A role for psychedelics in psychiatry?

I read with interest the editorial ‘Can psychedelics have a role in psychiatry once again?’ (Sessa, 2005). Aside from overcoming current legislative barriers, attention needs to be given to education about known research into this field, a function which this editorial usefully starts to fulfil.

The concern remains that the image of psychedelics was not shaped by the already existing extensive professional literature, but by the mass media sensationalising the accidents of unsupervised self-experimentation (Grof, 2001). It could therefore be surmised that decisive influences will be a variety of political, legal, economic and mass–psychological factors, rather than the results of current and ongoing scientific research. Interest from the psychiatric community will be paramount if this research information is to be critically reviewed with a view to clinical application.

The difference between psychedelics (entheogens) and other psychotropic drugs is that entheogens work as ‘non-specific amplifiers of the psyche’, inducing an altered or non-ordinary state of consciousness (Grof, 2000). The content and nature of the experiences are not thought to be artificial products of their pharmacological interaction with the brain (‘toxic psychoses’) but authentic expressions of the psyche revealing its functioning on levels not ordinarily available for observation and study. In order to conceptualise this, a vastly extended cartography of the psyche (Grof, 2000), one which challenges our biomedical psychiatric model, is required.

Within psychiatry, entheogenic substances (one of several methods of inducing a non-ordinary state of consciousness) could contribute to a powerful form of experiential psychotherapy; an important addition to a psychiatric armamentarium, working with domains of the psyche traditionally ignored in our ethnocentric Western model (Schlitz et al, 2005).

Potential credence for this field depends upon whether we view all non-ordinary states of consciousness as pathological or whether in some cases, some ‘psychotic’ experiences can be seen to have potential value as well as being potentially damaging. There is ongoing interest among mental health professionals in the concept of spiritual emergence as well as the therapeutic power of altered states of consciousness, the subject of a recent 1 day meeting held jointly with the Royal College of Psychiatrists and the Royal Society of Medicine (http://www.rcpsych.ac.uk/college/sig/spirit/index.asp). I would certainly value a continuing debate exploring this area.