For the fall edition of Methods and Mind I've taken a plunge into recent research into psychedelic-assisted therapy. This was prompted by an article published in March of this year in the Journal of the American Medical Association by Sarah McNamee and Nese Devenot describing evidence of serious adverse events and reports of long-lasting harms arising from interactions between therapists and participants in psychedelic-assisted clinical trials. By this time there was a flood of press coverage regarding a case involving a B.C. psychiatrist and her psychotherapist husband, who were facing a lawsuit for their actions in an MDMA trial that went horribly wrong, and I'd recently read Steven Petrow's column in the Washington Post describing his effort to address spiralling depression with ketamine-assisted psychotherapy. Petrow's article, titled "I tried ketamine to treat my depression. It was terrifying." takes the reader on a shocking journey into the dark side of this therapy - one that is entirely predictable given what we've learn about this drug from recreational users and ketamine addicts over the past several decades.
I began my investigation by surveying the current research literature in order to find examples of the studies that are getting everyone so excited. In the process, I examined dozens of studies and discovered that in the span of a single decade the field of psychedelic-assisted therapy has moved from the fringes to the mainstream. Researchers are positively gushing with optimism about PAT's rapid and life changing effects when used to treat problems like depression, anxiety, PTDS and alcohol abuse. In the United States, a revival is in process the likes of which I have not seen over my long career as a clinical psychologist. As I sifted through study after study, it was hard not to get caught up in the enthusiasm. For the first time in memory, people were talking not just about promising interventions, but about cures.
Anyone who is familiar with my work and my writing will recognize that the word "cure" is a trigger for me. I am by nature a skeptic. This skepticism has been fuelled by a life spent life on the ground trying to translate validated therapies into real world interventions to help real people with complex and longstanding difficulties. In doing this I've learned that providing real-life therapy for real-life mental health problems is immensely satisfying and worthwhile, but also very vulnerable to the influence of bad science and personal biases.
So when I took a hard look at the research into PAT, it did not take long to recognize something was very wrong. In study after study I noted problem after problem. This prompted me to hunt down even more research, including meta-analytic studies that systematically analyzed hundreds of PAT studies. The results were alarming, and I describe the reasons in this edition's Deep Dive article. Have a look. Start with my Key Fact sheets, which provide a quick synopsis of three representative clinical trials. Then join me as I take a Deep Dive into the Seven Sins of Psychedelic Studies. I guarantee that it will blow your mind.
Photo by Aziz Acharki on Unsplash
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