In 1956, psychiatrist Humphry Osmond wrote to his friend and correspondent, author and philosopher Aldous Huxley: “To fall in Hell or soar Angelic, you’ll need a pinch of psychedelic.” In combining the Greek words psyche (“mind”) and T (“manifest”), Osmond coined the term most commonly used today to describe the mind-altering experiences induced by hallucinogenic drugs. In his own words, Osmond saw the psychedelic experience as one of “enlargements, burgeonings of reality.” However, the wider community of American academic psychiatrists was not ready to accept this vision of the hallucinogenic experience—neither the term “psychedelic,” nor its spiritual, consciousness-expanding premise. Academic psychiatry did not yet have adequate language regarding mental illness, psychosis, and altered states of consciousness to capture the experience of using hallucinogenic drugs, and thus such experiences often seemed beyond classification within traditional paradigms of Western medicine.
By the mid-1950s, American psychiatrists had begun using hallucinogenic drugs, which they believed induced a model psychosis, to study mental illness in a controlled laboratory environment. But the history of medicinal uses for hallucinogenic drugs does not begin with American scientists in the 1950s. Indigenous peoples in the Americas have used substances such as ayahuasca, psilocybin, peyote, and ibogaine as part of healing practices for centuries—long before Osmond theorized about manifestation of the mind. Unlike Western academic psychiatrists, Indigenous medicinal practitioners treat hallucinogenic experiences as beyond the psychological, viewing sickness as related to spiritual rather than only physical forces, and thus attempt to use psychoactive drugs to access the spiritual world. In contrast to Osmond’s terminology for such transcendent experiences, many Indigenous healers prefer the term “entheogens” (implying religious inspiration for sacred use), rather than “psychedelics,” to reflect their alternate understanding of hallucinogenic drugs.
Within a Western framework of medicine that bifurcates the religious and the curative, hallucinogenic drugs—with their “psychedelic” or “entheogenic” properties—inherently challenge this paradigm. As historian Steven J. Novak explains, Osmond’s psychedelic vision, tinged with spirituality, mysticism, and transgressive notions of consciousness, “declared war on academic psychiatry.” The scientific establishment of the 1950s and 1960s was not kind to mystically-inclined scientists, like Osmond. And by the end of the 1960s, Congress had outlawed almost all psychedelic research, largely due to reports of unethical experimentation by both academic researchers and the US government and emerging accounts of its recreational use within the counterculture. In 1971, President Richard Nixon signed the Controlled Substances Act, rendering psilocybin, LSD, mescaline, and other psychedelic drugs illegal.
In the past few years, the scientific establishment’s attitude towards psychedelics has shifted radically. After a near total ban during the early 1970s, the United States Food and Drug Administration began approving a select few studies of psychedelic substances in the 1990s, but on the condition that they were subject to rigorous experimental controls and ethical standards. By the mid-2000s, a small but growing number of scientists were beginning to challenge the mythos of the danger of psychedelics.
Perhaps most emblematic of the scientific establishment’s increasing acceptance of psychedelics, in September of this year, Johns Hopkins Medicine opened its new Center for Psychedelic and Consciousness Research, the first in the United States and the second and the largest in the world. Scientists at Johns Hopkins had been early leaders in the psychedelic studies of the 2000s, and with $17 million from private donors and a foundation, they plan to expand the scope and depth of their research into psychedelics. The Center’s website lists among its current projects: “Psilocybin and Smoking Cessation,” “Psilocybin and Depression Study,” “Psilocybin and Alzheimer’s Disease Study,” “Psilocybin and Anorexia Nervosa Study,” and “Religious Professionals Study.”
This progress in the field of psychedelic studies has accelerated rapidly since the mid-2000s. An article published in the journal Drug Science, Policy and Law in September claimed that 2018 marked a “watershed year for psychedelic science,” citing advances within the scientific field, increased public interest, and regulatory changes around psychedelics. Indeed, research institutions seem to be publishing a steady stream of studies touting the therapeutic potential of psychedelic drugs. Some psychiatrists are even calling this recent revival a “psychedelic renaissance.”
Studies published in scientific journals have told an overwhelmingly positive narrative about developments in psychedelic science. “Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer,” claimed a 2016 study authored by researchers at Johns Hopkins. In 2017, some of the same researchers published a study on the psilocybin as a treatment for smoking addiction. Here they stated that “psilocybin holds considerable promise in promoting long-term smoking abstinence.” A 2016 paper published by researchers at Imperial College assessed psilocybin’s potential to cure treatment-resistant depression; it concluded by suggesting “preliminary support for the safety and efficacy of psilocybin for treatment-resistant depression and motivates further trials, with more rigorous designs, to better examine the therapeutic potential of this approach.”
Other research has suggested psychedelics’ efficacy for treating obsessive-compulsive disorder, post-traumatic stress disorder, alcohol addiction, and other mental illnesses. So much data has suggested psilocybin’s potential that in 2018, the FDA declared psilocybin-assisted treatment a “breakthrough therapy” for depression. In September 2019, two Harvard psychiatrists published an article in Current Psychiatry wondering if hallucinogenic drugs could be “‘miracle cures’ for patients with mental illness.”
