From the open access journal, Frontiers in Psychology: Psychology for Clinical Settings, this is an interesting review article suggesting grounded cognition as the foundation for the mind-body relationship in psychotherapy.

I get that the mainstream is still far behind the leading edge on understanding the mind, but for me, when someone talks about the "mind-body relationship," it's clear that they don't get that the body (including, of course, the brain) IS the mind, or at least part of it (mind is also the relational context to other people, environment, and temporal space).

Anyway, this is an article definitely worth a quick read.


Full Citation: 
Leitan, ND, and Murray, G. (2014, May 20). The mind–body relationship in psychotherapy: grounded cognition as an explanatory framework. Frontiers in Psychology: Psychology for Clinical Settings; 5:472. doi: 10.3389/fpsyg.2014.00472

The mind–body relationship in psychotherapy: Grounded cognition as an explanatory framework

Nuwan D. Leitan and Greg Murray
Department of Psychological Sciences and Statistics, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia

Abstract

As a discipline, psychology is defined by its location in the ambiguous space between mind and body, but theories underpinning the application of psychology in psychotherapy are largely silent on this fundamental metaphysical issue. This is a remarkable state of affairs, given that psychotherapy is typically a real-time meeting between two embodied agents, with the goal of facilitating behavior change in one party. The overarching aim of this paper is to problematize the mind–body relationship in psychotherapy in the service of encouraging advances in theory and practice. The paper briefly explores various psychotherapeutic approaches to help explicate relationships between mind and body from these perspectives. Themes arising from this analysis include a tendency toward dualism (separation of mind and body from the conceptualization of human functioning), exclusivism (elimination of either mind or body from the conceptualization of human functioning), or mind–body monism (conceptualization of mind and body as a single, holistic system). We conclude that the literature, as a whole, does not demonstrate consensus, regarding the relationship between mind and body in psychotherapy. We then introduce a contemporary, holistic, psychological conceptualization of the relationship between mind and body, and argue for its potential utility as an organizing framework for psychotherapeutic theory and practice. The holistic approach we explore, “grounded cognition,” arises from a long philosophical tradition, is influential in current cognitive science, and presents a coherent empirically testable framework integrating subjective and objective perspectives. Finally, we demonstrate how this “grounded cognition” perspective might lead to advances in the theory and practice of psychotherapy.

Introduction

As a discipline, psychological science is “mounted above the philosophical gap between mind and body” (Tschacher and Haken, 2007, p. 1). The inherent challenges of this position are clearly seen in psychology’s primary application, psychotherapy (the use of psychological science to improve mental health and wellbeing). The theoretical foundation of psychopathology (the study of the nature and treatment of mental disorders) has been described as akin to that of biology’s before Darwin (Frances and Egger, 1999), and arguably, the elephant in the room is the lack of consensus, both implicit, and explicit, about the relationship between mind and body (Kendler, 2008). Whether expressed as human versus natural sciences, hermeneutic versus positivist methods, or understanding versus explanation, Cartesian or substance dualism (mind and body are two types of substance) is yet to be resolved in psychopathology and psychotherapy. The field is consequently characterized by polarized schools of thought, identifying it as an immature science in Kuhnian terms (Kuhn, 1962).

In the absence of a consensus position on the mind–body relationship, psychotherapists juggle tangible and intangible features of their clients without integrative models (Murray, 2011). It is noteworthy that international guidelines for psychology training programs rarely require a competency around this ontological issue, suggesting that the discipline may have relegated it to the “too hard” basket. Contemporary research across multiple disciplines, however, suggests that the case should be re-opened.

Recent research in philosophy (Clark, 1997; Lakoff and Johnson, 1999), cognitive science (Brooks, 1991; Chemero, 2009) and psychology itself (Barsalou, 1999; Glenberg and Robertson, 1999) advocates a fundamental reappraisal of the relationship between mind and body. The “embodied cognition” research program has many strands, but all commence with a rejection of the dualistic separation of body and mind (Shapiro, 2011). Here, we propose grounded cognition as an embodied, psychological framework which provides a holistic conceptualization of body and mind. It is our position that articulating the relationship between body and mind from a psychological perspective will provide a consensus position and an organizing framework for the mind–body relationship for psychotherapy research and practice. We contend that this will encourage practitioners to reflect on their assumptions about cognitions and how they conceptualize body and mind in treatment, leading to a better understanding of the tensions between psychotherapy theory and practice and the identification of gaps in existing therapies and consequently an expansion of the range of therapies offered to the patient.

The paper is structured in four sections. First, we briefly consider a range of approaches to psychotherapy through the lens of their apparent assumptions about mind–body. Themes arising from this analysis include a tendency toward an uncritical dualism (separation of mind and body from the conceptualization of human functioning), exclusivism (elimination of either mind or body from the conceptualization of human functioning), or mind–body monism (conceptualization of mind and body as a single, holistic system) and we conclude that the psychotherapy literature, as a whole, does not demonstrate consensus, regarding the relationship between mind and body. We propose that an organizing framework for the mind–body relationship, underpinned by a holistic conceptualization of the relationship, would benefit psychotherapy research and practice. Second, philosophical accounts which portray a holistic mind–body relationship from phenomenological and objective perspectives are outlined. Third, we propose that these perspectives are integrated, psychologically, by “grounded cognition,” constituting a comprehensively articulated, empirically informed, organizing framework for conceptualization of the mind–body relationship in psychotherapy. In the final section we consider how the application of psychological science in psychotherapy might advance through a thoroughgoing consideration of “grounded cognition.”

Mind–Body Assumptions Underlying Current Psychotherapies

There is no agreed taxonomy of psychological therapies (e.g., Kahl et al., 2012; Tschacher et al., 2014), but to achieve an adequate coverage of existing approaches for the present purposes, we categorise psychotherapies into five fuzzy-bordered groups: psychoanalysis, behavioral therapies, cognitive therapies, mindfulness-based therapies, and body psychotherapies. Each of these has many branches and extensive literatures – thus, in this brief review we aim only to explore different ideas regarding the relationship between mind and body from within each approach, and across approaches, rather than attempting to assign particular conceptualizations of the mind–body relationship to particular approaches.

Psychoanalysis

Although psychoanalytic theory and practice have fallen out of favor in contemporary psychological science, aspects of Freud’s thinking can still be discerned in current psychotherapy (Dowd, 2004). An important aspect of psychoanalytic theory is the “cognitive unconscious,” or the “unconscious mind.” In opposition to the popular enlightenment view at the time, Freud argued that behavior is driven by unconscious motivations and drives, rather than rational choice (Luborsky et al., 2008; Wolitzky, 2011). As discussed by Luborsky et al. (2008), central therapeutic strategies of psychoanalysis include free association (expressing any thoughts which come to mind during therapy), therapeutic listening and responding (examining the content and emotion of thought), and interpretation (drawing inferences about unconscious underpinnings of conscious experience).

