Fischman, L.G. (2019). "Seeing without self: Discovering new meaning with psychedelic- assisted psychotherapy". Neuropsychoanalysis, 21 (2), 53-78.
<https://doi.org/10.1080/15294145.2019.1689528>
Psychedelic psychotherapy allows the patient, through the deactivation of defenses (in the mind) and the uncoupling of cortical structures (in the brain), to see/find new meaning in things; it is a transformative experience, a guided journey into the unconscious.
New research in psychedelic psychotherapy merits a re-examination of the neurobiology and phenomenology of psychedelic states. First-person accounts of psychedelic psychotherapy are used to reconceptualize the ego boundary as a defense mechanism that regulates the meaning that objects have for the self. The therapeutic action is attributed to the dissolution of the ego, which allows patients to see a new meaning in things. This process coincides neurobiologically with the uncoupling of certain midline cortical structures, and psychodynamically with the deactivation of defense mechanisms that mitigate the threat of losing the beloved object. It also allows for dream imagery, symbols and metaphor of the primary process, a regression to earlier ways of relating to objects, and feelings of love and connectedness. The process supports Freud's ideas about the oceanic way of relating to the world that exists alongside the narrower, more mature feeling of the ego. The former is more suited to finding meaning in life, while the latter is more suited to survival. The noetic quality of the psychedelic state derives from an unconscious recognition that experiences without character defenses feel more genuine than others, and conform to earlier ways of feeling and thinking. The accessibility of the primary process makes psychedelic psychotherapy transformative, not just informative. An analogy is drawn to Fonagy's model of mentalization development. Without the defensive, self-critical lens of a previous self-concept, psychedelic-assisted psychotherapy serves as an ideal paradigm for the transformative experience of seeing oneself through the eyes of another, leading to greater self-acceptance. Flight instructions for navigating this royal road to the unconscious are considered.
Nour, M.M., Evans, L., Nutt, D., & Carhart-Harris, R. (2016). "Ego-dissolution and psychedelics: Validation of the ego-dissolution inventory (EDI)". Frontiers in Human Neuroscience, 10:269
<https://doi.org/10.3389/fnhum.2016.00269>
Ego dissolution is a key element in the psychedelic experience. This study shows a positive relationship between the intensity of the psychedelic experience, ego dissolution and increased awareness, but also between ego dissolution and increased well-being.
The ego-dissolving effects of the psychedelic experience are transient, dose-dependent and, most importantly, intentionally sought, distinguishing them from psychosis (where such dissolution is neither sought nor desired, does not end in a timely manner and is generally terrifying) and from careless use.
Carhart-Harris, R.L., & Friston, K. J. (2010). "The default-mode, ego-functions and free- energy: A neurobiological account of Freudian ideas". Brain, 133(4), 1265-1283.
< https://doi.org/10.1093/brain/awq010>
Freud's conceptualizations of how the mind works have neurobiological foundations. This article demonstrates how Freud's descriptions of how the ego works are consistent with the functions of the Default Mode Network in the brain, a system that organizes and systematizes exchanges between brain systems, associated with the secondary process. In turn, the primary process, the most primitive mode of functioning, is consistent with the phenomenology and neurophysiology of REM sleep, psychotic states and states with hallucinogenic drugs.
This article explores the notion that Freudian constructs may have neurobiological substrates. Specifically, it is proposed that Freud's descriptions of primary and secondary processes are consistent with self-organized activity in hierarchical cortical systems and that his descriptions of the ego are consistent with default mode functions and their reciprocal exchanges with subordinate brain systems. This neurobiological explanation is based on a view of the brain as a hierarchical inference or Helmholtz machine. In this view, large-scale intrinsic networks occupy superordinate levels of hierarchical brain systems that attempt to optimize their representation of the sensory. This optimization is formulated to minimize free energy; a process formally similar to the treatment of energy in Freudian formulations. This synthesis is substantiated by showing that Freud's descriptions of the primary process are consistent with the phenomenology and neurophysiology of rapid eye movement sleep, the early and acute psychotic state, the aura of temporal lobe epilepsy and hallucinogenic drug states.
Carhart-Harris, R., Leech, R., Hellyer, P., Shanahan, M., Feilding, A., Tagliazucchi, E., Chialvo, D., & Nutt, D. (2014). "The entropic brain: A theory of conscious states informed by neuroimaging research with psychedelic drugs". Frontiers Human Neuroscience, 8, 20.
<https://doi.org/10.3389/fnhum.2014.00020>
Psychedelic drugs relax the deliberate control over thoughts (ego-) and increase, through a "bottom-up" process, the amount of sensory input received from the body, the brain/mind system and the outside world.
There is a marked increase in the brain's associative functions, as well as more sensory information reaching the neocortex. This rich variety of stimuli is noted as salient, causing the concerted breaking of old associative bonds and the emergence of new and unusual ones.
