The Elephant in the Room: Personal Use of Psychedelics among Psychedelic Researchers

Psychedelic MedicineVol. 1, No. 3 EditorialFree AccessThe Elephant in the Room: Personal Use of Psychedelics Among Psychedelic ResearchersPeter S. Hendricks and Charles D. NicholsPeter S. Hendricks*Address correspondence to: Peter S. Hendricks, PhD, Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, 530 Beacon Parkway West, Suite 702, Birmingham, AL 35209, USA, E-mail Address: [email protected]Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.Search for more papers by this author and Charles D. NicholsDepartment of Pharmacology and Experimental Therapeutics, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA.Search for more papers by this authorPublished Online:13 Sep 2023https://doi.org/10.1089/psymed.2023.29002.pshAboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookXLinked InRedditEmail In this issue, Pagán et al.1 report that among US medical students, personal use of psychedelics was associated with more positive attitudes toward psilocybin. More positive attitudes toward psilocybin were, in turn, associated with greater willingness to recommend psilocybin-assisted psychotherapy, if FDA approved. Herrmann et al.2 also found that psychiatric medication prescribers attributed improvements in depression, anxiety, and well-being to personal use of psychedelics. These two studies comport with a prior study in Psychedelic Medicine by Aday et al.,3 which found that almost 90% of the therapists associated with Usona Institute's Phase II clinical trial of psilocybin for major depressive disorder reported personal use of psychedelics. Collectively, this raises important questions around personal use of psychedelics among those conducting research (and in the anticipated future, clinical interventions) with these compounds.One question is whether personal use of psychedelics might play a role in the training of clinical research staff. This is not a novel idea. In 1957, when psychedelics were still thought of as psychotomimetics, the psychedelic pioneer Humphry Osmond wrote, "There is one golden rule that should be applied in working with model psychoses. One should start with oneself. Unless this is done, one cannot expect to make sense of someone else's communications and, consequently, the value of the work is greatly reduced."4 Osmond's perspective was shared by other luminaries in the field including Albert Hofmann5 and Timothy Leary, Ralph Metzner, and Richard Alpert,6 and appears to have resonated with the scientific community. Indeed, personal use of psychedelics among psychedelic researchers in the 1950s through the early 1970s may have been commonplace, and it has been promoted by contemporary researchers with similar rationale.7And yet, whether personal use of psychedelics might improve clinical competency is unknown. Drawing from the literature on client–therapist matching, there is scant support for the notion that shared experience represented by similar sociodemographic characteristics improves therapeutic efficacy.8 Furthermore, though it has long been argued—often impassionedly—that substance abuse counselors should have personal experience with addiction, there is no evidence that counselors with such experience are any more effective than those without.9,10 Of note, it is not expected that clinicians who intervene with other mental health conditions have personal experience with these conditions (e.g., those who treat individuals with psychotic or bipolar disorders are not expected to have a personal history of these conditions) nor are clinicians who specialize in the treatment of medical conditions expected to have a personal history of these conditions (e.g., oncologists are not expected to be survivors of cancer). What, then, might explain the ostensible intuitive appeal of personal experience with psychedelics among clinical scientists working with these substances?One possible explanation is the well-established principle of homophily, which is the tendency for people to interact with others who are similar with regard to sociodemographic, behavioral, and intrapersonal characteristics. Substance use, including psychedelic use, may play a significant role in identity formation11 and represent a salient homophilic characteristic. Though homophily may facilitate communication and help coordinate behavior, it can also limit social interaction and contribute to divisions across race, ethnicity, age, religion, education, occupation, and gender.12,13 Nevertheless, homophily may explain the apparent gut feeling that those who have used psychedelics are better suited to provide psychedelic-assisted psychotherapy than those who have not.However, again, there is no evidence that effective psychotherapy relies on shared life experience. If this were the case, taken to the extreme, one might only be qualified to provide treatment to those