DMT, Madness, and Healing: Psychosis Model, Therapy Model, and Their Relations to Mystical Experiences and Positive Emotionality
Abstract
<title>Abstract</title> <p> Paradoxically, psychedelics have long been used as models of both psychosis and therapy. After proposing mystical experiences as a link between these models for lysergic acid diethylamide (LSD), we aimed to extend and refine this framework for <italic>N,N</italic> -Dimethyltryptamine (DMT). In a randomised, placebo-controlled, double-blind, crossover study, 25 healthy participants received DMT (60mg) and an active placebo (0.6mg DMT), separated by two hours. Psychotic-like experiences were assessed via aberrant salience (Aberrant Salience Inventory [ASI]) and therapeutic-like experiences via suggestibility (Creative Imagination Scale [CIS]), including suggestion-induced mystical experiences. Psychedelic experiences were measured via the Six Dimensions and Eleven Factors of Altered States of Consciousness Questionnaire (6D-ASC and 11-ASC), Hallucinogen Rating Scale (HRS), and Mystical Experiences Questionnaire (MEQ). Compared to placebo, DMT increased all aberrant salience factors, most suggestibility modalities, including mystical experiences, and most 6D-ASC and HRS factors. Aberrant salience showed widespread correlations with psychedelic experiences, particularly mystical experiences (MEQ) and positive emotionality (e.g., Joyfulness [6D-ASC], Blissful State [11-ASC]). Suggestibility correlated with the same positive emotionality factors and inversely with negatively valenced aberrant salience (Heightened Emotionality [ASI]), emotionality (Dysphoria [HRS), and mystical experiences (Ineffability [MEQ]). In conclusion, DMT’s effects on aberrant salience and suggestibility support its role both as a psychosis and therapy model. The models’ link may be indirect with respect to mystical experiences, with emotionality playing a more crucial role. Importantly, suggestion-induced mystical experiences after DMT may suggest post-acute perceptual plasticity, informing the development of more tailored psychedelic treatments that induce, amplify, and guide therapeutic experiences. </p>
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