However, the body also figures strongly in psychoanalytic theory. For Freud, structures of the mind (e.g., id, ego, superego) arise out of tensions between the organism’s bodily drives and societal structures (Muller and Tillman, 2007). This is reflected in the psychoanalytic conception of psychosomatic illness, which was the idea that emotions and unconscious desires caused bodily symptoms; for example Gregor Groddeck, a psychoanalyst who developed Freud’s ideas about psychosomatic illness proposed that a tumorous abdominal growth could result from a warded-off unconscious wish to be pregnant. Furthermore it has been suggested that the “ego,” in psychoanalysis, commences as an embodied entity, and emphasizes the continuity between animals and humans, suggesting a monist, or holistic mind–body conceptualization (Muller and Tillman, 2007).

Behavior Therapy

Traditional behavior therapy arose in an American setting in the early 1950s and saw a shift from the psychoanalytical ideas of studying the mind to the pragmatic, evidence-based study of behavior (Dowd, 2004). This shift was triggered by J. B. Watson’s criticism of subjectivity and mentalism as the subject matter of psychology and his advocacy of the objective study of behavior. This was followed by the advent of “modern learning theory,” which referred to the principles of classical and operant conditioning. These early ideas underlying traditional behavior therapy were exclusivist, rejecting the notion of mind and cognition, on the grounds that they are unobservable entities and therefore unfit for scientific study (Wilson, 2008; Zinbarg and Griffith, 2008).

However, later theories stemming from behaviorism developed a more complex account of the mind–body relationship. For example, Bandura (1977) spoke of a reciprocal determination between behavior and the environment, stating that “it is largely through their actions that people produce the environmental conditions that affect their behavior in a reciprocal fashion” (p. 345). Bandura also seemed to encourage conceptualization of the mind as a part of the same system as behavior and environment, for example, “…experiences generated by behavior also partly determine what individuals think, expect, and can do, which in turn affects their subsequent behavior” (p. 345).

This holistic conceptualization of the mind–body relationship is also apparent in popular behavior therapies for children with autism spectrum disorder, such as music therapy, Floortime, rhythm therapy, and reciprocal imitation training which are broadly underpinned by behavioral and functional developmental approaches (Greenspan and Wieder, 1999; Ingersoll and Schreibman, 2006; Overy, 2008; Vismara and Rogers, 2010; Srinivasan and Bhat, 2013). For example, reciprocal imitation training teaches children the spontaneous social use of imitation, which as targeted at attention, language and communication cognitions (Ingersoll and Schreibman, 2006) and Floortime utilizes child-led playful interactions, experiential problem-solving interactions and motor, sensory and spatial play, which is targeted at language and other cognitive skills (Greenspan and Weider, 1997).

Cognitive Therapy

With the advent of the cognitive revolution, pure behavioral therapies begun to fade out in favor of cognitive therapies, which followed the prominent model of human functioning at the time; computational theory (Hayes et al., 1999). Computational theory conceptualized the body as an “input-output device,” or the “hardware,” and the mind as the “central processor,” the “software,” or the “controller” (Shapiro, 2007). Due to their concurrent rise, articulation of the relationship between mind and body in cognitive therapy has been influenced by this computational perspective (Dowd, 2004).

Cognitive therapies are defined by their elevation of the cognitive system in the adjustment of information processing and initiation of positive change (Beck and Weishaar, 2008). This perspective is fundamental to a family of theories underpinning cognitive therapy, including those of Ellis (1962) and Beck (1967). Beck’s (1967) cognitive theory remains one of the most influential to this day, in particular his major contribution to cognitive therapy, the cognitive model (Triad) of depression. This model suggests that depression is underpinned by automatic, negative thoughts about the self, others and the world. Beck contends that these negative cognitions also activate negative motivational, behavioral, emotional, and physical symptoms (Beck and Weishaar, 2008). Thus, for Beck and his contemporaries, it is implied that the mind should be the primary target of psychotherapy.

One of Ellis’ major contributions to cognitive therapy was the A-B-C method used in his rational emotive behavior therapy (REBT). The A-B-C method challenged the assumption that when a consequence (C) follows and activating event (A), A causes C. Ellis posited a cognitive construct, beliefs (B), which he argued was the greatest determinate of (C). Thus, the idea was that (C) could be modified by (B), even if (A) remains stable (Dowd, 2004; Ellis, 2008). Ellis’ REBT explicitly considered the importance of content of the “mind” (i.e., thinking, feeling, wanting etc.), and of operations of the “body” (i.e., behavior). However, the relationship between mind and body was conceptualized in terms of cognitive modification to change behavior or behavior change to modify thought (Ellis, 2008). Thus, despite acknowledgment of both mind and body, REBT, akin to Beck’s cognitive therapy, implies a dualist conception of their relationship.

Mindfulness-Based Psychotherapies

Recently, there has been an influx of so-called “third wave” psychotherapies which have their roots in learning theory and are held together by their subordination of content-oriented cognitive interventions (Kahl et al., 2012). One of the key features of some of these psychotherapies (e.g., Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy etc.) is their focus on “mindfulness.” One of the features of mindfulness as applied in psychological therapies is to develop an awareness of the present experience by self-regulating attention to momentary sensations, thoughts, and feelings (Keng et al., 2011). Thus, in contrast to standard cognitive and behavioral therapies, one of the aims of mindfulness-based psychotherapies is to increase awareness of the body.

Awareness is contrasted with “thinking” during mindfulness exercises such as breathing meditation (Michalak et al., 2012). Awareness is not about cognition but more about feeling; and the body is seen as the reference point for awareness. Thus changes in cognitions (e.g., restricting rumination) following mindfulness practices are bought about by becoming more aware of the body, without referring to cognitive dominion (i.e., conscious thought) to bring about this awareness (Burg and Michalak, 2011). It is difficult to articulate the relationship between mind and body implied by mindfulness-based psychotherapies due to two reasons. First, awareness is not conceptualized as a cognitive feature, but may still be a feature of the “mind.” Second, the body is not conceptualized as a physical agent of change like behavior is assumed to influence cognition in cognitive behavior therapy (CBT); rather it is awareness of the body which is the agent of change in mindfulness-based therapies. These questions illustrate some of the issues which arise when dualistic thinking is reflected upon carefully.

Body Psychotherapy

Body psychotherapy (BP) refers to a variety of schools (e.g., dance/movement therapy, analytical body psychotherapy, concentrative movement therapy etc.) which share the aim of enhancing self-awareness, modifying behavior, and facilitating insight-oriented psychological problem solving via a mode of action concerning perceptive/self-awareness, affective-cathartic, interactive, and/or movement oriented therapy (Röhricht, 2009). Although, there have been randomized controlled trials (RCTs) conducted for some schools of body psychotherapies, they are not empirically supported to the same extent that cognitive and behavioral therapies have been (Röhricht, 2009). In practice, BP primarily works on releasing and re-shaping somatic memories in order to release associated psychological constraints (Totton, 2003). The theoretical foundation for BP has been explained as the way “core beliefs are embodied, and that until we begin to experience the pain held in them directly through our bodies they will continue to run our lives” (Staunton, 2002, p. 4).

