics researchers and mental health clinicians is more important than ever. Although mental health clinicians and healthcare researchers have a lot to learn about this topic, these same professionals also have a lot to contribute in this dynamic cultural/scientific landscape.
The topic of psychedelics in psychology has been featured at APA conventions in the past, including an invited address given by Timothy Leary in 1963 to a group interested in psychology and religion, entitled “The religious experience: Its production and interpretation.”
The APA appearance was Leary’s first public speaking engagement after the Harvard drug scandal. It explored questions of science and spirituality in the context of the Good Friday Experiments. This groundbreaking study examined whether psilocybin could induce mystical-type experiences when compared to an active placebo. It was designed by Walter Pahnke, who was supervised by Leary at Harvard. Most study participants in the comparison group who received psilocybin had religious and mystical-type experiences, changes in consciousness associated with known effects of “drug-free” mystical experiences.
The topic resurfaced at the APA convention in 2010, when a symposium entitled “Therapist Training for Psychedelic Research and Psychotherapy Practice” featured a Johns Hopkins University research team that included Roland Griffiths, whose psilocybin studies followed up on some of the lines of inquiry begun in the Good Friday Experiments. The group found that levels of mystical experience mediated therapeutic outcomes in reducing anxiety associated with terminal illness. Other presentations at APA conventions have also focused on possible healthcare applications of psychedelics, including a presentation last year entitled “Pot, Psychedelics and Speed: Exploring Therapeutic Potential of Abused Drugs” (Schlienz, Vandrey, Johnson & Berry).
It is probably more rare for psychedelics to be discussed in mainstream healthcare conferences, apart from issues of drug abuse or spirituality. In addition to the reappearance of psychedelics research at the American Psychological Association convention, the American Psychiatric Association has also featured such presentations. In 2015, a panel, including MDMA researcher Michael Mithoefer and other members of the Multidisciplinary Association for Psychedelic Studies (MAPS), appeared at the American Psychiatric Association annual conference to discuss their research.
The hosting of our symposium by the Society for the Advancement of Pharmacotherapy at the 126th annual APA convention is part of a broader cultural shift in mental healthcare fields, in which psychedelic pharmacotherapeutic research is no longer relegated to contexts limited to spirituality or drug abuse. In recent years, this formerly forbidden topic has begun to appear at mainstream professional conferences as a legitimate modality in its own right. Much of that has been made possible by high quality randomized controlled trials funded by MAPS, including a study that will be presented in our symposium by Dr. Alicia Danforth, principal investigator of groundbreaking clinical research with MDMA. Too often, psychedelics have been subject to exaggerations regarding their dangers, as well as their benefits. This symposium responds to the growing need for rational, culturally informed, interdisciplinary dialogue on the possible roles for psychedelics in mental healthcare, and navigates through many scientific, as well as clinical and cultural, issues related to this topic.
Symposium “Psychedelics and Psychology: New Developments in Research and Practice”
Adam Snider, PsyD candidate, Co-Chair
Stanley Krippner, PhD, Discussant
After many years of dormancy, research and public interest in psychedelics has expanded. Once-obscure topics, such as ayahuasca, now receive major media coverage in stories claiming psychological benefits, and the public routinely hears about MDMA and other substances. This exposure creates a need for psychologists to respond with scientifically and multiculturally informed perspectives, to bring expertise to the discussion. Psychedelic substances have been combined with psychotherapy to form unique, multimodal interventions for mental health problems. Recent randomized controlled trials have provided evidence for the utility of MDMA and psilocybin as adjuncts to psychotherapy. MDMA is in the third and final phase of clinical trials to become part of an FDA-approved treatment for PTSD. Granted “breakthrough status,” it might soon be available to more patients as a combined psychotherapeutic/psychopharmacologic intervention. Psychologists have the opportunity to help navigate new clinical, ethical, and cultural issues in current expansions of research in psychedelic-assisted psychotherapy, and develop competence in related practices.
