Research on the therapeutic application of psychedelic serotonin 2A receptor agonists (such as LSD or psilocybin) constitutes a curious outlier in this regard, considering the strong emphasis it places on the role of psychological, social, and cultural context of administration–popularly known as ‘set and setting'–for attaining therapeutic success ( Leary et al., 1963 Hartogsohn, 2016 Hartogsohn, 2017 Carhart-Harris, 2018 Carhart-Harris et al., 2018b). The ‘biomedical revolution' of the 1970 and 80s led to an explosive infiltration of pharmaceutical interventions into psychiatric practice and the marginalization of previously favored psychodynamic approaches, consequentially inviting the charge that clinical psychopharmacology offers an atomized and decontextualized approach to mental illness, improving revenues rather than mental health outcomes or stigma ( Deacon, 2013 Kleinman, 1988 Kleinman and Cohen, 1991 Peele, 1981). A positive relationship between participants and facilitators, and the perceived impact of emotional support, facilitated the emergence of communitas.Ĭonclusion: Highlighting the importance of intersubjective experience, rapport, and emotional support for long-term outcomes of psychedelic use, this first quantitative examination of psychosocial factors in guided psychedelic settings is a significant step toward evidence-based benefit-maximization guidelines for collective psychedelic use. Path analyses revealed that the effect of ceremony-communitas on long-term outcomes was fully mediated by communitas experienced in reference to the retreat overall, and that the extent of personal sharing or ‘self-disclosure’ contributed to this process. Furthermore, communitas during ceremony was significantly correlated with increases in psychological wellbeing ( r = 0.22), social connectedness ( r = 0.25), and other salient mental health outcomes. Results: The adapted Communitas Scale demonstrated substantial internal consistency (Cronbach's alpha = 0.92) and construct validity in comparison with validated measures of intra-subjective (visual, mystical, challenging experiences questionnaires) and inter-subjective (perceived emotional synchrony, identity fusion) experiences. Using correlational and multiple regression (path) analyses, predictive relationships between psychosocial 'set and setting' variables, communitas, and long-term outcomes were explored. Demographics, psychological traits and state variables were assessed pre-ceremony, in addition to changes in psychological wellbeing and social connectedness from before to after the retreat, as primary outcomes. Methods: In this observational, web-based survey study, participants ( N = 886) were measured across five successive time-points: 2 weeks before, hours before, and the day after a psychedelic ceremony as well as the day after, and 4 weeks after leaving the ceremony location. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats. Nevertheless, current small-scale clinical and laboratory studies have tended to bypass a ubiquitous contextual feature of naturalistic psychedelic use: its social dimension. Historically and contemporarily, psychedelic studies have emphasized the importance of contextual elements ('set and setting') in modulating acute drug effects, and ultimately, influencing long-term outcomes. 3Centre for Complexity Science, Imperial College London, London, United Kingdomīackground: Recent years have seen a resurgence of research on the potential of psychedelic substances to treat addictive and mood disorders.2Data Science Institute, Imperial College London, London, United Kingdom.
1Centre for Psychedelic Research, Department of Brain Sciences, Imperial College London, London, United Kingdom.
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