Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness.

H Kettner,L Roseman,C Timmermann,L Kärtner,F E Rosas,R L Carhart-Harris

doi:10.3389/fphar.2021.623985

Abstract

Background: Recent years have seen a resurgence of research on the potential of psychedelic substances to treat addictive and mood disorders. Historically and contemporarily, psychedelic studies have emphasized the importance of contextual elements ('set and setting') in modulating acute drug effects, and ultimately, influencing long-term outcomes. Nevertheless, current small-scale clinical and laboratory studies have tended to bypass a ubiquitous contextual feature of naturalistic psychedelic use: its social dimension. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats. Methods: In this observational, web-based survey study, participants (N = 886) were measured across five successive time-points: 2 weeks before, hours before, and the day after a psychedelic ceremony; as well as the day after, and 4 weeks after leaving the ceremony location. Demographics, psychological traits and state variables were assessed pre-ceremony, in addition to changes in psychological wellbeing and social connectedness from before to after the retreat, as primary outcomes. Using correlational and multiple regression (path) analyses, predictive relationships between psychosocial 'set and setting' variables, communitas, and long-term outcomes were explored. Results: The adapted Communitas Scale demonstrated substantial internal consistency (Cronbach's alpha = 0.92) and construct validity in comparison with validated measures of intra-subjective (visual, mystical, challenging experiences questionnaires) and inter-subjective (perceived emotional synchrony, identity fusion) experiences. Furthermore, communitas during ceremony was significantly correlated with increases in psychological wellbeing (r = 0.22), social connectedness (r = 0.25), and other salient mental health outcomes. Path analyses revealed that the effect of ceremony-communitas on long-term outcomes was fully mediated by communitas experienced in reference to the retreat overall, and that the extent of personal sharing or ‘self-disclosure’ contributed to this process. A positive relationship between participants and facilitators, and the perceived impact of emotional support, facilitated the emergence of communitas. Conclusion: Highlighting the importance of intersubjective experience, rapport, and emotional support for long-term outcomes of psychedelic use, this first quantitative examination of psychosocial factors in guided psychedelic settings is a significant step toward evidence-based benefit-maximization guidelines for collective psychedelic use.

Highlights

The ‘biomedical revolution’ of the 1970 and 80s led to an explosive infiltration of pharmaceutical interventions into psychiatric practice and the marginalization of previously favored psychodynamic approaches, consequentially inviting the charge that clinical psychopharmacology offers an atomized and decontextualized approach to mental illness, improving revenues rather than mental health outcomes or stigma (Deacon, 2013; Kleinman, 1988; Kleinman and Cohen, 1991; Peele, 1981)
Acknowledging the obvious safety benefits of highly controlled clinical and laboratory environments, the current findings suggest that certain elements in naturalistic settings, in particular their collective social dimension, may hold a unique potential for enhancing positive outcomes of psychedelic use
Even though the present results suggest positive prosocial effects of collective psychedelic use, qualitative studies have found a tendency, in neoshamanic settings of ayahuasca use (Gearin, 2015b; Gearin, 2016a; Rodd, 2018), for individualistic and narcissistic cultural priors to be reproduced in ideas of self-actualization and -development, which are defining for New Age culture (Graf, 1986; Farias and Lalljee, 2008; Lahood, 2010; Masters, 2010) as they are for neoliberalist-entrepreneurial constructions of selfhood (Adams et al, 2019)

Summary

Introduction

The ‘biomedical revolution’ of the 1970 and 80s led to an explosive infiltration of pharmaceutical interventions into psychiatric practice and the marginalization of previously favored psychodynamic approaches, consequentially inviting the charge that clinical psychopharmacology offers an atomized and decontextualized approach to mental illness, improving revenues rather than mental health outcomes or stigma (Deacon, 2013; Kleinman, 1988; Kleinman and Cohen, 1991; Peele, 1981). Motivated by pragmatic and safety reasons, modern trials of psychedelic-assisted psychotherapy have almost exclusively employed individual, rather than systemic or group therapy approaches–consistent with dominant psychedelic therapy models of the 1950s–70s (Grof, 1980), modern (Anderson et al, 2019) and historical group-therapy exceptions do exist (see Trope et al, 2019 for a historical review of psychedelic-assisted group therapy research) This focus on individual therapy, delivered in highly engineered clinical and laboratory settings, might partially explain why contemporary psychedelic research has remained largely silent in relation to what might be one of the most prevalent factors impacting psychedelic effects in natura: the social dimension of psychedelic use. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats

Methods

Results

Discussion

Conclusion