Developing Methods for Observing Awe Narration in Psilocybin-Assisted Therapy.
Healthcare (Basel, Switzerland) June 5, 2026 Elise C Tarbi, Ian Bhatia, Nabil Balach et al.
A direct observation coding system can reliably identify moments when people narrate experiences of awe during psychedelic-assisted therapy. In 32 video-recorded therapy sessions from a Phase 2 trial of psilocybin-assisted therapy for advanced cancer, two coders independently identified 246 moments of awe narration across 16,760 minutes. Coders were substantially more confident when vastness was present (odds ratio 4.3). The coding system was refined to split accommodation into two components: initial cognitive disruption and later engagement with that disruption. Awe narration is observable using explicit definitional criteria, providing a foundation for larger-scale studies.