But the ‘miracle cure’ narrative of the ‘psychedelic renaissance’ does not paint a complete picture of contemporary perspectives on psychedelics within the scientific establishment. A number of researchers within the scientific community have raised concerns about the approaches, exclusions, and erasures of contemporary research. These critiques, however, are often subsumed under a larger story of optimism and revolutionary therapeutic potential.
One of the most prominent researchers suggesting the potential for psychedelic treatments is Robin-Carhart Harris, head of the Psychedelic Research Group within the Centre for Psychiatry at Imperial College. He has explained the effects of psychedelics on the mind with the “entropic brain” hypothesis, arguing in a January 2019 article published in Current Opinion in Psychiatry that psychedelic drugs destabilize normal systems of order in the brain, resulting in a “cascade of neurobiological changes that manifest at multiple scales and ultimately culminate in the relaxation of high-level beliefs.” Carhart-Harris contends that “Psychedelics are, by definition, ‘mind-revealers.’” These explanations—of the relaxation of beliefs and entropy within neural systems—have been widely cited by other scientists as credible or authoritative understandings of psychedelic experiences.
Other psychedelic researchers are not so convinced by the entropic brain explanation. Manoj Doss, a postdoctoral research fellow at Johns Hopkins studying the cognitive, emotional, and neural mechanisms of psychedelic drugs, told the College Hill Independent that he has come to realize that “most cognitive research with drugs is pretty bad.” He explained that much of the evidence that scientists cite supporting the entropic brain hypothesis is taken from one study of only 12 subjects—the 2016 paper mentioned earlier suggesting the potential for psilocybin to cure treatment-resistant depression. “This is what's known as salami slicing,” he explains, “where you're just publishing loads and loads off of one data set.” Doss says he is not alone in doubting the ironclad validity of the science surrounding the entropic brain hypothesis: “I might be the loudest person,” he says, but “everyone else also has issues with their work.”
These ideas of “relaxation of high-level beliefs” and revelation of the mind have prompted researchers within the scientific establishment to reconsider the older understanding of the place of mysticism within psychedelic science. Mystical experiences are often characterized by ineffable feelings of interconnectedness, ecstasy, transcendence of time and space, and sacredness, or as philosopher Walter Stace describes, “the apprehension of an ultimate nonsensuous unity in all things.” Despite a long history of mysticism in Western religions, in contemporary American usage, the term evokes coded references to Eastern and Indigenous spiritual practices, often fetishized and aestheticized within the American counterculture. In a radical departure from the 1950s and 60s, when academic psychiatry marginalized spiritual or mysticism-sympathetic psychedelic scientists, contemporary researchers, especially at Johns Hopkins, have openly embraced not only the idea that mystical experiences could be induced by psychedelic drugs, but also that such experiences could be crucial to psychedelic therapy’s treatment potential.
Much of this research has been directed by Dr. Roland Griffiths, the director of the Johns Hopkins Center. In 2006, Griffiths and colleagues published a landmark article in Psychopharmacology titled “Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance.” This publication was followed by a number of other studies from the Center linking mystical experiences to treatment outcomes, including a 2018 article in Current Topics in Behavioral Neurosciences in which Dr. Griffiths and his colleagues proposed a functional neural model of mystical experiences. Citing descriptions of “interconnectedness” in “‘naturally occurring’ mystical-type experiences,” they argue that such states are “strikingly similar to profound spiritual experiences occasioned by hallucinogenic substances.” These scientists claim that mystical experiences can be understood empirically and quantified as a set of neural processes. To measure such experiences, they propose the Mystical Experience Questionnaire (MEQ), a set of questions that reduce specific factors or dimensions of mystical experiences, asking subjects to assess factors like their “experience of pure being and pure awareness (beyond the world of sense impressions).” But in attempting to describe transcendent feelings, such questions seem to flatten them.
Doss, the Johns Hopkins post-doc, is skeptical of these narratives of psychedelically-induced mystical experiences. He believes that much of the research focused on mystical or emotional responses to psychedelics has been influenced by scientists’ personal use of the drugs: that they set out to confirm their own mystical-seeming experiences in their research. “I think a lot of people just basically did psychedelics,” he explains, “and they get this weird illusion that they're onto something about the mind that these drugs will reveal something about the mind to them.” But as Doss argues, “it's so obvious that it has biased their work and it produces garbage science.”
And Doss is not convinced that scientific understandings of psychedelically-induced mystical experiences are linked to the drugs’ therapeutic potential, as some have claimed. Citing studies on the psychedelic therapy for treatment-resistant depression, he says that “depressed subjects don't always have a good time” during their psychedelic experience. “But yet they're seeing benefit from it,” so he wonders if it is “necessary at all to have the mystical experience.” “I feel like some people might be afraid that it might be the case that this whole mystical experience thing might be, if not vacuous, just not as important as we think it is,” he explains. Indeed, narratives of mysticism equate psychedelics with religious ecstasies, a much more palatable characterization than disruption of neural systems, disorientation or psychosis.
