Psychotherapy assisted by psilocybin, the psychedelic compound in “magic mushrooms,” seems to be remarkably effective in treating a wide range of psychopathologies, but also causes a raft of unusual nonclinical changes not seen elsewhere in medicine.
Although its precise therapeutic mechanisms remain unclear, clinically relevant doses of psilocybin can induce powerful mystical experiences more commonly associated with extended periods of fasting, prayer or meditation.
Arguably, then, it is unsurprising that it can generate long-lasting changes in patients: studies report increased prosociality and aesthetic appreciation, plus robust shifts in personality, values and attitudes to life, even leading some atheists to find God. What’s more, these experiences appear to be a feature, rather than a bug, of psilocybin-assisted psychotherapy, with the intensity of the mystical experience correlating with the extent of clinical benefit.
These are undoubtedly interesting findings, but should any of it matter? However unusual a treatment’s consequences, shouldn’t we prioritize the preferences of an informed, consenting patient? Yes, I understand that this might change me in strange ways. But my depression is debilitating. I will roll that dice.
Putting aside the matter of how well-informed one could really be about such radical transformations, political realities make things more complicated, with the case of psilocybin— currently a Schedule 1, highly illicit drug—showing vividly how values, politics and social narratives can influence the development of biomedical science.