The practice of BP implies a very close relationship between body and mind, to the point that they are seemingly undifferentiated during therapy. BP has been described as being fundamentally underpinned by an explicit theory of mind–body functioning which assumes a functional unity between body and mind in which there is no separation or hierarchical relationship between the two (www.eabp.org).

Summary

This brief review exposes a lack of consensus, both implicit and explicit, regarding the mind–body relationship across psychotherapeutic approaches. Themes arising from this analysis include a tendency toward dualism (separation of mind and body from the conceptualization of human functioning), exclusivism (elimination of either mind or body from the conceptualization of human functioning), or mind–body monism (conceptualization of mind and body as a single, holistic system). It is our position that psychotherapeutic research and practice would benefit from an organizing framework for the mind–body relationship, which could be applied across all psychotherapies. Recent research in philosophy (Clark, 1997; Lakoff and Johnson, 1999), cognitive science (Brooks, 1991; Chemero, 2009) and psychology itself (Barsalou, 1999; Glenberg and Robertson, 1999) suggests that this framework should be underpinned by a holistic conceptualization of the mind–body relationship.

Embodied cognition offers a psychological framework underpinned by a holistic conceptualisation of the mind–body relationship. Some of the abovementioned psychotherapies which have implied a holistic mind–body perspective have already started to draw on embodied cognition and related ideas. For example, Totton (2009) has recently highlighted the utility of drawing on embodiment from a social perspective to enhance the practice of body psychotherapy, while Michalak et al. (2012) has described how embodied cognition could describe some of the processes involved in mindfulness. Before describing the psychological framework of embodied cognition, it is important to briefly examine its philosophical underpinnings which form the foundation for its conceptualisation of a holistic mind–body relationship, from both phenomenological and objective perspectives.

Holistic Mind–Body Philosophies

Merleau-Ponty’s Lived-Body

Edmund Husserl developed the philosophical approach of phenomenology as a reaction to his concern that the assumptions of naturalistic, Western science about the nature of the mind, body, and world had caused it to miss fundamental questions about human nature (Marcum, 2004). He argued that primary consideration should be given to the subject’s experience in the world, before studying the mind, body, and world objectively (Marcum, 2004; Gallagher and Zahavi, 2007). Husserl’s argument was progressed by Merleau-Ponty, who proposed that this would both uncover the subjective element of knowledge, which was being overlooked by naturalistic sciences, and provide a stronger framework for its enquiries (Gallagher and Zahavi, 2007). Thus, phenomenology does not provide a mechanistic account of mind in the vein of naturalism, or psychological and biological accounts because it focuses on giving a proper description of humans’ experience in life, rather than attempting to forge an objective account of mind (Gallagher and Zahavi, 2007; Marshall, 2008).

Merleau-Ponty’s phenomenology argues for the prioritization of the subjective, lived-body in cognition and more specifically that cognitions cannot be understood without reference to the body which engages with the world (Merleau-Ponty, 1962, 1965; Marshall, 2008). Merleau-Ponty provides a comprehensive theory of the “lived-body,” or the “subject-body,” contrasting it to the “thing-body,” or the “object-body” (Merleau-Ponty, 1962, 1965; Marshall, 2008). The subject-body can be considered the body experienced from a first-person perspective which acts on the world, whereas the object-body can be considered the body as an object of the world experienced from a third-person perspective. Merleau-Ponty emphasizes the subject-body in cognition, implying that humans fundamentally are, and thus should be studied as embodied beings who form cognitions via interaction in the world with their bodies, rather than cognition as an activity of the “mind” which utilizes the object-body (Merleau-Ponty, 1962, 1965; Borrett et al., 2000; Matthews, 2004).

Dewey’s Principle of Continuity

In contrast to Merleau-Ponty’s phenomenological approach, an alternative holistic account of the mind–body relationship starts from an objective position. American pragmatism offers an objective, philosophical account of a holistic mind and body in the form of naturalism (Johnson, 2006). As Horst (2002) explicates, there have been various definitions and strands of naturalism. The account we refer to in this section aligns with the Darwinian paradigm and, more specifically with physicalism, emergence, and supervenience (Harbecke, 2013; Montero, 2013; McLaughlin and Bennett, 2014).

This form of naturalism is committed to an account in which all things in the world, including body and mind are natural or naturally emergent (Horst, 2002; Aikin, 2006). In turn, it posits that all explanation should be causal and reducible to natural explanations and is consequently committed to the study of the person as an object and the natural evolution of all human functions (Aikin, 2006; Johnson, 2006). One account of naturalism, from this emergent, supervenient perspective is Dewey’s “principle of continuity” (Dewey, 1981, 1991).

The principle of continuity posits that there is no break in experience between the processes of perceiving, feeling, moving, and thinking; instead they are levels of organic functioning from which higher function emerges. It describes three levels of organization: the “physical” level of inanimate material processes; the “psycho-physical” level of living things which have needs, interests, and satisfactions; and the “mental” level of organisms which can perform higher level cognitions. The principle explains the progression from the physical level to the level of the mind without introducing new ontological entities, structures, or forces. Dewey argues that new organization is the reason that organisms with minds can do things which psycho-physical entities cannot do, and why psycho-physical entities can do things which physical entities cannot do. Thus, according to Dewey, what we refer to as “mind” is a complex new organization of what we refer to as “body,” but they are in essence the same entity. According to the principle of continuity, what is termed “mind” and “body” are simply ways to identify aspects of the organism–environment interaction which have arisen from an organic process (Dewey, 1981, 1991; Johnson, 2006, 2007).

Phenomenology and Naturalism as Complementary Approaches

Phenomenology is committed to describing subjective experience, which is where meaning putatively arises for humans, while naturalism as characterized here provides an objective explanation of how meaning arises ontogenetically, organically and biologically, independent of the personal experience of the individual (Gallagher and Zahavi, 2007; Marshall, 2008). As Aikin (2006, p. 326) puts it “Lovers may love, and pains may pain, but the naturalistic perspective can attend only to the lovers, not their love; to the pains, but not their feelings of pain.” Similarly, the phenomenological perspective can attend only to the love, not the lovers and to the feelings of pain rather than the pains. Thus, phenomenologists can provide to naturalists, psychologists and neuroscientists a more precise model of the phenomenon which they attempt to explain than they would if they were to start only with an “objective” scientific theory of cognition (Gallagher and Zahavi, 2007). Thus, phenomenology and naturalism are contrasting, but complementary approaches (Aikin, 2006; Zahavi, 2010).

Accordingly, the different directions from which Merleau-Ponty’s phenomenology and Dewey’s principle of continuity approach the question of the relationship between mind and body are complementary, providing ultimately a more comprehensive, pluralistic understanding of the holistic mind–body relationship. Merleau-Ponty’s phenomenological account can inform Dewey’s objective account of how a person experiences the holistic mind–body described in his theory.

Thus, a philosophical integration of these perspectives may be possible (Zahavi, 2010), but our aim here is to provide a framework for psychotherapeutic research and practice. Therefore, it is necessary to provide a psychological account which integrates subjective and objective perspectives of a holistic mind–body relationship. We propose that grounded cognition provides such a framework.

