Max Wolff

Are Psychedelic Experiences Just Brain Activity?

Bill reflects on a debate between Guy Goodwin and Max Wolff @trpwolff.bsky.social where it was suggested what people say about their experiences may be a kind of smokescreen and that the real explanation lies only in what is happening in the brain.

As a way of being a bit more active on here, I'll try to post some papers I have read each week + plus some opinions.
So let's start with February 9th-15th:

Berlin: 28.1. Trip auf Rezept? Zur Zukunft Psychedelika-assistierter Therapie.

Öffentliche Veranstaltung unseres Forschungsprojekts PSYCHEDELSI zu allerlei, auch nicht-medizinischen Themen.
psychedelsi.org

18 Uhr, Medizinhistorisches Museum der Charité.

Come along!

I'd love to!

The use of the psychological flexibility model to support psychedelic assisted therapy Psychedelic assisted therapy comprises three stages: Preparation, Psychedelic Session, and Integration. Preparation is key for maximising the potentia…

...tested psilocybin against escitalopram for depression. Whereas the main paper speaks of "psychological support", this paper on the same trial (by the lead therapist) describes an elaborate ACT-based psychotherapy & treats the drug as a psychotherapeutic tool: www.sciencedirect.com/science/arti...

...regulation (and written by PIs who are mostly not themselves involved as psychotherapists).

Secondary publications written by those who coordinate and/or provide the actual clinical work in those trials paint a very different picture.

Another example of this is the Psilodep 2 trial that...

Treatment with psychedelics is psychotherapy: beyond reductionism Treatment of psychiatric disorders with psychedelic substances represents one of the most promising current treatment approaches in psychiatry. Since its inception in the 1950s, therapy with psychedel...

It's the paper by Tai et al. that we refer to in these two commentaries (probably also of interest to you):

www.thelancet.com/journals/lan...

www.sciencedirect.com/science/arti...

Main outcomes papers typically misrepresent the psychotherapy component, presumably because they're relevant for...

Glad to see you classified the treatment tested by Goodwin et al. (2022) as psychotherapy rather than psychological support, although I'd say that's not only probably but in fact clearly the case, based on the paper describing the therapist training for that trial.

You mean "non-hallucinogenic psychedelic" as in "non-food bread"?

Unfortunately, the idea that repressed memories can & should be recovered in therapy is quite common in some traditions of therapy (e.g., "Internal Family Systems") that are popular among psychedelic practitioners, especially those who are not trained psychotherapists & operate in the underground.

@herzog.bsky.social @tkaiser.science this commentary is probably of interest to you

Lest we forget the Satanic Panic.

Questioning the recovery of dissociated traumatic memories under psilocybin: comment on “Therapeutic emergence of dissociated traumatic memories during psilocybin treatment for anorexia nervosa” - Journal of Eating Disorders In their recent case report article, Peck and colleagues suggested that two patients recovered dissociated traumatic memories during psilocybin treatment for anorexia nervosa. These case reports are of clinical and scientific interest and confirm that psychedelics may induce vivid memory-like experiences. However, the reports warrant scrutiny. Here, based on what is known about recovered memories and the effects of psychedelics, we argue that the authors may not have adequately considered alternative explanations. The cases do not necessarily demonstrate that psilocybin induces recovery of dissociated traumatic memories or could treat dissociative amnesia. We further caution against the authors’ suggestion of explicitly preparing patients for the emergence of forgotten material.

Critical commentary on a recent paper reporting emergence of dissociated traumatic memories during psilocybin treatment now out in the Journal of Eating Disorders, with @trpwolff.bsky.social, @manojdoss.bsky.social, Lilian Kloft-Heller, and @henryotgaar.bsky.social.

doi.org/10.1186/s403...

Thank you, Bjørn, looking forward to reading it. Very important topic!

A review covering our clinical experiences working with people experiencing peristent challenges after using psychedelics and the research literature. Might be of interest @philosojules.bsky.social @trpwolff.bsky.social @trpr-ucsf.bsky.social

www.psykologtidsskriftet.no/artikkel/202...

@eeschenberg.bsky.social

authors.elsevier.com/a/1m7M3bXYiy...

In this new commentary, @kangaslampi.bsky.social and I argue against viewing the psychedelic experience as a "biomarker" and challenge reductionistic drug-centered framings that obscure key psychosocial determinants of psychedelic therapy outcome, most notably psychotherapeutic processes.

LINK ⬇️

Pharmacodynamic biomarker or psychotherapeutic process? Comment on “the role of the psychedelic experience in psilocybin treatment for treatment-resistant depression”

Is the psychedelic experience a pharmacodynamic biomarker? Or do psychotherapeutic processes matter? Comment with @trpwolff.bsky.social on the recent Goodwin et al. (2025) paper now available online in the Journal of Affective Disorders: www.sciencedirect.com/science/arti...

Postdoctoral Fellowship Opportunity

We are looking for excellent MD Psychiatrist applicants to work & train at the CPCR at Johns Hopkins
@jhpsychedelics.bsky.social, the largest and most comprehensive psychedelic research program in the world.

Email Dr. Sandeep Nayak smn@jhmi.edu

Thank you, Lukas!

Finally got around to reading this great paper. A really insightful argument for treating psychedelic-assisted therapy as psychotherapy!

To those who dismiss psychodynamic therapy, and perhaps especially to those who dismiss anything except psychodynamic therapy, this article comes highly recommended:

psycnet.apa.org/doiLanding?d...

I've been saying that since I was 18, as I exited a Jimi Hendrix concert in Kansas City

psycnet.apa.org/fulltext/202...

New long-read theory paper in Psychological Review:

Im short, we propose that effective psychedelic therapy employs the uniquely context-dependent effects of psychedelic drugs to engage & augment the same psychological change processes that underlie all effective psychotherapies.

Full text below ⬇️

Psychedelic-assisted therapy as a complex intervention: implications for clinical trial design - S. D. Muthumaraswamy, M. J. Baggott, E. E. Schenberg, D. Repantis, M. Wolff, A. Forsyth, T. Noorani, 20... Psychedelic-assisted therapy (PAT) has typically been evaluated using conventional randomised controlled trials (RCTs), which assess treatment efficacy under hi...

journals.sagepub.com/doi/10.1177/...

Classical randomized controlled trials (RCTs) can't capture the complexity of psychedelic therapy.
In this new paper led by @sdmuthu.bsky.social and @tehseennoorani.bsky.social, we argue for pragmatic trials designs that accommodate this complexity and better align with real-world clinical practice.

No worries. At least my name is not misspelled in the actual paper like @sdmuthu.bsky.social's! Hope he can get that corrected.