# Motivation and emotion/Book/2021/Psilocybin and spirituality

* Multimedia presentation (3 min)

## Overview

Psilocybin is a psychoactive alkaloid found in hallucinogenic mushrooms (see Figure 1) that can be ingested to facilitate a spiritual experience. It has a rich, cross-cultural history of use. The physiological effects on the brain relate to those of serotonin, involve brain connectivity changes and have a direct association with neuronal mechanisms. There are several psychological frameworks/theories useful for understanding how psilocybin can facilitate spiritual experiences. Reported emotional and spiritual benefits include unconstrained cognition and reported enhanced perception of significance, mood, positivity, and openness. Psilocybin has been used in therapeutic settings and the risks of adverse effects appear to be low.
This video provides a simple background on psilocybin, brings to life its effect on the brain, how it facilitates spiritual experiences and the risks.

## What is psilocybin?

Psilocybin is a psychoactive alkaloid found in hallucinogenic mushrooms that are commonly ingested for spiritual, religious, cultural, emotional, therapeutic, and recreational reasons (Tylš et al., 2014).
The psilocybin content of mushrooms varies across mushroom species and the literature does not provide an explicit dosage guide. Tys et al. (2014) stated that 15mg of oral pure psilocybin was a low dose, whilst over 25mg was a high but safe dose, whereas Griffiths et al. (2008) identified 30mg/70kg bodyweight as a high but safe dose. Future research should focus on creating a comprehensive guide.
Academic literature often refers to pure psilocybin amounts not grams of mushrooms. For example, 30mg of psilocybin is close to 5g of dried psychedelic mushrooms.
The effects vary upon dosage according to Tylš et al. (2014):
* Low doses cause some drowsiness and exacerbate current mood.
* Moderate doses induce a controllable altered state of consciousness
* High doses cause a powerful psychedelic experience.
Other common effects include hallucinations, a body tingling, altered self-perception, derealisation, distorted time perception, magical thinking, and various emotional changes such as anxiety, nervousness, laughter, and euphoria. Figure 2 shows an extreme example of potential distortions from a very high dose. The onset of effects is typically 20 to 40 minutes, with a maximum of 60 to 90 minutes. Effects persist for around 4 to 6 hours, with most gone after 6 to 8 hours.
Possession of psilocybin-containing mushrooms is illegal in many countries (Tylš et al., 2014).

## What are spiritual experiences?

[Provide more detail]

### Traditional spiritual experiences

Koenig and Harold (2008) discussed that spirituality was traditionally something experienced by followers of formal, structured religions. Many people still consider spirituality to be intertwined with traditional religion; however, perceptions appear to be changing, reflecting a very individually subjective concept.

### Modern spiritual experiences

Spirituality has become more broadly viewed as a concept of overall wellbeing, often not linked to religion. Spirituality has been a popular research topic, however there is dispute over a comprehensive definition.
Stace (1961) analysed the first-person accounts of spiritual experiences of people from a variety of religions. He defined seven universal elements of spiritual experiences:
* Diminished spatial and temporal awareness
* Diminished subjectivity (equivalent to increased objectivity)
* Feelings of profound joy and peace
* A sense of divinity
* Paradoxicality (where two opposing things appear to be true)
* Ineffability (the difficulty of expressing the experience in words)
* A sense of oneness with the world, otherwise known as "the unitive experience."
Koenig and Harold (2008) investigated how researchers have measured spirituality to find a common conceptualisation. They found the way measurement of spirituality has changed in academia reflects how it has grown to encompass the religion-seeking, those pondering religion/higher entities and meaning, and those seeking wellbeing and purpose. Spirituality is now seen to contain concepts like optimism, forgiveness, gratefulness, reflectiveness, and purpose.
This demonstrates that spirituality is now a broad, nebulous concept centred around emotion and wellbeing and individual perception. While being both subjective and broad makes spirituality challenging to define, it also demonstrates the breadth of its applications and relevance. Spirituality forms part of both formal religion and modern culture. It can have an impact on humans physiologically, psychologically, emotionally, and therapeutically.

## History of psilocybin facilitating spiritual experiences

This section overviews the historical use of psilocybin in facilitating spiritual experiences.