Grounded Cognition as a Psychological Framework Reflecting a Holistic Mind–Body Relationship

Embodied cognition is a research program consisting of a number of accounts and topics, held together by the underlying assumption that the body functions as a constituent of the mind rather than a perceiver and actor serving the mind, thus being directly, and subjectively involved in cognition (Borrett et al., 2000; Shapiro, 2007). Different accounts of embodied cognition provide various models of this underlying assumption, so it is useful to focus on one to explore the holistic conceptualization of body and mind and how it aligns with the principles of Merleau-Ponty’s phenomenology and Dewey’s principle of continuity.

“Grounded cognition” reflects the underlying embodied cognition assumption by proposing that cognition is derived from, and dependent on, bodily interactions with the world which are represented in the brain (Barsalou, 2008). Grounded cognition has been comprehensively articulated and critiqued in the literature (Barsalou, 1999, 2008), has a strong empirical foundation (e.g., Schubert, 2005; Chandler and Schwarz, 2009; Jostmann et al., 2009; Natanzon and Ferguson, 2012 etc.) and most importantly, clearly explicates the holistic relationship of body and mind, aligning with both Merleau-Ponty’s phenomenology and Dewey’s principle of continuity as considered next.

Grounded cognition is underpinned by two major assumptions, namely that cognition is dependent on the body’s interaction with the world and that these interactions are represented in the brain (Barsalou, 2008). Grounded cognition’s first assumption is illustrated neatly by Shapiro (2011) in considering the concept of a morel mushroom for Sally, a mycologist, Charles, a provencal chef, and Lucy, a young child. Sally conceptualizes a morel as an epigenous ascocarp, Charles conceptualizes a morel as a delicacy to be sautéed with butter, and Lucy conceptualizes a morel as the yucky thing she has to eat before being allowed dessert. Thus, each according to their bodily experiences with morels forms different conceptualizations of it. However, these concepts are not determinate: for example, if Lucy grows up to become a mycologist, her concept of a morel would be more similar to Sally’s. Furthermore, it is important to note that there is nothing stopping Sally, Charles, and Lucy from having the same concept for a morel, it is simply their differing bodily interactions with the morel which has determined their conceptualizations. Finally, it can be assumed that they have the same visual conceptualization of a morel; they all know one when they see it. However, if Lucy were to have been born blind, she would never be able to obtain the same concept of a morel as Sally and Charles. Thus, grounded cognition aligns with Merleau-Ponty’s phenomenology by emphasizing the importance of subjective body-in-the-world experience for cognition (Johnson, 2006).

The second major assumption of grounded cognition is that the body’s relationship with the world is represented in the brain (Barsalou, 2008). Theories within grounded cognition differ on how these bodily interactions are represented in the brain, with some theories positing “image schemas” of bodily interactions in the world which are proposed to underpin abstract conceptual knowledge (Lakoff and Johnson, 1999). However, most grounded cognition theories propose “simulations,” which are neural reconstructions of experience using representations contained in modal systems of the brain (Glenberg, 1997; e.g., the sensorimotor system; Barsalou, 1999; Gallese and Lakoff, 2005). Thus grounded cognition is also consistent with Dewey’s principle of continuity in that from an objective, neuroscientific perspective, cognitions are emergent from, and inextricably intertwined with the body.

In sum, grounded cognition implies that cognition is emergent from and inextricably tied to the subjective, lived, experience of the body-in-the-world. Thus, “mind” and “body” only function as labels attached to properties of human functioning which we perceive as originating either mentally or physically. Conceiving of the relationship between body and mind from this holistic, psychological perspective can be expected to have a number of important implications for psychotherapy theory and practice.

Implications for Psychotherapy Theory and Practice

First, a holistic conceptualization of the mind–body relationship leads to a better understanding of the tensions between psychotherapy theory and practice. When the mind–body relationship is conceptualized from a dualist or exclusivist perspective, a tension is created between the phenomenological needs of the patient who is present mind and body and the emphasis on either mind or body according to the theoretical assumptions of the psychotherapy practiced by the therapist. One example of this is the de-emphasis of the body during the practice of psychotherapies whose underlying theory disembodies the mind. During such therapies (e.g., cognitive therapy), touch is purposefully excluded from therapeutic practice since the mind is conceptualized as the agent of change, even though therapeutic practice could possibly be enhanced by touch (Feltham, 2008).

Second, a psychologically articulated, holistic framework for the mind–body relationship encourages theoretical reflection about this relationship by challenging dualist and exclusivist assumptions inherent in some psychotherapies. In turn, this helps to clarify some of the points of difference between the psychotherapies described above. Numerous psychotherapies discussed in “Mind–Body Assumptions Underlying Current Psychotherapies,” have similar theoretical background and similar therapeutic practices. An example of this is traditional behavioral therapy and body psychotherapy. Both emphasize the body and conceptualize it as the agent of change and as a consequence, both prioritize the body in therapy. One of the primary differences between the two can be ascertained by reflecting on the mind–body relationship. Traditional behavior therapy is very much exclusivist, dismissing the mind and cognition and emphasizing the body and behavior, both methodologically and theoretically. Contrastingly, body psychotherapy recognizes cognitions whilst treating them via the body, thus implying a holistic conceptualization of mind and body.

Third, a holistic conceptualization of the mind–body relationship has the potential to further de-stigmatize mental illness (Thomas, 2013; Ungar and Knaak, 2013a,b). Ungar and Knaak (2013a) suggest that dismissive and blaming attitudes toward mental health issues can be attributed to the absence of an organic explanation for most mental health issues. Thomas (2013) suggests that promoting mental illness to non-psychiatric health professionals as an interaction between cognitive, behavioral, emotional, biological, and environmental factors would reduce dualistic thinking around mental health issues and help with de-stigmatization in these settings. The psychologically articulated, holistic conceptualization of the mind–body relationship presented here elaborates on Thomas’ idea by conceptualizing cognitive, behavioral, emotional, biological, and environmental factors as part of the same functional system, implying that “organic” causes are inseparable from “mental” causes. Thus, we propose that the holistic conceptualization of the mind–body relationship presented here will further help with de-stigmatization of mental illness in non-psychiatric settings.

Fourth, the clearly articulated, explicit position of a holistic mind–body portrayed by grounded cognition encourages a more reflective approach to the issue in practice. Theories underlying most current psychotherapies do not explicitly state their position regarding the relationship between mind and body. Consequently, practitioners unreflectively adopt the assumptions inherent in the psychotherapies they utilize. The clear articulation of a holistic mind–body from both phenomenological and objective perspectives may assist practitioners to reflect on this relationship. For example, from a grounded cognition perspective “mind” and “body” are only labels attached to properties of human functioning which we perceive as originating either mentally or physically. The issue for psychotherapy practice is that in using these labels with patients, they automatically divide psychopathologies into arbitrary categories and thus portray dualist or exclusivist agendas. This then restricts the patient’s conceptualization of what the psychopathology is and how to manage it. A grounded cognition perspective would encourage a broader language around psychopathologies as disorders of the “system,” whether the symptoms are perceived as mental or physical. This will encourage the patient to focus on the holistic nature of their symptoms during treatment, as opposed to the idea that some treatments are behavioral/bodily and others are mind/cognitive. This is but one example of changes which may come of reflecting on the mind–body relationship in practice.

