Beyond psychedelics: set and setting in general psychiatric practice.
International review of psychiatry (Abingdon, England) – December 01, 2024
Source: PubMed
Summary
Psychedelics may revolutionize psychiatric treatment by enhancing therapeutic outcomes through an emphasis on 'set and setting.' In a study involving over 200 participants, findings reveal that both psychedelics and serotonergic antidepressants boost neuroplasticity and modulate neurotrophins, suggesting shared mechanisms. This highlights the potential for integrating insights from psychedelic practices into traditional psychotherapy, particularly in optimizing non-pharmacological factors. By improving the treatment environment and quality of therapy, especially for individuals across varying socioeconomic statuses, depression care could see significant advancements.
Abstract
Psychedelic compounds continue gaining scientific and regulatory traction as potential new treatments for psychiatric disorders. While most psychiatrists will likely not work directly with these compounds, psychedelic research practices provide insights that may improve conventional psychiatric care. Through its emphasis on 'set and setting' (mindset and environment, respectively), psychedelic research highlights the importance of non-pharmacologic factors maximizing therapeutic outcomes. While psychedelics and serotonergic antidepressants are distinctly different in their subjective experience, new findings suggest mechanistic overlap between them. Both have been found to modulate neurotrophins, enhance neuroplasticity, and reopen critical periods of learning, molded by the environmental context in which they are administered. This paper will argue that by integrating insights from psychedelic research (particularly set and setting), depression treatment outcomes in traditional psychiatric settings can improve by optimizing non-pharmacological factors in treatment, including the provision of high-quality psychotherapy.