Saturday, January 22, 2022

Attitudes to psychedelic therapy among people using mental health services




There has been increasing interest in the use of psychedelic drugs as a means for treating certain mental health conditions. For example, there is emerging evidence that psilocybin-assisted therapy may be of benefit in depression, although more trials with larger samples and better control/comparison conditions are required to provide a clearer picture.     

Of course, even if psilocybin is shown to be effective for ameliorating depression, will many people be reluctant to try it? One can imagine that some people with depression, battling the "demons" associated with trauma, may prefer to keep trying anti-depressants that lead to gradual reduction in depression over time, rather than a psychedelic drug recreational users use to induce an experience that alters one's perception of reality; some people may have an understandable fear of a "bad trip" or similar. 

recent article looks at attitudes towards the use of psychedelic drugs among mental health service users in Ireland. The researchers conducted a survey with 99 people, recruited via a psychiatric hospital and a community mental health service. It is interesting to see what the attitudes are among people who are engaging with mental health services, as opposed to a general population survey, where for many respondents, interventions for mental health is a more hypothetical idea, or something that "happens to other people".  

In this survey, a clear majority supported further research (72%). A slimmer majority (59%) supporting psilocybin as a medical treatment; a similar proportion (55%) said they would accept psychedelic drugs if recommended by their doctor, with 20% saying they would not accept them. A fifth of the respondents also said they viewed psychedelics as unsafe even under medical supervision. Although such concerns may be unfounded for some people who could benefit, it was concerning that a handful of people with conditions that could be exacerbated by psilocybin (e.g. psychosis) thought that psilocybin would be useful for them. Some participants reported they would be reluctant to come off existing medication in order to accept psilocybin therapy, given that some were satisfied with their current treatment, as well as the worries relating to previous history of addiction or the broad illegality of psilocybin.       

Perhaps unsurprisingly, the authors found that younger people (the mean age overall was 42) were more likely to have favourable attitudes towards the use of psilocybin; this was also the case for those with previous recreational experience of such drugs, as well as those who were less religious. Males had a higher lifetime rate of using psychedelics, although their attitudes towards therapeutic use did not seem to differ substantially from females. As the sample was not that large, we should be careful about drawing generalisations about how predictive different demographic characteristics will be about the acceptability of psychedelic drugs. Nonetheless, the overall results seem to suggest there is a willingness out there among people using mental health services to try psychedelic drugs if recommended by a clinician, but a substantial minority will be reluctant to do so.  

It should be emphasized that this work is looking at the controlled used of psychedelic drugs under medical supervision. Self-medication with psychedelic drugs (or other drugs, legal or otherwise) is not recommended. If you have concerns about your mental health, speak to your GP. A free listening service is provided by Samaritans for those experiencing mental health problems. Also, I think a lot of people don't realise that many workplaces offer complementary employment assistance programs that allow employees to avail of talk therapy.  


Corrigan, K., Haran, M., McCandliss, C., McManus, R., Cleary, S., Trant, R., ... & Kelly, J. R. (2021). Psychedelic perceptions: mental health service user attitudes to psilocybin therapy. Irish Journal of Medical Science (1971-), 1-13. https://doi.org/10.1007/s11845-021-02668-2

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Sunday, January 9, 2022

What we talk about when we talk about the past



Irish society has changed a lot over the last few decades. Along with more international changes like globalisation, the ubiquity of the internet etc., Ireland specifically has seen rapid economic growth as well as sea changes in social policy (e.g. going from criminalisation of homosexual activity at the start of 1990's to legalising gay marriage by a referendum in the 2010's). Even people in their forties and younger will recognise they live in a country that is different in many ways from the Ireland they lived when they were children (notwithstanding often high rates of emigration). As Fintan O'Toole (and others) put it, We don't know ourselves.

The autobiographical intersects with changes over society. Do you reckon that you were ahead of your time when looking back at how things used to be? Or do you remain nostalgic and wish things were more like the past? (It will depend, of course, on the subject or aspect of life). 

A recent chapter in a book on psychobiography followed on from an in-depth look I had with some collaborators from Maynooth University and DIT. The sense of self was not always so stable, and could be affected by changing economic circumstances-one individual mentioned she used to look forward to going away on a holiday for a long time, and would discuss it at length for long after, but would now (in more prosperous times) would get back from holidays and just wonder where she and her family would be going next. (I should say this was from before the COVID-19 pandemic!)

Besides actual changes, counterfactual descriptions of the past can be used to think through the value of different decisions. What if I had taken that job, or married that person? What if that politician hadn't been elected, or if most people had had the internet in the 1980's? These can often be tinged with regret that things could have worked better, with the benefit of hindsight.

People may alternate between a first-person description of autobiographical events and a broader third-person description more routed in the family, friends or society around them (people often use the second person as a generic person, "you'd want to think twice about that" can sometimes mean "one would want to think twice about that", rather than just the listener). The lines between the individual, inter-individual, cultural and societal can get blurred by language. Pre-autobiographical "memories" can have an instructive function when shared with younger relatives, to give a sense of continuing extended self with one's family. 

Indeed, there are various different functions that reminiscence about the past can play. A story from one's past can act as an instructive (perhaps cautionary) tale for a younger person going through a similar phase in life that one went through in the past. At other times, such a story may be used to demonstrate or think through how one's self has been formed over time, or to build rapport with someone by illustrating how two past lives were quite alike, or just for simple entertainment value.

How we talk about the past can vary in terms of the extent to which we situate ourselves in the events that have shaped our lives and our society (Note how I'm segueing into first-person plural here). We don't know ourselves, so we'll have to keep constructing them on the fly.


Allen, A. P., Doyle, C., Doyle, C. M., Monaghan, C., Fitzpatrick, N., & Roche, R. A. (2021). What we talk about when we talk about the past: Discursive psychological analysis of autobiographical reminiscence in older Irish adults. In Psychobiographical illustrations on meaning and identity in sociocultural contexts (pp. 327-344). Palgrave Macmillan, Cham.

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