This symposium will bring together an international panel of seven experts from different disciplines in the field of psychedelic studies, including psychology and anthropology, to discuss their research and its application to clinical practice. The first presentation will describe results from a randomized controlled trial, recently completed by the presenter, on the efficacy of MDMA-assisted psychotherapy for social anxiety in adults with autism. The second and third presenters will discuss results from their empirical investigations of psychological and spiritual mechanisms of psychedelic substances in controlled settings. The fourth and fifth presenters will discuss ayahuasca use from a multicultural, interdisciplinary perspective, and include phenomenological reports from ayahuasca users, as well as interviews with psychologists and other health-care professionals with expertise in ayahuasca-related clinical issues. Discussant comments will emphasize roles of psychologists and legal/ethical issues.
MDMA-Assisted Therapy for Social Anxiety in Autistic Adults
Alicia L. Danforth, PhD
This presentation will discuss findings from the first exploratory blinded, randomized, placebo-controlled study to suggest that symptoms of social anxiety associated with autism may be treatable with therapy in a clinic setting, assisted by two doses of 3,4- methylenedioxymethamphetamine (MDMA), spaced a month apart (Danforth, Struble, Yazar-Klosinski & Grob, 2016). Analysis of 12 autistic participants with severe social anxiety demonstrated an acceptable safety profile and feasibility, with significant and durable reduction in social anxiety, based on results from a 6-month follow-up. The study followed a placebo-controlled, double blind methodology to explore safety and efficacy of a flexible dosing regimen of two sessions with 75-125 mg MDMA or placebo control. The primary outcome measure was the Leibowitz Social Anxiety Scale (LSAS) administered by a blinded independent rater. Secondary outcome measures include self-reported symptoms of anxiety, depression, emotion regulation, perceived stress, tests of social inference, and interpersonal reactivity. All participants received core mindfulness training as a part of therapy. Encouraging safety and outcome data will be presented, which will be used to estimate statistical power for future safety and efficacy studies of MDMA-assisted therapy for treatment of social anxiety in autistic adults. Given the lack of treatments customized for autistic adults, the search for new treatment options for social anxiety is highly relevant.
Danforth, A. L., Struble, C. M., Yazar-Klosinski, B., & Grob, C. S. (2016). MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults. Progress in Neuro- Psychopharmacology & Biological Psychiatry, 64, 237–249.
Psychedelics and Mental Health: A Study of Psychological Mechanisms of Therapeutic Action
Adele Lafrance, PhD
This presentation will explore possible psychological mechanisms of various psychedelic substances, such as psilocybin and ayahuasca, in the treatment of anxiety, depression, and eating disorders. Separate lines of empirical research support both the role of emotion regulation and the role of spirituality as mechanisms of psychotherapeutic effects in the literature (Gross & Jazaieri, 2014; Koenig, 2015). A study testing a mediation model designed to investigate the process through which psychedelic use might lead to positive psychological outcomes will be presented. Approximately 170 participants were recruited who endorsed past use of a classical hallucinogen (including psilocybin, LSD, and ayahuasca). As part of a larger study, participants completed a number of commonly used measurement tools to determine frequency of hallucinogen use, as well as self-reported levels of spirituality and emotion regulation. Results from structural equation modeling suggest that hallucinogen use led to an increase in spirituality, which in turn led to an increase in emotion regulation in the sample. Increased emotional regulation is associated with lower levels of anxiety, depression, and disordered eating behaviors. These findings contribute to the advancement of our understanding of possible psycho-spiritual mechanisms through which certain psychedelics may help improve mental health in controlled settings. Clinical and policy implications as well as needs for further research will be discussed, along with issues relevant to clinical practice.
Gross, J. J., & Jazaieri, H. (2014). Emotion, emotion regulation, and psychopathology: An affective science perspective. Clinical Psychological Science, 2(4), 387–401.
Koenig, H. G. (2015). Religion, spirituality, and health: A review and update. Advances in mind- body medicine, 29(3), 19–26.
