A Neurocognitive Framework for Psychedelics as Learning Opportunities

Existing theories of psychedelics focus on their disruptive effects, but a new framework proposes that serotonergic psychedelics create learning opportunities by activating the orienting response via the noradrenergic system. This response, which naturally occurs only in compelling situations, disrupts ongoing processes to reorder attention toward salient stimuli, harnessing neural plasticity to generate adaptive behaviors through real-time learning. The perspective has implications for therapy, including preparation, set and setting, dosage, and outcome measurement, suggesting that a minimum effective dose may vary based on therapeutic learning goals. This approach could expand therapeutic possibilities and improve outcomes.

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Abstract

Existing neurocognitive theories have mainly concentrated on the disruptive aspects of psychedelics, such as cognitive disruption, cortical-thalamic filtering disturbances, and disordered/entropic brain states, but they fail to fully account for the emergence of new beneficial behaviors, responses, and insights. This paper proposes a novel framework that shifts the focus from the disruptive aspects of serotonergic psychedelics to their potential as learning opportunities via the engagement of basic neurobiological learning mechanisms. We propose that serotonergic psychedelics promote new beneficial outcomes by activating the orienting response, mediated by the noradrenergic system. The orienting response, which organically occurs only in response to highly compelling and biologically relevant circumstances, leads to psychological and neurophysiological features characteristic of serotonergic psychedelic states. Additionally, there is evidence demonstrating the impact of serotonergic psychedelics on both classic orienting behavior and noradrenergic functioning. The orienting response disrupts ongoing neurocognitive processes to re-order attentional resources according to what is salient in the moment, thus harnessing the plasticity of the nervous system to generate adaptive responses based on learning new associations in real time. Framing psychedelic states as learning opportunities has implications for various aspects of therapeutic practice, including preparation, set and setting, dosage, and outcome measurement. For example, a minimum effective dose might vary depending on therapeutically relevant learning goals. We propose that this perspective can expand the therapeutic possibilities for serotonergic psychedelics, ultimately improving the ability to facilitate positive therapeutic outcomes.