Enthea

A research project assessing the humanitarian impact of psychedelics.

Belser et al. 2017 – Interviews with psilocybin-treated cancer patients

Mon 23 July 2018

tl;dr:

Belser et al. 2017 interviewed 13 participants of Ross et al. 2016, a double-blind trial of psilocybin for depression & anxiety in cancer patients which found big + persisting antidepressant & anxiolytic effects.

I don't know much about qualitative academic research methodology – it looks like they basically talked to a bunch of people who tripped, recorded the interviews, then summarized themes that appeared across conversations.

So what did the cancer patients who tripped have to say?

Relationships came up a lot:

There were no questions in the interviews regarding relationships, but, without prompting, all the interviewees addressed crucial relational aspects of their experiences. These relationships were most likely to concern the participant’s father or mother (seven participants), or romantic partner (five participants).

... Relationships were woven throughout participant narratives—throughout the histories, memories, hopes, feelings, visions, and realizations as reported by the participants.

Some relational behavior change was self-reported:

Five participants described how their ways of relating to other people changed as a result of their involvement in the study. One participant said that he “stayed in touch with more people as a result of the study” and strove to “show people that you care about them, be kind to other people, take care of the people in your life.”

Another described how she now spends more time being with her daughter, talking to her: “I changed. I just was different. I just felt happier.” Edna described “a greater understanding of the people around me”

One guy proposed to his girlfriend:

"I was appreciating the pureness of her, if you will, her being, in a way. In a way, I had not allowed myself, or not realized, or whatever the case was. And so that was pretty much immediate, but I felt like that had a lasting effect. I feel that kind of changed my perception of our relationship over the ensuing weeks in a way. It allowed me to be more open with her, express my appreciation a lot for her in way that I had not. I think it had a positive effect – kind of a bit of a snowball effect."

Dan reflected that the state of mind into which he entered helped him become “more emotionally open” to his girlfriend. Within 3 months, Dan bought an engagement ring and proposed marriage to her.

Catharsis experiences happened for 5 of the 13:

Five participants reported having access to long-held strong or repressed emotions such as grief, sadness, and traumatic pain. Adam, a young medical student, had previously dismissed the feeling emotions altogether because “it doesn’t solve anything, and you have to be strong, or that is what I used to think.”

During his psilocybin session, Adam grieved a broken relationship with his father. For the first time since he was 6 years old, Adam cried, weeping tears of grief and sadness, which he had held in abeyance for nearly two decades. This catharsis provided him with a profound sense of relief.

Most people thought their experience had an ineffable quality, yet produced enduring insights to which they could return to when sober:

Despite this difficulty in accurately articulating each experience, eight participants felt that their insights arrived from an inner or otherwise enduring source, to which they could return in ordinary states of consciousness.

Three participants expressed the need to actively integrate their psilocybin insights into their daily lives in order to continue deriving meaning from them.

Unfortunately Belser doesn't give details about what "integrating the insights into daily life" looks like.

Most interesting for our purposes is the "Lasting Impact" section...

All study participants reported experiencing benefits related to their lifestyle and quality of life after the treatment sessions. Some of the participants expressed coming to honor a different side of themselves, a more still, emotional, or spiritual side that involved connecting to the simplicity of the present moment:

"The percentage of my life that I am able to be present in just a moment has increased dramatically, and it’s really just been restored from almost nonexistent to often existent ... it is unique and monumental in a way."

...

Participants described a shift in their life priorities away from the busy demands of modern work life, to find a deeper or more authentic mode of existence: “It has made me more aware that: I cannot just live for material stuff and success.”

And:

Augusta share[d] how participating in the study has helped her “wake up in the most profound way.”

She also reported better practical outcomes, like feeling less alone, having less “tunnel vision” and feeling more confident.

The trip also appears to have helped some people with time management:

... some participants reported that the psilocybin experience afforded them greater confidence to put up boundaries against various stressors in their life and the ability to overcome barriers that were impeding life goals, allowing a greater sense of peace and freedom.

...

When one participant was asked, in what ways you feel the study has affected your life since undergoing the sessions, she replied:

"Just tremendously, tremendously. I am so much more able to do things that I wanted to do, and didn’t feel I could, something always holding me back ... I really want to enjoy every minute. I want to enjoy being alive, and I knew that before the study, but afterwards I became able to do it much more often. I have found ways to make that happen."

This participant, who struggled with emotional/compulsive eating following her cancer diagnosis, reported gaining confidence to commit to dietary goals and a YMCA membership, losing 30 pounds as a result, an outcome she attributed directly to her psilocybin session.

The post-trip outcomes of three of the 13 weren't as good, though all three said they'd do the trip again:

One reported ambiguity regarding his experience, saying, “I still have to work on my problems myself ... [the psilocybin experience] confirms certain thoughts and hopes, ah, about who we are. Who I am. What’s important to me.”

Another participant reported persisting anxiety: “I still worry. It’s not like life is so perfect now, but it’s better. It’s just better ... I just don’t think that I feel as sad as I used to feel.”

A third participant reported prolonged difficulty following her session, which required intensive support in integration psychotherapy sessions with her therapists to process a childhood trauma.

Of these three participants who continued to struggle to integrate their experiences, all three reported that they would repeat the psilocybin dosage session.

So what do we make of all this?