### Aztec, Mayan, and Incan psilocybin usage

Research shows that psilocybin and other psychoactive ethnobotanical substances were critical aspects of religion and spirituality in Aztec, Mayan, and Incan cultures. Nichols (2020) noted that South American Aztec Indians called psilocybin teonanacatl (God's flesh) and ingested it for religious/spiritual healing rituals. The Aztecs associated teonanacatl with the prince of flowers Xochipilli (see Figure 3), a god known for creativity, dancing, feasting, flowers, love, painting, pleasure, souls, and summer. Psilocybin was used in pre-Columbian Mesoamerican societies, according to Carod-Artal (2015). The shamans used it in spiritual ceremonies and the Aztec emperors in coronation ceremonies. Ancient works of art illustrated the intertwinement of psychedelics, religion, and spirituality. An ethnobotanical review of Aztec, Mayan, and Incan ritual medicine by Bolen (2020) found prominent use of psychoactive substances such as psilocybin (see Table 1).
Table 1. Different cultural psilocybin usage :
| Aztec | Psilocybin use was for spiritual rituals asking for wisdom and protection from the Gods, and recreationally to laugh and dance. |
| Mayan | Ethnobotanical tradition was centred around craftsmanship and scientific knowledge to present to the Gods. |
| Incan | Ethnobotanical tradition focused on reinforcing social structure; it helped leaders and spiritual healers see Incan citizens' health. |

### Modern history of psilocybin usage

Nichols (2020) noted that in the 1500s, Spanish missionaries tried to remove all evidence of psilocybin use by the Aztecs. However, a 16th-century Spanish Franciscan friar/historian discussed teonanacatl in his work. This inspired 20th-century ethnopharmacologists, leading to a 1957 magazine article about psilocybin. In the mid-twentieth century, its use became widespread in therapeutic and psychiatric pursuits. However, by the late 1960s and early 1970s, it had become associated with counterculture and controversies led to the discontinuation of research.

### 21st century psilocybin usage

Scientific interest re-emerged in the twenty-first century, with more results supporting psilocybin's therapeutic benefits. Nichols (2020) noted that psilocybin research resumed when clinical studies approved by the American Food and Drug Administration showed its possible medical and psychological potential. It is often used recreationally and for individualised, less-structured use than the more-structured, religious, historical use.

## Physiological effect of psilocybin on the brain

This section explores the research surrounding the physiological effects of psilocybin on the brain.

### Relationship to serotonin

Psilocin is the pharmacologically active metabolite of psilocybin. Its chemical structure is similar to serotonin, an essential mood-related hormone (James et al. 2020). Psilocin is also a functional agonist of specific serotonin receptors, a modifier of these receptors that can cause neuroplasticity and psychological adaption.

### Brain connectivity changes

The effect of psilocybin on the brain was analysed by Carhart-Harris et al. (2012). They used two types of Magnetic Resonance Imaging (MRI) to measure blood flow changes. MRIs were administered to 30 participants, half receiving each type of testing. Each participant was tested after psilocybin consumption and after placebo consumption. Results showed exponential changes in consciousness and thinking after psilocybin consumption. Only decreases in cerebral blood flow and oxygenation were found in the maximal hub regions such as the thalamus and anterior and posterior cingulate cortex (ACC and PCC). They consistently found decreased activity in the ACC/medial prefrontal cortex, a significant predictor of the strength of the subjective effect. Future studies could replicate this study but with spiritually and non-spiritually inclined participants to examine potential neurological differences. Figure 4 shows the significant differences in communication in the brain between people who have taken psilocybin (right) and those who have not (left).
Mertens et al. (2020) investigated whether psilocybin changed amygdala functional connectivity during face processing. MRI data showed decreased ventromedial prefrontal cortex-right amygdala functional connectivity during face processing. This demonstrates neural connectivity changes with response to fearful and neutral faces. A moderate psilocybin dose was administered to 12 participants in a study by Barret et al. (2020). Participants were assessed for emotional and neural effects 1-day before, 1-week after, and 1-month after administration. After 1-week, negative affect and amygdala response to facial affect stimuli decreased, and positive affect and dorsal lateral prefrontal and medial orbitofrontal cortex responses to emotionally challenging stimuli increased. After 1-month negative affect and amygdala response to facial affect stimuli returned to baseline. Positive affect stayed heightened, and trait anxiety lessened. Significant resting-state functional connections increased over time. The small sample size reduces generalisability of results. Future studies could include longer-term follow-ups to measure persistence of effects.

### Association with neuronal mechanisms

Kometer et al. (2015) analysed whether psilocybin-induced spiritual experiences were associated with neuronal mechanisms. They conducted a double-blind placebo-controlled study where 50 participants ingested a moderate dose of psilocybin. Electroencephalogram recordings were taken during eyes open and closed resting states. Results showed that psilocybin-induced spiritual experiences had a direct association with neuronal mechanisms[Provide more detail].

## Psychological theories and framework

This section provides a theoretical framework and psychological theories relevant for understanding how psilocybin facilitates spiritual experiences.