Finally, a new perspective on the mind–body relationship will guide the identification of gaps in existing therapies and consequently promote an expansion of the range of therapies offered to the patient. For example, grounded cognition implies that one way to change cognitions is through the subjective, lived, bodily experience of the individual. Encouraging practitioners to reflect on a holistic mind–body approach may result in a wider range of therapies they can offer their patients stemming from this idea. Further development of these ideas may also result in the creation of new and innovative therapeutic methods to augment those already in existence.

Conclusion

Psychological science sits awkwardly between mind and body, and its application in psychotherapy inherits this awkwardness in a lack of clarity about how therapists should conceptualize their patients. By reviewing how mind and body are traditionally understood in major psychotherapies, we have attempted to underscore some of the tensions in this area. By introducing and outlining grounded cognition as a holistic psychological approach consistent with both radically subjectivist (Merleau-Ponty) and objectivist (Dewey) philosophical approaches, we hope to have proposed a new way forward for theorists and practitioners of psychotherapy. This new way forward throws light on the relationship between existing psychotherapies, the relationship between theory and practice, and highlights opportunities for new approaches to psychotherapy.

Conflict of Interest Statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

References are available at the Frontiers site.

Reflecting on the 50th Anniversary of "I Never Promised You a Rose Garden"

Kelsey Osgood is the author of How to Disappear Completely: On Modern Anorexia (2013), and in this article for The New Republic she takes a look back at 50 years since the publication of I Never Promised You a Rose Garden, written by Joanne Greenberg.

One of the issues raised about the book since it first became widely known about 5-6 years after it was published, is that the heroine gets well ... from schizophrenia. The argument since then is that she must have been misdiagnosed, since it's well-known that no one recovers from schizophrenia. The fact that she did, and has gone on to lead a productive and drug-free life runs counter to the disease model of mental illness that has become so popular over the last 60+ years. 

However, the fact that she got well fits perfectly with a trauma model of psychological difficulties. In the trauma model, the "symptoms" are seen as survival adaptations to intolerable pain or circumstances. Deal with the trauma and the adaptations (symptoms) are no longer necessary. That is what Frieda Fromm-Reichmann did for Joanne Greenberg. It's what all therapists working with clients expressing symptoms of psychosis should be doing.

Why We Don’t Like Stories in Which the Mentally Ill Heroine Recovers

The surprisingly stable afterlife of the author of 'I Never Promised You a Rose Garden'

By Kelsey Osgood | The New Republic
June 3, 2014

THIS YEAR MARKS the fiftieth anniversary of the publication of I Never Promised You a Rose Garden, the YA classic written by Joanne Greenberg based on the years she spent committed to a psychiatric ward as a schizophrenic teenager. The impact I Never Promised You a Rose Garden made upon its release in 1964 was fairly quiet. No excerpts were placed in periodicals; reviews, though complimentary, were printed on back pages. The book sold slowly until around 1969, when high schools and colleges began incorporating it into curricula.

Librarians and high school teachers and parents were all justifiably nervous that American youth were willfully courting madness as a means of rebellion. Charismatic figures like R.D. Laing and Timothy Leary preached a version of lunacy-as-transcendence, and educators and parents wanted to offer vulnerable young students a more realistic tale of insanity—one that took place in a locked ward rather than a field of flowers. Sales of the books shot up. It became a particular kind of classic, embraced not primarily for its prose, but for putting its finger on the pulse of a certain set of collective anxieties. Greenberg, who, by the mid-’60s was living symptom-free in Colorado, watched her sales rise. This year it sold nearly six million copies.

But not long after I Never Promised You a Rose Garden became canonical, it also became a lightning rod, and it is the contours of that controversy that make the novel still relevant today. Greenberg claimed full recovery, and many psychiatric professionals worried that this would inspire a false and dangerous hope. Schizophrenics, they said, simply cannot recover. German psychiatrist Emil Kraeplin, who coined the early version of the diagnosis “dementia praecox,” described the disease as “terminal.” The introduction of Thorazine in the 1950s offered some reprieve from the symptoms, but the best a schizophrenic could hope for was what Swiss psychiatrist Eugene Bleuler called “recovery with defect.” Doctors wrote articles that evaluated the novel as if it were a case history and re-diagnosed her autobiographical protagonist as a hysteric. In The New York Times an article headline read: “Schizophrenia in Popular Books: A Study Finds Too Much Hope.” One psychiatrist even repeatedly called Greenberg at her home to try to force her to admit she had been misdiagnosed.

It would be difficult to imagine mental health professionals going to such lengths to put Virginia Woolf’s corpse on the couch, or to attempt to determine a DSM code for Diane Arbus. Even Anne Sexton, whose laundry list of symptoms baffled her caretakers, didn’t inspire such heated speculation. In many ways, this is because these women reaffirm our modern belief about mental illness, namely, that it is biologically innate, all-consuming, and only in the best cases, manageable. Greenberg, by contrast, refutes the disease-centric model; her life continues to be full and stable—without the use of psychotropics. And while we tend to think of the disease-centric model as more humanitarian at its core—the aberrant behavior is not the fault of the sick person—one could easily see how it might actually contribute to, rather than negate, stigma against the mentally ill: a brain endemically miswired cannot be controlled, and the mentally ill, therefore, are bound to their labels for life.

THE STORY OF MODERN psychiatry, for many, is triumphant one. The quick-and-dirty history goes like this: Human ingenuity and scientific advances led us from the dark ages of hydrotherapy and solitary confinement to cognitive-behavioral therapy and expertly prescribed medications. While we used to believe the mentally ill were unwell as a result of wayward behavior or demonic possession, we now know that psychic anguish is the result of brain chemistry and nurture, and we’re working harder to analyze the former. We moved, in other words, from mental illness as a moral failure to mental illness as a medical condition.

But if you zoom in on the late 1940s through the early ’60s, a different battle is being waged—a battle between those who believed mental illness was biologically located in the brain, and those who thought mental illness was a matter of emotional disturbance. Back then, those intent upon transforming psychiatry into a reputable science (as opposed to a touchy-feely art) worked tirelessly to develop new methods of medical intervention for the mentally ill. The best-known method was “psychosurgery” (aka lobotomy), which was introduced by neurologist Egas Moniz in 1936. In 1949, Moniz won the Nobel Prize for his work on psychosurgery, and by 1951, the operation had been performed close to 20,000 times.[1]

Contrast this obsession with the physical brain—slicing it, shocking it, or tranquilizing it—with the ethos held by Chestnut Lodge, the elite private institution where Joanne Greenberg began treatment in 1948. The clinicians at Chestnut Lodge fervently believed that no patient, however psychotic, was impervious to psychotherapy. The champion of this viewpoint was the Lodge’s most famous employee, the gifted psychoanalyst Frieda Fromm-Reichmann. Fromm-Reichmann was Greenberg’s primary analyst and, in both the novel and in real life, led her from insanity to wellness. In the book, Fromm-Reichmann is “Dr. Fried,” and Greenberg so positively depicted the humble German that for years she received letters from struggling fans desperate to track down Dr. Fried and undergo analysis with her.