who share the almost infinite qualities that make humans uniquely who they are, a statistical probability approaching zero. On the contrary, psychotherapy relies on therapist characteristics such as empathy, and characteristics of the client–therapist relationship, such as therapeutic alliance, among other factors that do not hinge on having something in common.8 What is more, therapists who share life experience with their clients risk the assumed similarity bias, which can lead to a number of detrimental outcomes.14One example of the assumed similarity bias with psychedelics involves another psychedelic pioneer, Al Hubbard. Hubbard was a devout Catholic, and according to Aldous Huxley, Hubbard saw LSD "as an instrument for validating Catholic doctrines and giving new life to Catholic symbols" (as quoted in Stevens, p. 71).15 Though this may have been true for Hubbard, it was a mistake to assume others would share his experience. Hubbard administered LSD to the general manager of Ampex, and "the result was disastrous. The general manager was Jewish. The last thing he wanted to do was look at pictures of Jesus Christ, but that's what Hubbard kept waving at him".15 Though this practice would not meet contemporary standards of psychedelic-assisted psychotherapy, it nonetheless illustrates how personal experience with psychedelics could result in therapeutic approaches that are constrictive, if not dogmatic, and harmful.Of course, these concerns do not discount the findings of Pagán et al.1 or Herrmann et al.,2 which together suggest that personal use of psychedelics among clinicians is associated with more positive dispositions toward psychedelic-assisted psychotherapy and self-reported improvements in mental health. These changes might be expected to improve outcomes in psychedelic-assisted psychotherapy, but not as a consequence of improved appreciation for the psychedelic experience as argued by Osmond and others. Still, whether personal psychedelic use among clinicians can enhance clinical competency above and beyond currently available approaches is an important question for future research. Given the self-selection bias inherent in naturalistic survey studies, randomized clinical trials will serve critical roles in interrogating this empirical question, with attention to mechanisms of change. Psychedelic Medicine welcomes submissions that test this long-held hypothesis.Author Disclosure StatementP.S.H. was previously in a paid advisory relationship with Silo Pharma and is currently in paid advisory relationships with the following organizations regarding the development of psychedelics and related compounds: Bright Minds Biosciences Ltd., Eleusis Benefit Corporation, Journey Colab Corporation, and Reset Pharmaceuticals, Inc. C.D.N. is a venture partner with Palo Santo, founder of 2A Biosciences, and a board member of the Heffter Research Institute.Funding InformationNo funding was received for this article.References1. Pagán AF, Lex C, Soares JC, et al. Medical students' attitudes and beliefs toward psilocybin: Does terminology and Personal experience with psychedelics matter? Psychedelic Med 2023;1:130–138. Abstract, Google Scholar2. Herrmann Z, Levin AW, Cole SP, et al. Psychedelic use among psychiatric medication prescribers: Effects on well-being, depression, anxiety, and associations with patterns of use, reported harms, and transformative mental states. Psychedelic Med 2023;1:139–149. Abstract, Google Scholar3. Aday JS, Skiles Z, Eaton N, et al. Personal psychedelic use is common among a sample of psychedelic therapists: Implications for research and practice. Psychedelic Med 2023;1:27–37. Link, Google Scholar4. Osmond H. A review of the clinical effects of psychotomimetic agents. 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Webb M, Copes H, Hendricks PS. Narrative identity, rationality, and microdosing classic psychedelics. Int J Drug Policy 2019;70:33–39. Crossref, Medline, Google Scholar12. Fu F, Nowak MA, Christakis NA, et al. The evolution of homophily. Sci Rep 2012;2:845. Crossref, Medline, Google Scholar13. McPherson M, Smith-Lovin L, Cook JM. Birds of a feather: Homophily in social networks. Annu Rev Sociol 2001;27:415–444. Crossref, Google Scholar14. Raja A. Ethical considerations for therapists working with demographically similar clients. Ethics Behav 2016;26:678–687. Crossref, Google Scholar15. Stevens J. Storming Heaven: LSD and the American Dream. The Atlantic Monthly Press: New York, NY, USA; 1987. Google ScholarFiguresReferencesRelatedDetails Volume 1Issue 3Sep 2023 InformationCopyright 2023, Mary Ann Liebert, Inc., publishersTo cite this article:Peter S. Hendricks and Charles D. Nichols.The Elephant in the Room: Personal Use of Psychedelics Among Psychedelic Researchers.Psychedelic Medicine.Sep 2023.122-123.http://doi.org/10.1089/psymed.2023.29002.pshPublished in Volume: 1 Issue 3: September 13, 2023PDF download