Within the scientific establishment, preferences for these rosy narratives that confirm experiential mystical accounts tend to suppress alternate explanations of psychedelic experiences. Doss references psychedelic scientists in Switzerland whose work has supported the idea of the psychedelic experience as a model psychosis, as American scientists in the mid-twentieth century had suggested. “The group in Switzerland has done the best psychedelic work out there, as far as looking at it from a really rigorous point of view, and they're the least cited,” he explains, because “all their initial studies they framed in terms of psychosis, which doesn't sound as sexy as, ‘Oh, mystical experiences are just going to help the world.’”
Even the story of psychedelics’ radical therapeutic potential may be omitting some doubt, or at least overstating the efficacy of such treatments. While findings suggesting psychedelics’ ability to treat mental illnesses are promising, they should not be accepted without question. “There's definitely a massive potential for there to be a placebo effect,” cautions Doss. “I imagine that the effects are going to get much smaller in the larger clinical trials,” he speculates. “Setting people's expectations,” he explains, is “the heart of the process” at Johns Hopkins. Patients come in primed with expectations of the psychedelic experience and narratives of countercultural mysticism, and hope that this might be the ‘miracle cure’ they need.
Other scientists are critiquing what they see as the silences in the dominant narrative of the ‘psychedelic renaissance’ from a different angle: antiracism and anticolonialism. Similar to Doss, they are drawing attention to flaws in the science itself and the biases of psychedelic researchers that have compromised it. In an article published by the Chacruna Institute for Psychedelic Plant Medicines, clinical psychologist Dr. Jae Sevelius argues that “current psychedelic science is driven by a Western medicalized framework, and thus reflects all of the same limitations.”
By nature of its participants, current psychedelic research reproduces, rather than challenges, existing power structures. In an article published in the Journal of Psychedelic Studies, Jamilah George, PhD candidate in clinical psychology, and colleagues explained that white people are overrepresented in psychedelic research, both as patients and as authors. In their own review of 17 psychedelic studies conducted between 2000 and 2017, the authors found that 82.5 percent of subjects were non-Hispanic white. Only 2.2 percent of subjects were Black, and only 4.7 percent were Indigenous. Additionally, they claimed that psychedelic practitioners who are women or people of color (or both) are less likely to be considered leaders in their fields. In fact, the authors found that the editorial board of the journal that published their study itself is 78 percent male and predominantly white. This exclusion helps explain why psychedelic researchers have largely ignored race: Robin Carhart-Harris has claimed that “psychedelic therapy can treat a pan-diagnostic pathophysiology,” citing a wide range of disorders without regard for the fact that people of color experience and express mental illnesses (such as depression, anxiety, and PTSD) differently because of racial discrimination and historical trauma.
And the current ‘psychedelic renaissance’ also fails to recognize its indebtedness to the psychedelic healing practices of Indigenous peoples. Griffiths and Carhart-Harris do acknowledge Indigenous psychedelic treatments in their publications. But the fundamental structure of the American medical establishment arguably cannot encompass or honor Indigenous healing practices.
Western medicine by nature privileges medical doctors, a profession historically most available to men, despite the traditional status of healing as women’s work, particularly among Indigenous peoples. And the approaches of current psychedelic research are defined by what George calls “Westernized hyperindividualism,” which emphasizes the substances’ universal applications rather than cultural contexts, and “makes for an isolated experience removed from its social context and the communal environment.”
Psychedelic therapies do have revolutionary potential to improve treatment outcomes across different populations, these critics claim, but only if we reconsider and revise current frameworks and methods. “We need to be willing to question how we use power and privilege,” Sevelius claims, “because it is holding back the science. In order to be generalizable, we must be able to demonstrate that these therapies are applicable to different types of people.” In fact, it is psychedelics’ long history outside of the scientific establishment that provides these distinctive radical possibilities: “As a field whose history is deeply rooted in non-Western traditions, the psychedelic science movement has a unique opportunity to acknowledge and resist the replication of existing structures of power,” George argues, “thereby improving the lives of the marginalized and setting an example that can be replicated more broadly within medicine and society.”
Psychedelic drugs cannot be the revolutionary treatment that many in their growing field hope until scientists reckon with the failures of current paradigms to critically examine who is participating in the research and what narratives are silenced for the sake of telling a cohesive, publishable story. Perhaps what is most groundbreaking and vexing about psychedelic drugs is the threat they pose to Western science itself. These substances that Humphry Osmond could only call “psychedelic” challenge scientists to find empirical or quantitative explanations for experiences that have persistently eluded description, to subject these experiences to the rigid norms of laboratory controls, and to validate ways of curing and knowing they have long marginalized.
But the most prominent voices of the ‘psychedelic renaissance’ have been telling a limited story that pushes boundaries and challenges existing paradigms, but only to a certain degree. “There's something to be said about science being able to tell a story,” says Doss. “There's also telling stories on very little information.” The challenge, then, facing psychedelic scientists is to find a more comprehensive, suitable, and inclusive way to tell the story. Only then can psychedelics be subversive. By complicating perceptions of reality, psychedelics can also challenge oppressive realities.
If GEMMA SACK B’21 has experienced ultimate nonsensuous unity, her description certainly won’t do it justice.