Role of Psychedelics in Psychology

The functional use of psychedelics as a treatment modality for mental illness is a controversial topic in the scientific community. This controversy is due, in part, to the history of psychedelics which first began with substances which were known to be “consciousness expanding”Harman, W. W. (1963). Some Aspects of the Psychedelic-Drug Controversy. Journal of Humanistic Psychology, 3(2), 93–107. https://doi.org/10.1177/002216786300300209 . The widely known members of the schdeule-one, psychadelic drug category like DMT, LSD, and psilocybin have been used in spiritual practices throughout the centuries . Despite the social and religious implications centered around the use of these mostly illegal substances, psychedelic drugs are receiving renewed attention for their possible efficacy in treating a variety of neuropsychiatric disorders .  
Mood disorders are often accompanied by cognitive dysfunction and cognitive rigidity. Recent studies show that psylocibin may have neuropsychoplastogenic effects which may help people with major depressive disorder (MDD) Doss, M.K., Považan, M., Rosenberg, M.D. et al. Psilocybin therapy increases cognitive and neural flexibility in patients with major depressive disorder. Transl Psychiatry 11, 574 (2021). https://doi.org/10.1038/s41398-021-01706-y . Impairments in cognitive flexibility have been found in obsessive-compulsive disorder and depression . Psylocibin has an acute effect on 5-HT2A receptors which appear to have enduring antidepressant qualities. These are shown to potentially be as effective as traditional medications for MDD . The circuit-level mechanisms of psylocibin are still unknown, but studies have shown it induces widespread dysregulation of cortical activity which is thought to be the contributing factor to cognitive flexibility #Frederick S. Barrett, Samuel R. Krimmel, Roland R. Griffiths, David A. Seminowicz, Brian N. Mathur,
Psilocybin acutely alters the functional connectivity of the claustrum with brain networks that support perception, memory, and attention, 
NeuroImage, Volume 218, 2020, 116980, ISSN 1053-8119, https://doi.org/10.1016/j.neuroimage.2020.116980 . To better understand the circuitry of psylocibin, we take a closer look at the effects on the claustrum function on the cerebral cortex. The claustrum was once thought to be the seat of consciousness; we now know it’s a thin sheet of gray matter that reaches out to every other region in the brain, expresses 5-HT2A receptors, and provides glutamatergic inputs . The results have shown both the default mode network and areas of the brain believed to be responsible for setting attention and switching tasks may be disrupted by the intake of psylocibin. Alterations in the claustrum may account for these changes . 
== Ethics and Psychedelics ==
As the popularity and demand continues to rise, mental health professionals have an ethical duty to meet the need for providing support for clients interested in using psychedelics as a treatment modality. A research article by Brian Pilecki et.al. studies ethical and legal issues in psychedelic harm reduction in psychedelic-assisted therapy Pilecki, B., Luoma, J.B., Bathje, G.J. et al. Ethical and legal issues in psychedelic harm reduction and integration therapy. Harm Reduct J 18, 40 (2021). https://doi.org/10.1186/s12954-021-00489-1. Therapists trained in a useful framework for conducting therapy for clients using psychedelics may help minimize risks and maximize benefits . Assessing risk is tricky since the potential risks of psychedelics comes from the first wave of research and experimentation in the 1950’s, 1960’s, and 1970’s that would not meet the scientific and ethical standards we have today Noorani, T. (2020). Making psychedelics into medicines: The politics and paradoxes of medicalization, Journal of Psychedelic Studies, 4(1), 34-39. Retrieved Dec 5, 2021, from https://akjournals.com/view/journals/2054/4/1/article-p34.xml . Psychiatric disorders like schizophrenia are similar to psychedelics due to cortex overactivation during hallucinations which may resemble some of the core symptoms of schizophrenia Pantelis Leptourgos, Martin Fortier-Davy, Robin Carhart-Harris, Philip R Corlett, David Dupuis, Adam L Halberstadt, Michael Kometer, Eva Kozakova, Frank LarØi, Tehseen N Noorani, Katrin H Preller, Flavie Waters, Yuliya Zaytseva, Renaud Jardri, Hallucinations Under Psychedelics and in the Schizophrenia Spectrum: An Interdisciplinary and Multiscale Comparison, Schizophrenia Bulletin, Volume 46, Issue 6, November 2020, Pages 1396–1408, https://doi.org/10.1093/schbul/sbaa117 . However, there needs to be more research on the synaptic and network mechanisms to determine if differences of where the hallucinations originate .  
