Abstract
Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy’s (ACT’s) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2-weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.
Highlights
Hypothesis #1: Decreases in Experiential Avoidance, Depression Severity, and Suicidal Ideation Over Time To examine whether there were decreases in (a) experiential avoidance (BEAQ), (b) depression severity (QIDS), and (c) suicidal ideation (SIcomposite) after psychedelic use, we conducted three general linear models (GLM) repeated measures ANOVAs, which are robust to non-parametric data with large samples [i.e., > 30; [85, 86]], with Bonferroni corrections for multiple comparisons
Previous research has indicated that psychedelics hold promise for the treatment of a wide range of psychiatric concerns; little research has been done to assess the impact of psychedelics on depression severity or suicidal ideation among non-clinical samples
We suggest that psychedelics may show promise for the treatment of mental health concerns characterized by experiential avoidance [see [87]]
Summary
“Afterwards, I allowed myself to experience everything —even if it is sadness. I know how to deal with my feelings rather than repress them” [1]. The increasingly popular psychotherapeutic model termed “acceptance and commitment therapy” (ACT) identifies experiential avoidance as an essential component of psychological flexibility [i.e., openness to one’s experiences and engagement in behaviors that are congruent with one’s values; [26]] and as a transdiagnostically relevant factor that is central to the development and treatment of psychopathology [26] In line with this view, clinical and experimental research has begun to suggest that psychedelics may lead to decreases in experiential avoidance. There is limited research on whether decreases in the process of experiential avoidance occur in parallel with positive therapeutic outcomes (e.g., depression severity and suicidal ideation) after the use of psychedelics
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