Could that psychedelic-induced dreamlike state help scientists figure out how to better treat mental illness?
Chelsea Victoria / Stocksy
“I suddenly became strangely inebriated. The external world became changed as in a dream. Objects appeared to gain in relief; they assumed unusual dimensions and colors became more glowing. Even self-perception and the sense of time were changed.”
It’s in those terms that Albert Hoffman, the first scientist to synthesize and learn about the psychedelic effects of LSD, described how he felt after ingesting the drug in 1944. This idea that dreamlike experiences can be elicited by drugs has been around for a long time. Even before Western societies became interested in psychedelics, the ceremonial use of plants and fungi containing psychoactive compounds by pre-industrial societies had ascribed them the role of "transporters" to the realm of dreams and to the spirit world.
However, it’s only during the last decade that researchers have made more important steps in studying this connection between the dream state and the psychedelic state. They’ve been interested in looking at how these drugs alter the mind, and how they might be helpful in clinical practice. Our normal state—during waking hours—is just one state of consciousness we experience. Looking at other states (such as when we’re sleeping or under the influence of drugs) can give us a more comprehensive picture of the human mind, and how it can be treated. Recent research has compared those different states to understand how psychedelics transform us and our experience of reality, and how they can contribute to treating our mental health problems.
The many restrictions in place around the world to use these substances in the lab, of course, have slowed down scientific progress in the field. Still, tenacious efforts have rewarded scientists the opportunity to use neuroimaging tools to map changes in consciousness elicited by psilocybin, a psychedelic molecule found in shrooms. The neurophysiological changes induced appeared similar to those seen in previous studies of dream neuroimaging.
But researchers have wanted to find more robust evidence that the changes in the mind caused by psychedelics not only looked the same in the brain of users as dreaming, but also felt the same. This is key to understand how different states of consciousness manifest themselves in people, and how these different states can be manipulated to offer better psychiatric care. “While MRI scans can help you see similarities between different states of altered consciousness, like dreaming or the psychedelic-induced state, there are limits to this approach. It overlooks perception entirely," says Enzo Tagliazucchi, a researcher at the University of Buenos Aires in Argentina who studies human consciousness. "It’s possible that two states look similar, but for some unknown reason, the subjective feeling is different. It’s important to investigate this aspect too."
To find out more, he and his student Camila Sanz recently conducted a study to compare the experiences of drug users with that of dreamers. They came up with an original approach to get around the restrictions surrounding the use of these substances in research settings. They turned to online testimonials where many drugs users go to report their experiences with a great variety of substances, from psychedelics and deliriants to sedatives and antipsychotic drugs. Using sophisticated analytical tools, they studied the content of thousands on these testimonials, to see which drugs were reported to induce a state most similar to dreaming.
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The scientists analyzed the language used by people to describe their experiences of drug use and their dreams, and compared these reports to identify similar phrases and expressions that could indicate a similarity between the two experiences. Of all the drugs tested, classical psychedelics such as LSD, dissociative psychedelics like ketamine, and deliriants led to reports of experiences more similar to the dreaming state. Users often described how their perception and their self-awareness became distorted when they took these substances, much like in a dream. The scientists were thus able to confirm empirically, in a rigorous way, the hypothesis that the psychedelic trip ‘feels’ the same as dreams.
There has recently been a renewed interest in using psychedelic substances as treatment for psychiatric disorders. Large trials with drugs like ketamine or psilocybin to treat depression, or MDMA to treat PTSD have been conducted, with promising results. In a trial of psilocybin-assisted therapy for treatment-resistant depression for instance, 67 percent of patients were depression-free a week after their two sessions, and 42 percent remained so after three months.
“For far too long, mental health treatment has rested heavily on SSRI antidepressants. Patients need to take these every day; they have no beneficial effect for at least 30 percent of users, with numerous side effects,” says Amanda Feilding, director of the Beckley Foundation, a UK-based think tank at the forefront of psychedelic research and drug policy reform. “Furthermore, the pharmaceutical industry hasn’t come up with anything new for over three decades. Our research has shown that with the addition of a psychedelic to the therapeutic process we get remarkable results.”
Tagliazucchi’s study adds to this growing body of research which suggests that psychedelic substances could be given safely in combination to improve treatment—and to make psychotherapy more beneficial. By showing the similarities between dreaming and the psychedelic experience, his work indeed suggests that the state of altered consciousness induced by the drugs might allow insights to come to patients more naturally during therapy, giving a more precise account of the issues they may be facing to their doctors.
Freud once posited that dreams allowed an access to unconscious thoughts and memories, and were thus interesting for therapists to analyze. While there are flaws to his theories, studying the connections between dreaming and the psychedelic state today thus allows us to reexamine the idea that working with patients in an altered state of consciousness can be beneficial to treat them.
“What our work shows is that these drugs can create a transient dream state, during which it might be possible to access unconscious thoughts and memories in real time. We need more research to back this up, but psychedelics might be a way to access things that are below the surface, and to transform the superficial links between patient and therapist, to get a deeper insight of the issues the person might be experiencing,” Tagliazucchi explains.
More generally, it appears that comparing dream and psychedelic states can shed deeper insights into how the human brain works and, in some ways, improve scientific knowledge of specific psychiatric diseases.
“Psychedelics alter the mind in such a way that they reveal aspects of the mind that we are not ordinarily conscious about. In the last 70 years, psychiatry has been dominated by the cognitive model of the mind, which has brought interesting insights, but has also impoverished the field by denying the existence of the unconscious mind,” says Robin Carhart-Harris, a neuroscientist at Imperial College London who has worked extensively with psychedelics. “We need an understanding of the unconscious mind, otherwise we'll only ever have a superficial knowledge of psychiatric diseases, and superficial treatments.”
As scientists continue to obtain solid evidence that the dreamy state, the acute psychotic state, and the psychedelic state all share important similarities (they look and feel the same), they’ll be able to start thinking about psychiatric diseases, like psychosis, in new ways.
“Maybe psychedelics can help us think more carefully about how we should treat early psychotic episodes. Instead of going in and giving medicines as soon as someone displays signs of psychosis, if we treated the early psychotic state just as we manage a psychedelic experience, with calming music and the therapist mediating the patient through the episode, we might have more positive effects,” Carhart-Harris explains.
While researchers don’t yet agree on the best ways to use these substances and on what their effects are, they are all certain of one thing: It won’t be possible to make significant scientific progress in the field unless the demonization and the prohibition that has surrounded these compounds for the last decades comes to an end.
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