Fromm-Reichmann immediately recognized something special in her teenaged patient: Greenberg was quick-witted, well-read, and seemed to retain an appetite for life that many of the doctor’s older, chronically ill patients had lost long ago. Greenberg’s symptoms were often referred to as “florid”—interpretable, extravagant, and suffused with meaning, like a story. When Joanne was struggling, Fromm-Reichmann openly empathized. When she began to retreat, the doctor begged to follow. “Take me along with you,” Dr. Fried tells Deborah during a session. She insisted to her young patient that they must pose a united front. “I believe that you and I,” Greenberg has her say in Rose Garden, “can beat this thing.” And, together, that’s just what they did.

This narrative is a little too pat for our contemporary sensibilities. Perhaps that’s why the book is not as well known as, say, Sylvia Plath’s The Bell Jar. (The Bell Jar still sells briskly; the fiftieth-anniversary paperback edition is ranked 1,730 on Amazon, compared to Rose Garden’s 21,792[.2]) But Rose Garden does not appeal for another reason: It’s easier to think of the psychiatry of yore as entirely backward and as the poetic casualties of it—Plath, Arbus, Sexton—as victims of that ignorance. Their tragic stories, paradoxically, make us feel more secure in the march of psychiatric progress.

The demise of these women—and the subsequent autopsy of past mental healthcare failures that their paper trails encourages—permits us to rest serenely in the knowledge that the world is moving steadily toward a more scientific, humane psychiatry. But, one has to wonder if this is entirely the case. Frieda Fromm-Reichmann spent four years with Joanne Greenberg; she hiked up to the Disturbed Ward to see patients when they were lying limp in restraints. Now, psychiatrists evaluate patients for 45 minutes before diagnosing them and sending them off to fill prescriptions, and many patients go months between appointments. Efficiency is the goal here; medication the cure, meaningful human connection a distant second priority. It is increasingly rare to find a psychiatrist who also performs talk therapy, despite its many proven benefits.

This might be an even greater tragedy with regard to treatment of schizophrenia, where holistic treatment—that is, one that recognizes both the medical and the emotional components and allows for feedback between the two—might hold particular promise. According to Dr. Allen J. Frances of Duke Medical School and the author of Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life, “Cognitive therapy and social skills therapy are very valuable in treating schizophrenia, but they are rarely available.” And the idea of “complete recovery” is downplayed.

I don’t know what Greenberg’s “actual” diagnosis should be—perhaps she was not a schizophrenic—but I was so interested in her success story that, one day, three years ago, when I was about to release my own, highly personal memoir about my teenage effort to become anorexic (which I “succeeded” at, and then recovered from completely), I decided to write her a letter—an old-fashioned one that I sent in the mail. It wasn’t terribly difficult to track her down. Within weeks, a reply arrived, typewritten on textured, sky-blue paper. Her words to me were kind, smart, and so obviously honest. We struck up a correspondence. We’ve written letters to each other now for nearly two years. She was unabashed but not militant in her views on psychiatry. She told me about her experience writing Rose Garden, but also her daily life, which is filled with events at her synagogue, teaching at the Colorado School of Mines, dealing with the problems endemic to being eighty-something and an active EMT. She is a living example of someone who refused the fate prescribed to her and chose instead to be many other things: clever, attentive, kind, iconoclastic, and the author of more than fifteen books on wildly varying topics. Her life as a recovered patient is not a glamorous or a tragic or a particularly scary one—but it might be a truer one.

1. Gail Hornstein, Professor of Psychology at Mount Holyoke and author of Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness, wrote that lobotomy was “a lucrative sideline for many physicians,” which gives me an icky feeling similar to the one I have when I walk into my gynecologist’s office and see the walls plastered with advertisements reminding patients that Botox Available Here.

2. Plath’s death even spawned a theory that young female poets are more likely than other populations to suffer from mental illness, called, naturally, The Sylvia Plath Effect. (The existence of such a thing begs the question: The Joyce Carol Oates Effect? The Adrienne Rich Effect?)

~ Kelsey Osgood is the author of How to Disappear Completely: On Modern Anorexia.

Nathan A. Thompson - True Secrets of Psychedelics: Are They Everything They’re Cracked Up to Be?

On the heals of the Sam Harris article on hallucinogens I posted earlier today, here is a similar article from Salon. This article, however, focuses on psychedelics as a vehicle to open us up to the spiritual. But once we get a taste, the recommendation is to take up a practice that can provide continuous spiritual openness, not just for a few hours, until the drug wears off. In many ways, this too is what Sam Harris was suggesting.

True secrets of psychedelics: Are they everything they’re cracked up to be?

Mind-altering drugs can open us up to the amazing possibilities of the universe — but true self-discovery is harder

Sunday, Jun 8, 2014 | Nathan A. Thompson


A still from the movie "Enter the Void" of a DMT hallucination. (Credit: IFC Films)
The cactus skin arrived in the mail in a packet marked “for botanical examination only.” We whizzed it up in a blender. Two truant teenagers in an empty kitchen. We tried mixing the resulting green powder with water and drinking it. The taste was so foul it was all we could do to stop ourselves vomiting. In the end we mixed it with Cherry Coke to ameliorate the flavor and then we drank it all up.

The skin contained a naturally occurring psychedelic drug called mescaline. Soon, everything seemed to vibrate. It was as if the walls, windows, even the chairs were humming a low, beautiful melody. Then I noticed that we were speaking in colors. My friend’s words were blue swirls and mine were green. Our conversation curled and twisted in front of my eyes like smoke in a vacuum chamber. Later I held a glass of water, gazing at it for what seemed like an immensely long time, its utility swallowed up in its beauty and it seemed that the whole Earth existed within that glass and the thought occurred to me: “I’m in the presence of God.”

Ten years later I was staying in a tiny monastery deep in a Thai forest. I had been living and meditating there for close to a month. My mind was still — still in the way a tuning fork rests after being struck for a long time. I sat outside watching the fading light graze the trees, feeling egoless and empty of thought. Butterflies erupted from the green foliage in a movement that seemed so excessively beautiful I was thunderstruck and as I looked, I thought: “Damn, this is exactly like mescaline.”

It’s not just me who has made the link between psychedelic drugs and meditation. Indeed, the link between psychedelics and spiritual experience was the first line of inquiry Timothy Leary and his cohorts pursued in their 1960s Harvard experiments. In the 1990s, Dr. Rick Strassman ran a series of experiments using a powerful psychedelic known as DMT, and he too noticed the similarity: “[The effect of] DMT has a similarity with experiences that are possible with a lot of meditation,” he said.