Mechanisms of Psilocybin-Assisted Psychotherapy for Existential Distress Associated with Cancer
Gabby Agin-Liebes, MA
In blinded placebo controlled trials, psilocybin has been associated with significant and lasting decreases in anxiety and existential distress among individuals with life-threatening cancer (Griffiths et al., 2016; Ross et al., 2016). To provide a fuller account of psychological mechanisms of psilocybin experiences of 13 research participants, data collected by Ross et al. (2016) were further analyzed using Interpretive Phenomenological Analysis methods (Smith, Flowers & Larkin, 2009). Hypotheses regarding psilocybin’s capacity to facilitate self-transcendent and mystical states through a metacognitive process of decentering will be presented. This presentation will discuss safety considerations related to psilocybin administration in clinical research settings and in its translation to clinical practice. Although legal barriers restrict the current clinical use of psilocybin to research contexts, the findings of this study may be used to inform practitioners who deliver care to cancer patients and individuals with life-threatening illnesses. The psilocybin-assisted psychotherapy paradigm has the potential to complement the delivery of psychological treatment for individuals whose diagnosis precipitates debilitating existential distress and who are seeking to assimilate the existential reality of cancer into their lives.
Griffiths, R. R., Johnson, M. W., Carducci, M. A., Umbricht, A., Richards, W. A., Richards, B. D., & Klinedinst, M. A. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), 1181–1197.
Ross, S., Bossis, A., Guss, J., Agin-Liebes, G., Malone, T., Cohen, B., … Schmidt, B. (2016). Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life- threatening cancer: A randomized controlled trial. Journal of Psychopharmacology, 30(12), 1165–1180.
Smith, J. A., Flowers, P., & Larkin, M. (2009). Interpretative Phenomenological Analysis: Theory, method and research. London: Sage Publications.
An Examination of Psychological Healing with Ayahuasca
Clancy Cavnar, PsyD and Beatriz Labate, PhD
This interdisciplinary presentation combines methods and perspectives from anthropology and psychology. Ayahuasca has been increasingly regarded as a tool for psychological exploration, healing, and mental well-being (Labate & Cavnar, 2014). Family dynamics, past trauma, and unacknowledged feelings are often reported in early experiences of drinkers (Kavenská & Simonová, 2015), and several authors have written about the importance of integration of the powerful visionary experiences some individuals report while under the influence of psychedelic substances (Loizaga-Velder & Verres, 2014). In addition to reviewing phenomenological accounts of users, this presentation will discuss what is known empirically about ayahuasca’s effect on mood. The presentation will also discuss ethical and legal issues relevant to psychologists, and describe risks of ayahuasca use. This paper will consider reports of psychological insights gained, and the resulting personal transformation or healing that took place. The specific elements of the ayahuasca experience, both within the experience and afterward, that are considered to be mechanisms of psychological healing will be identified and analyzed; these aspects will be related to psychodynamic and humanistic theories applied to clinical practice.
Labate, B. C. & Cavnar, C. (Eds). (2014). The therapeutic use of ayahuasca. Heidelberg: Springer..
Kavenská, V. & Simonová, H. (2015). Ayahuasca tourism: Participants in shamanic rituals and their personality styles, motivation, benefits and risks. Journal of Psychoactive Drugs, 47(5), 351–359.
Loizaga-Velder, A., & Verres, R. (2014). Therapeutic effects of ritual ayahuasca use in the treatment of substance dependence–qualitative results. Journal of Psychoactive Drugs, 46(1), 63–72.
Ayahuasca-Related Clinical Issues, Resource for Mental Health Practitioners
Adam Snider, PsyD candidate
Despite the increasing cultural and scientific relevance of the South American sacrament ayahuasca, many mental health clinicians may not be familiar with its traditional religious and contemporary health-oriented uses by members of the public. There may be widespread misconceptions about why and how patients might use ayahuasca, as well as the impact such use may have on psychological health (Snider & Magalhães, 2017). This presentation will discuss results from interviews with mental health care professionals who have experience supporting clients for whom ayahuasca use figured prominently as a topic of psychotherapy or psychiatric consultation. Interviews were conducted with clinicians in the United States, and included clinical psychologists, psychiatrists, marriage and family therapists, and clinical social workers. Participating clinicians were given a semi-structured interview protocol designed to assess various domains relevant to clinical practice with this population. Results from these interviews, as well as a literature review, were used to develop a resource for clinicians to increase competence in supporting clients who use ayahuasca. Several clinical scenarios involving ayahuasca use will be described, as well as safety, legal, and ethical issues relevant to psychologists supporting a client who uses ayahuasca.
Snider, A., Magalhães, C. Duran, R. (2017, April). Psychotherapy with clients who participate in ayahuasca ceremonies. Paper presented at the 2nd Psychedelic Science Conference, Oakland, CA.
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