Mental health professionals should move towards equity and inclusion in the psychedelic movement and how it may affect neurodivergent and diverse populations. The current representation for the psychedelic movement is mostly encompassed by White males and is lacking cultural and gender diversity Persad, I. (2010). Seeking a Kaleidoscopic Lens: A Holistic Analysis of the Psychedelic Field (Doctoral dissertation).. Given that psychedelics have been a part of indigenous traditions for centuries, the shift in representation is alarming. Equity and inclusion are not only considering neurodiversity, but it also means creating representation for Black, Latinx, Native, Asian/Pacific Islander, LGBTQIA+, documented and undocumented immigrants, people with disabilities, and women . The potential of psychedelic research is exciting and changing the world of psychology. There are still many unknowns to be explored to ensure safe and ethical integration of these substances into society.
== Psychedelics and Default Mode Network ==
Psychiatric doctor and ayahuasca researcher Simon Ruffell compared the effects of psychedelics on the DMN to “defragmenting a computer.” When you ingest a psychedelic, activity of the DMN is significantly decreased while connectivity in the rest of the brain increases Netzband, N., Ruffell, S., Linton, S., Tsang, W. F., & Wolff, T. (2020). Modulatory effects of ayahuasca on personality structure in a traditional framework. Psychopharmacology, 237(10), 3161-3171. .  As a result the sense of self appears to temporarily shut down, and thus ruminations may decrease. The brain states observed show similarities to deep meditative states, in which increased activity occurs in pathways that do not normally communicate. This process has been compared to defragmenting a computer. Following this, it appears that the default mode network becomes more cohesive . Due to psychedelics’ ability to disrupt the activity of the DMN, they have a particularly strong therapeutic potential when it comes to changing negative thought patterns Carhart-Harris, R. L., Muthukumaraswamy, S., Roseman, L., Kaelen, M., Droog, W., Murphy, K., ... & Nutt, D. J. (2016). Neural correlates of the LSD experience revealed by multimodal neuroimaging. Proceedings of the National Academy of Sciences, 113(17), 4853-4858. . A study by Imperical College London assessed the impact of psilocybin-assisted therapy on patients with severe depression. Results demonstrated that psilocybin-assisted therapy was able to dramatically reduce their depression scores for a period of up to three months .  
In general, it has been shown that psychedelics produce increases in psychological flexibility, positing another explanation for why we see decreases in depression and anxiety following a psychedelic experience Davis, A. K., Barrett, F. S., & Griffiths, R. R. (2020). Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. Journal of contextual behavioral science, 15, 39-45. Based on what is known about the DMN, it could play an influential role in one’s ability to be psychologically flexible. That is to say that open, freer conversations begin to take place between brain regions that are normally kept separate . Default Mode Network Activity in Psychopathology.
Further Readings
Reiff, C. M., Richman, E. E., Nemeroff, C. B., Carpenter, L. L., Widge, A. S., Rodriguez, C. I., Kalin, N. H., & McDonald, W. M. (2020). Psychedelics and psychedelic-assisted psychotherapy. American Journal of Psychiatry, 177(5), 391–410. https://doi.org/10.1176/appi.ajp.2019.19010035 
Reiff, C. M., Richman, E. E., Nemeroff, C. B., Carpenter, L. L., Widge, A. S., Rodriguez, C. I., Kalin, N. H., & McDonald, W. M. (2020). Psychedelics and psychedelic-assisted psychotherapy. American Journal of Psychiatry, 177(5), 391–410. https://doi.org/10.1176/appi.ajp.2019.19010035 
Schenberg, E. E. (2018). Psychedelic-assisted psychotherapy: A paradigm shift in psychiatric research and development. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.00733 
References
Category:Psychedelics
Category:Psychology