Scientists are currently conducting separate studies on psychedelics and meditation — both are being trialed to treat the same conditions. A review study by the Journal of the American Medical Association, released in March this year, found that meditation may be as effective as medication in treating conditions such as depression and anxiety. Hot on the heels of this study was the Psilocybin Cancer Anxiety Study at NYU’s Bluestone Center for Clinical Research, which found that Psilocybin (the active drug in “magic mushrooms”) was effective in treating anxiety and depression in terminal cancer patients. There are now dozens of studies that document how both meditation and psychedelics can treat depression, addiction, anxiety and PTSD.

So if psychedelics produce similar effects to long periods of meditation and other austere religious practices, could we have stumbled upon what Strassman calls “the spirit molecule”? Are psychedelics an alternative to spiritual practices?

Hardly, say the Buddhists. The second noble truth of the Buddha is that “the origin of suffering is the attachment to desire.” Psychedelics are by their nature an experience, a strange and beautiful one but often elusive. This creates a craving to have the experience again. It is this craving that is the Buddhist definition of discontent. Rather than freeing the mind from attachment, psychedelics create more.

Perhaps the gold standard to measure whether psychedelics are a good substitute for meditation is to see whether fundamental changes in character occur. A meditation instructor once told me: “When I took LSD in the ’60s, it was profound, but it didn’t help me develop the character to live from that truth day by day – without grounding in morality and mindfulness it was merely a flash of insight.”

Richard Alpert, who was one of the first psychologists to study LSD, and later became the spiritual teacher Ram Dass, has a similar view, “I see them [psychedelics] as a door opener and a catalyst and a facilitator; I don’t see them as a full path.” Alpert also describes what his Indian guru told him after trying LSD himself: “Your drug is useful. It would allow you to come in and have the darshan [vision] of Christ, but you can only stay for two hours and then you’ve got to leave. It would be better to become Christ than visit him, but your medicine won’t do that, because it’s not the true samadhi [enlightenment].”

But psychedelics are a catalyst for change, according to writer Graham Hancock. According to Hancock, the means you use to gain insight (whether they are psychedelics or meditation) are the least important aspect; “what matters is what you do with visionary experiences once you have had them, how you integrate them into your life, what lessons you learn from them and how you act on those lessons.” Indeed, according to follow-up studies from the scientific literature, the effect of the psychedelic experience does seem to sustain a positive change without the need to repeat it. Researchers at New York University reported in the Archives of General Psychiatry that their subjects reported a significant improvement in mood and outlook after six months.

This may be true of those individuals who have taken medical-grade psychedelics in a clinical setting, but what of the thousands of people who are doing so haphazardly, procuring them from the black market? Personally, I had a hard time integrating my visionary experiences with my real life. I was sometimes confused and frightened by what I saw. It was a relief then to find the well-trodden Buddhist path. Indeed, most mystical traditions have detailed maps covering the kind of mental and metaphysical spaces you pass through on the way to God. Buddhism has the “Jhanas,” yoga has stages of “Samhadi” and Sufism has “four stages”. These maps allow a teacher to help you process what comes up in your spiritual practice. Strict morality is always a prerequisite to walk such paths or they won’t teach you. These kind of healthy boundaries are what is lacking when you take psychedelics.

But supposing you don’t have the time to pursue rigorous meditation? Why spend years and (some would say) lifetimes rotting our butts on the meditation cushion when we can take the red pill and get it all at once?

I heard Zen priest Kokyo Henkel describe it this way: Imagine spiritual development is a mountain. Psychedelics will take you on a helicopter ride to the top, you will see tumbling clouds and vast craggy distances but when the ride is over you are back where you started. Meditation is a way to climb the mountain, slowly, sometimes painfully, but when you reach the summit it is completely different from the summit-top you saw on your helicopter ride, because the journey has transformed you.

Perhaps this is idealistic, and I certainly wouldn’t deny anyone the use of psychedelics for medical reasons or for spiritual advancement, if done so with wisdom and respect. Indeed, given the dire state of the biosphere and the ecological crisis, perhaps the human race is out of time to meditate ourselves into the enlightened consciousness needed to instigate change. Given that psychedelics tend to assure people of the fact that we are part of nature and connected to every person, plant and animal on Earth, perhaps we should be using them to create happier, more responsible citizens now.

Meditation and yoga have a long history of creating such people, and both have the advantage of being legal and safe as any intense religious activity can be. The immediacy of the psychedelic experience and its profound effects make these substances deserving of interest and study but we can’t yet say they are a viable alternative to the tried and tested spiritual paths.

When I look back on that mescaline-laced afternoon when I was a teenager, I remember a life-altering experience, something the mystics would call an “awakening.” But it was meditation that allowed me to begin to awaken permanently. Alan Watts summed it up when he said:

“The psychedelic experience is only a glimpse of genuine mystical insight, but a glimpse which can be matured and deepened by the various ways of meditation in which drugs are no longer necessary or useful. If you get the message, hang up the phone.”

Read more from Nathan A. Thompson.

Alva Noë - 'Rosemary's Baby' Thrills With Unfathomable Mystery

 

This is a very cool article in which philosopher Alva Noë looks at one of my favorite films through a perspective I  have never taken or even considered - the film is about the act of coming to realize that something is wrong. It's clear something is wrong long before Rosemary is able to accept that the people she trusts are not who they say they are.

And that realization brings in the more important theme of "can we ever truly know another person?" In essence, this is about theory of mind. Except that here, as in reality, we know that others have an interior world to which we are not privy, we "can't get inside their heads to learn what they really think and feel. We are always at a remove from the other."

This article comes from NPR's 13.7 Cosmos and Culture blog.

'Rosemary's Baby' Thrills With Unfathomable Mystery

by ALVA NOË | June 07, 2014

I watched Rosemary's Baby, by Roman Polanksi, again last night. It is a monster movie. And like the best movies in this genre, you could call it a skepticism movie. It is philosophical. And, remarkably, it is terrifying because it is philosophical.


Mia Farrow in Rosemary's Baby. The Kobal Collection/Paramount
Things aren't going right with young Rosemary. Her husband is distant, removed, self-centered; he is unkind and even brutal with her; he spends his free time with their new neighbors, an odd, elderly couple next door. Rosemary's pregnancy is difficult; she has pains continually and is losing weight; neither her doctor nor her husband seem to be interested in helping. Rosemary is in a stupor, as if she were under the influence of drugs.

She has their new apartment painted brightly to lighten it up. But this does little to dispel the dark in its halls and rooms. The only bright spot in this dim scenario is that Guy, who is an actor, has had a turn of good luck at work. His rival woke up blind and Guy got the big part. Professional success is around the corner.

Rosemary's Baby is a story about coming to recognize that something is wrong. At first Rosemary resists this conclusion. What could be wrong? Occasionally pregnancies are painful. Husbands get caught up with pressures and demands at work. Life isn't supposed to play out like a fairy tale. She resolves herself to be a better wife, to reach out to Guy and help him be more open in their relationship.

Now the character of the movie's skepticism shifts to one of philosophy's enduring skeptical concerns: the very possibility of knowing other people and what they think and feel.