### James-Lange theory of emotion

The James-Lange theory states that emotional experiences are a bodily response following external stimulus (James 1884). This means that emotion comes from perceived bodily states and that awareness of bodily signals shows the intensity of emotion (see Figure 5).
This theory applies to psilocybin as ingesting the substance is the stimulus causing a physiological response which then impacts emotion (commonly euphoric and relating to facets of spirituality). However, Cannon (1927) offered criticisms of the James-Lange theory, such as physiological reactions not having a corresponding individual emotion. This is consistent with much of the literature reviewed that found people have different emotional experiences from psilocybin use, despite similar physiological reactions. Both the James-Lange theory and the criticisms of it may be useful in understanding the effects of psilocybin.

### Facial feedback hypothesis

The facial feedback hypothesis postulates that facial muscle movements, facial temperature changes, and glandular activity in facial skin have a causal relationship with emotion (Buck 1980). However, the effects were slight. Despite this, multiple studies reviewed by Barret et al. (2020) and Kometer et al. (2012) show support for psilocybin helping facilitate more positive facial affect and higher recognition of negative facial expression. This supports the facial feedback hypothesis being relevant to psilocybin's impact on emotion and spirituality.

### Complex appraisals framework

Lazarus and Folkman (1984) theorised a concept called complex appraisals. It is based around the way that people evaluate a situation/life event for personal relevance to wellbeing, then use different types of complex appraisals such as type of benefit, type of harm, and type of threat leading to a variety of emotions. Factors impacting appraisal can be personal relevance, goal congruence, and ego involvement. People continue to assess their perceived coping abilities, which impacts appraisal, which impacts the emotional outcome.
This can be applied to psilocybin facilitating spiritual experiences. Consumption of psilocybin can be considered as the life event/situation that involves a primary appraisal (what is at stake) that can affect psychological health and spirituality. They then have a secondary appraisal (coping potential appraisal) which assesses whether the psilocybin has potential for benefit, harm, or threat. This corresponds with the literature, which finds that psilocybin exacerbates the person’s current state of being. The framework depicts emotion as following personal motives such as goals and wellbeing. As a person’s appraisals and motives change, their emotions also change. This shows that their appraisal of psilocybin, and their coping potential will impact their experience. If they believe psilocybin will facilitate spiritual experiences and believe that they can cope with this, they could achieve a positive emotional experience.

### Quiz/scenario
## Emotional and spiritual benefits of psilocybin

This section explores psychological research into psilocybin facilitating spiritual experiences through its effect on enhancing positive emotions. It includes therapeutic uses for psilocybin.

### Enhanced positive emotions

The meaning-enhancing properties of psychedelics were investigated by Hartogsohn (2018). He emphasised how the enhanced perception of significance contributed to facilitating spiritual experiences, therapeutic processes, and creativity. Research supports this explanation of how psychedelics facilitate spiritual experiences. Future research should focus on the mechanisms psychedelics offer and analyse the specific correlation with spiritual outcomes. This would help enhance the understanding of whether people have spiritual experiences due to being spiritual or if psychedelics facilitate them.
Kometer et al. (2012) tested 17 participants on 4 separate days, administering a placebo, psilocybin, ketanserin, or psilocybin plus ketanserin. Mood was analysed with self-report measures, and behavioural and event-related measurements were utilised to quantify facial emotional recognition and goal-aimed behavior toward emotional cues. Psilocybin improved mood and recognition of negative facial expressions and increased goal-directedness. This highlights psilocybin’s value as a potential antidepressant and mood enhancer. As psychological wellbeing is commonly a measure of spirituality, this study supports the idea that psilocybin can enhance spiritual experiences.
Several studies demonstrated that psilocybin use could enhance positivity, making the brain more open to facilitating spiritual experiences. Mertens et al. (2020) investigated whether psilocybin changed amygdala functional connectivity. It found that there were connectivity changes with response to fearful and neutral faces. These results support other research claiming psilocybin helps emotional responsiveness neurologically and psychologically, helping therapy and positivity. Barret et al. (2020) tested the emotional and neural effects of psilocybin supporting emotional positivity, neuroplasticity, and therapeutic outcomes.
The study by Carhart-Harris et al. (2012) analysed the effect of psilocybin on the transition from standard consciousness. They found that subjective/emotional effects of psychedelics could cause a state of unconstrained cognition showing the euphoric and connected emotional states. This unconstrained cognition shows potential for how the brain could be more open to facilitating spiritual experiences. Carhart-Harris et al. (2014) reviewed theories to investigate spiritual experience and consciousness. They examined the history of psilocybin inducing spiritual experiences from shamanic healing ceremonies to modern experiments. They discussed Jung's theories of the collective consciousness (shared archetypes all humans have access to). Shared archetypes are frequently reported in intense psychedelic experiences and religious symbolism (Jung 2014). Stace (1961) described a unitive experience (a sense of connectedness) as the main component of spiritual/psychedelic experience. This is believed to lead to more openness to spiritual experiences such as feeling connected and a sense of meaning.