This happens in parallel with the dissolution of the ego, which neuroscientific research has shown is accompanied by altered dynamics in the Default Mode Network.
Entropy is a dimensionless quantity that is used to measure uncertainty about the state of a system, but it can also imply physical qualities, where high entropy is synonymous with high disorder. Entropy is applied here in the context of states of consciousness and their associated neurodynamics, with particular emphasis on the psychedelic state. The psychedelic state is considered an exemplar of a primitive or primary state of consciousness that preceded the development of modern, adult, human and normal waking consciousness. Based on neuroimaging data with psilocybin, a classic psychedelic drug, it is argued that the defining characteristic of "primal states" is the high entropy in certain aspects of brain function, such as the repertoire of functional connectivity motifs that form and fragment over time. In fact, since there is a larger repertoire of connectivity motifs in the psychedelic state than in normal waking consciousness, this implies that primary states can exhibit "criticality", i.e. the property of being positioned at a "critical" point, in a transition zone between order and disorder, where certain phenomena such as power law escalation appear. Furthermore, if primary states are critical, then this suggests that entropy is suppressed in normal waking consciousness, which means that the brain operates just below criticality. It is argued that this suppression of entropy provides normal waking consciousness with limited quality and associated metacognitive functions, including reality testing and self-awareness. It is also proposed that entry into primary states depends on a collapse of the normally highly organized activity within the resting mode network (DMN) and a dissociation between the DMN and the medial temporal lobes (which are normally significantly coupled). These hypotheses can be tested by examining brain activity and associated cognition in other candidate primary states, such as rapid eye movement (REM) sleep and early psychosis, and comparing them with non-primary states, such as normal waking consciousness and the anesthetized state.
Carhart-Harris, R., Friston, K.J., & Barker, E.L. (2019). "REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics". Pharmacological Reviews, 71(3), 316-344.
<https://doi.org/10.1124/pr.118.017160>
This document formulates the action of psychedelics by integrating the principle of free energy and the entropic brain hypothesis. This formulation is called relaxed beliefs under psychedelics (REBUS) and the anarchic brain, based on the principle that - through their anthropic effect on spontaneous cortical activity - psychedelics work to relax the accuracy of high-level antecedents or beliefs, thereby freeing up the flow of information from below, particularly through intrinsic sources such as the limbic system. We gather evidence for this model and show how it can explain a wide range of phenomena associated with the psychedelic experience. With regard to its potential therapeutic use, it is proposed that psychedelics work to relax the precision weighting of the over-weighted pathological antecedents underlying various expressions of mental illness. It is proposed that this process implies a heightened sensitivity of high-level antecedents to bottom-up signaling (from intrinsic sources), and that this heightened sensitivity allows for the potential review and weighting of overweighted antecedents. We end by discussing other implications of the model, such as the possibility that psychedelics may provoke the revision of other highly weighted high-level antecedents not directly related to mental health, such as those underlying partisan and/or overconfident political, religious and/or philosophical perspectives.
Gashi L, Sandberg S & Pedersen W. (2021). "Making "bad trips" good: How users of psychedelics narratively transform challenging trips into valuable experiences". International Journal of Drug Policy, 87, 102997.
<https://doi.org/10.1016/j.drugpo.2020.102997>
Within a safe, contained and creative therapeutic space, affective eruptions (what we might call catharsis or ab-reaction in psychoanalytic language) can lead to a transformative investigation into the nature of challenging or overwhelming experiences. This article studies the meaning of stories about bad trips among users of psychedelics. Drawing on narrative theory, it describes the characteristics of such stories and explores the work they do. Methods: In-depth qualitative interviews with 50 Norwegian users of psychedelics. Results: Almost all participants had frightening experiences when using psychedelics and many described them as bad trips. The key characteristic of a bad trip was a feeling of losing oneself or going crazy, or of ego dissolution. Most users said that these experiences could be avoided by following certain rules, based on tacit knowledge in the users' subcultures. Possessing such knowledge was part of a symbolic boundary work that distinguished between insiders and outsiders in the drug culture. Some also rejected the validity of the term bad trip altogether, arguing that such experiences reflected a lack of such competence. Finally, and most importantly, the majority of participants argued that unpleasant experiences during bad trips had been beneficial and had sometimes given them profound, life-altering existential insights. Conclusion: Bad travel experiences are common among users of psychedelics. Such experiences are often transformed into valuable experiences through storytelling. Bad trip narratives can be a powerful coping mechanism for substance users in uncontrolled environments, allowing them to make sense of frightening experiences and integrate them into their life stories. This type of storytelling, or narrative work, facilitates the continued use of psychedelics, even after unpleasant experiences with drugs.
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