How Psychedelic-Assisted Treatment Works in the Bayesian Brain
Frontiers in Psychiatry – March 08, 2022
Source: OpenAlex
Summary
Psychedelics are experiencing a Renaissance in clinical **Psychology**, offering promising **Psychological intervention**. Their unique synergy combines **Neurotransmitter Receptor Influence on Behavior** with **Psychotherapist** guidance. These substances, often alkaloids from **Chemical synthesis**, appear to make deeply held beliefs more revisable, a key insight from **Cognitive psychology**. This allows new input to be incorporated more readily. Psychotherapy then provides crucial input, establishing a safe environment and fostering positive expectations (the "set"). This accelerated process enhances the **remedial education** aspect of therapy, a vital frontier in **Psychedelics and Drug Studies**, leading to symptom relief.
Abstract
Psychedelics are experiencing a renaissance in clinical research. In recent years, an increasing number of studies on psychedelic-assisted treatment have been conducted. So far, the results are promising, suggesting that this new (or rather, rediscovered) form of therapy has great potential. One particular reason for that appears to be the synergistic combination of the pharmacological and psychotherapeutic interventions in psychedelic-assisted treatment. But how exactly do these two interventions complement each other? This paper provides the first account of the interaction between pharmacological and psychological effects in psychedelic-assisted treatment. Building on the relaxed beliefs under psychedelics (REBUS) hypothesis of Carhart-Harris and Friston and the contextual model of Wampold, it argues that psychedelics amplify the common factors and thereby the remedial effects of psychotherapy. More precisely, psychedelics are assumed to attenuate the precision of high-level predictions, making them more revisable by bottom-up input. Psychotherapy constitutes an important source of such input. At best, it signalizes a safe and supportive environment (cf. setting) and induces remedial expectations (cf. set). During treatment, these signals should become incorporated when high-level predictions are revised: a process that is hypothesized to occur as a matter of course in psychotherapy but to get reinforced and accelerated under psychedelics. Ultimately, these revisions should lead to a relief of symptoms.