Centre for Psychedelic Research, Division of Brain Sciences, Department of Medicine, 4615Imperial College London, London, UK.
Department of Anthropology/Hearing the voice, 3057Durham University, Durham, UK.
Transcult Psychiatry. 2022 Oct;59(5):691-704. doi: 10.1177/13634615221082796. Epub 2022 Mar 22.
A striking feature of psychedelics is their ability to increase attribution of truth and meaningfulness to specific contents and ideas experienced, which may persist long after psychedelic effects have subsided. We propose that processes underlying conferral of meaning and truth in psychedelic experiences may act as a double-edged sword: while these may drive important therapeutic benefits, they also raise important considerations regarding the validation and mediation of knowledge gained during these experiences. Specifically, the ability of psychedelics to induce noetic feelings of revelation may enhance the significance and attribution of reality to specific beliefs, worldviews, and apparent memories which might exacerbate the risk of iatrogenic complications that other psychotherapeutic approaches have historically faced, such as false memory syndrome. These considerations are timely, as the use of psychedelics is becoming increasingly mainstream, in an environment marked by the emergence of strong commercial interest for psychedelic therapy. We elaborate on these ethical challenges via three examples illustrating issues of validation and mediation in therapeutic, neo-shamanic and research contexts involving psychedelic use. Finally, we propose a pragmatic framework to attend to these challenges based on an ethical approach which considers the embeddedness of psychedelic experiences within larger historical and cultural contexts, their intersubjective character and the use of practices which we conceptualise here as forms of . This notion of goes beyond current approaches of and by stressing the central importance of validation practices based on by an experienced therapist or guide.
致幻剂的一个显著特点是,它们能够增加人们对所经历的特定内容和想法的真实性和意义的归因,而且这种影响可能会在致幻作用消退后持续很长时间。我们提出,在致幻体验中赋予意义和真理的过程可能是一把双刃剑:虽然这些过程可能带来重要的治疗益处,但它们也引发了一些重要的考虑因素,涉及到在这些体验中获得的知识的验证和调解。具体来说,致幻剂诱导启示性的认知感觉的能力可能会增强特定信仰、世界观和明显记忆的重要性和归因,这可能会加剧其他心理治疗方法历史上所面临的医源性并发症的风险,如虚假记忆综合征。这些考虑是及时的,因为致幻剂的使用越来越主流,而在这个环境中,强烈的商业利益对迷幻疗法的出现是有标志的。我们通过三个例子来说明治疗、新萨满教和研究背景下涉及致幻剂使用的验证和调解问题,详细阐述了这些伦理挑战。最后,我们提出了一个基于伦理方法的实用框架来应对这些挑战,该方法考虑到了迷幻体验在更大的历史和文化背景中的嵌入性、它们的主体间性以及我们在这里概念化为 的实践的使用。这种 的概念超越了当前的 和 的方法,强调了基于有经验的治疗师或指导者的验证实践的核心重要性。