### Therapeutic uses

Modern definitions of spirituality are measured by components such as overall wellbeing, optimism, and openness to experience. These areas are all targeted therapeutically and could potentially benefit from the use of psilocybin.
James et al. (2020) conducted a narrative review on the literature of psilocybin occasioning mystical-type experiences and the implications for helping psychiatric conditions. They found benefits for anxiety, depression, addiction, and existential anxiety. These included improved psychological wellbeing and increased openness and spirituality. However, a stigma is associated with psilocybin which holds back beneficial clinical research/treatment. Furthermore, the cognitive and neural mechanisms are still not fully understood despite the therapeutic benefits, demonstrating the need for more clinical trials.
A smoking-cessation program involving 15 smokers was conducted by Johnson et al. (2017). Participants consumed psilocybin while undergoing four weekly preparatory meetings that used CBT, mindfulness, and guided imagery. At a 12-month follow-up, approximately 67% of participants stated that they stopped smoking due to psilocybin-induced spiritual experiences. The intervention was not specifically spiritual, however participants consistently claimed their experiences were spiritually significant. Future researchers could separately test the effectiveness of psilocybin and CBT methods for smoking-cessation effectiveness.

### Spiritual benefits example study

Griffiths et al. (2008) analysed long-term effects of high-dosage psilocybin use in a double-blind study. Participants included 36 adults who had not tried psychedelics and who self-reported as spiritual/religious. At the 14-month-follow-up, participants rated the experience as one of the five most personally meaningful and spiritual experiences of their life, with 64% claiming increased wellbeing/life satisfaction and 58% claiming a mystical, spiritual experience. While this is a small sample size, the results support spiritually inclined individuals successfully using psilocybin to facilitate a meaningful spiritual experience. Furthermore, these results implied that people who went into the experience with a particular emotional state enjoyed heightened results. For more detail, visit the original article.

## Risks in using psilocybin to facilitate spiritual experiences

Psilocybin has been found to have a low risk of adverse effects. The risk of addiction or substance dependence to psilocybin is low, and it has not been shown to cause cravings or withdrawals in humans (De Veen et al., 2017). Tylš et al. (2014) reviewed toxicological studies on psilocybin, finding it has very low toxicity. Psilocybin users did not appear to suffer from organ damage or somatic toxicity. They found that the main danger of psilocybin use was people mistaking toxic mushrooms (see Figure 6.) for the hallucinogenic variety. Tylš et al. (2014) also reviewed clinical studies on psilocybin, finding setting and personal expectations impacted the subjective effects. Individuals in a safe environment with an experienced intoxication guide (a trip-sitter) were more likely to enjoy their experience. People with psychotic episode predispositions were triggered more by hallucinogens. A quantitative textual analysis of 346 negative self-reports after psilocybin usage investigated potential adverse outcomes using factor analysis (Bienemann et al., 2020). Negative outcomes (bad trips) were typically perceived as caused by anxiety, a bad contextual environment, mixing with other substances, and high psilocybin dosages. Limitations of the study include the self-selection of participants with negative experiences. Quality control was an issue, given psilocybin was often illegal.

## Conclusion

Psilocybin is a psychoactive alkaloid found in hallucinogenic mushrooms. There is a long, culturally rich history of using psilocybin to facilitate spiritual experiences. The physiological effects of psilocybin on the brain relate to those of serotonin, involve brain connectivity changes and have a direct association with neuronal mechanisms. The James-Lange theory of emotion, the facial feedback hypothesis, and the complex appraisal framework provide a basis for understanding how psilocybin can facilitate spiritual experiences. Emotional and spiritual benefits of psilocybin include unconstrained cognition and enhanced perception of significance, mood, positivity, and openness. It appears to exacerbate existing emotions, so if someone is already spiritual and desires a spiritual experience, it can emphasise this. Psilocybin has a low risk of adverse effects and has had therapeutic success. Future studies on spirituality should attempt to operationalise the concept of spirituality, so measurement across studies is clear and generalisable. A standard psilocybin dosage guide should be developed. Future studies should aim to identify neurological differences between spiritually and non-spiritually inclined participants. Future researchers could further investigate the mechanisms and the longitudinal effects of psilocybin facilitating spiritual experiences.