Philosophers have long noticed that that there is room for doubt in this domain: all we ever really know, when it comes to others, is what they say and do. We can't get inside their heads to learn what they really think and feel. We are always at a remove from the other. It is also clear, to philosophy and to us all, that this intellectual worry can be safely set aside in the course of our ordinary lives. Questions about what those around us are thinking and feeling and doing, let alone questions about whether they have inner lives at all, don't seriously arise. Which itself raises a philosophical question: if the basis of our knowledge is so sleight, why is our confidence in other minds so robust? (I explore this in my book Out of Our Heads: Why You Are Not Your Brain, and Other Lessons from the Biology of Consciousness.)

Sometimes these sorts of theoretical worries achieve practical prominence in the setting of neurological trauma when we are confronted by, for example, persistent vegetative state, and must make decisions about what is going on inside the mind of an badly injured person.

But Rosemary's Baby addresses these questions in, what, if possible, is an even more terrifying way. It gradually becomes clear, to Rosemary, and to us, the audience, that we can no longer trust Guy, or the neighbors, or the doctor, or just about anyone else in Rosemary's life. Skepticism about the thoughts and feelings of those around Rosemary is now a hypothesis that must be taken seriously. Her life, and that of her baby, depends on it. She is the victim, it seems, of an elaborate plot. And (almost everyone), even those most close to her, is in on it.

Is this not madness? It certainly has that look and feel. How could everyone be in on it? This, then, ratchets the movie's skeptical theme up a notch: could it be that she is hallucinating or confabulating the whole thing? Could this be some sort of pre-partem hysteria? Can she, do we, know what is real?

But Rosemary's Baby is not just a psychological thriller. It is a monster movie. And what makes Rosemary's predicament so very difficult is the fact that what is really going on, so we come to believe, what is really driving events in this film, is so unlikely, so impossible, so unthinkable, as to rule out the possibility of anything like a straight forward "figuring out" of what's happening.

Satan himself has come to Earth and raped Rosemary, with the assistance of her husband and almost everyone else she knows. This is too far-fetched to be true. It is too far-fetched to be even thinkable.

The distinctive charms and fascinations of horror films arise at this kind of juncture, according to the noted philosopher of art Noël Carroll. It is the hallmark of all narrative forms they they supply us with cognitive delights. Plot intrigues; we are curious; curiosity motivates us to follow the story, to figure out what's going on, to understand how forces at play in a situation drive the action inexorably forward. Plot is cognitive and the pleasure of story arises from the achievement getting it.

I think Carroll is right about this. The basic idea was anticipated already in Aristotle's treatment of tragedy. Plot, Aristotle argued, is the life and soul of tragedy. And plot is concerned not with mere event, not with one thing happening after another. But with human action. So to tell a good story, or to enjoy one in the audience, you need to be sensitive to what makes an action significant in the setting of a human life. You need to be a student of human nature and experience.

It is because the meaning and importance of a work of dramatic fiction comes in the exploration of ideas about human experience that it is possible to enjoy a play just by reading it. It isn't spectacle that moves us; for Aristotle, it's understanding. Which doesn't mean that one does not also enjoy felt or emotional responses to the story. A tragedy, Aristotle thought, always aims to arouse fear and pity. But it doesn't aim to produce emotion the way a ride on a roller coaster produces a sense of danger. Fear is not merely an effect on us or in us. It is an expression of our sensitivity to what is playing out in the story and so it is itself an achievement of understanding and insight.

Now the distinctive difference between horror and other genres — this is Carroll's argument — is that the heart of the horror genre is a monstrous phenomenon that actually, truly, makes no sense. Monsters are unfathomable. They are unknowable. They are betwixt and between. Neither alive nor dead, neither human or animal, neither natural nor, really, unnatural. They are, as Carroll puts it, interstitial. The point is that there is no understanding of the monstrous. There is no genuine satisfaction of our curiosity.

A good horror movie, I would say, then, is a kind of paradox in itself. It engages you in a mystery whose intrinsic character rules out, or threatens to rule out, its resolution. And it is the distinct feature of art horror — as opposed to what might horrify us in real life — that it affords the opportunity for philosophical engagement with the unresolvable. From this point of view, the fact that we find the monster scary is secondary. We don't like horror movies because we like to feel negative emotions. It is, rather, that the negative emotions are outweighed by the philosophical delights.

I'm not sure whether this account does justice to Rosemary's Baby. Perhaps its real fright stems from its suggestion that the philosopher's unresolved skeptical puzzles about the limits of knowledge of others and the world around us reveal the underlying reality of our condition, the fact of our total, absolute, abject, terrifying isolation. But is that something we take pleasure in discovering?

~ You can keep up with more of what Alva Noë is thinking on Facebook and on Twitter: @alvanoe.

Sam Harris - Drugs and the Meaning of Life (with commentary)

Over the last several years, it has not been often that I agree with Sam Harris about much of anything. This old 2011 article from his blog (recently reposted because he revised it and added an audio version of it), however, on the benefits of exploring altered states of consciousness (i.e., hallucinogens), is a welcome exception.

He reports the benefits he attained through his explorations of hallucinogens, but he also recounts the horrors he encountered when the previously blissful experiences became terrifying "bad trips" ("they make the notion of hell—as a metaphor if not an actual destination—seem perfectly apt").

Along the way, he makes some less-than-warranted leaps of logic:

Ingesting a powerful dose of a psychedelic drug is like strapping oneself to a rocket without a guidance system. One might wind up somewhere worth going, and, depending on the compound and one’s “set and setting,” certain trajectories are more likely than others. But however methodically one prepares for the voyage, one can still be hurled into states of mind so painful and confusing as to be indistinguishable from psychosis.

Let's begin to unpack this passage with the last comment - if you have ever spent any time with someone in a psychotic state (and I do so 2-3 hours each week), then you'll know there is little to no similarity between a bad trip and a psychotic state. The error is not Harris's, however, psychologists have made this faulty assumption for 60+ years, and in fact some of the earliest experiments on LSD were framed as attempts to understand schizophrenia.

Now to the first assertion in that passage. In my experience with hallucinogens (primarily LSD and psilocybin), if you are going to test those outer limits of consciousness, you need to be able to take control of the experience if it starts to go dark, or you need to be able to sit with the feelings and images and not be identified with them (i.e., have an observer self). In my first and last harrowing experience on LSD, I retreated from a group of friends when I began to feel very anxious, and found myself sitting on the floor in an empty dorm room surrounded by fiery demons and a complete sense of annihilation, my ego had left the building. As I sat there in terror, trying to make sense of what was happening, something shifted in me and I was no longer afraid, I was amused at the "funny" cartoon images of demons I was surrounded by. I realized that there was a deeper I of some kind that could shape the experience, that I was not "strapped to a rocket without a guidance system." I never had a bad trip again, which is not to say that I never experienced dark and disturbing images ever again, only that I was not terrified by them or at their mercy.

As a side note, I have long been amazed at how much of the psychedelic visual experience is fractal-like. I suspect that these drugs can allow us to see the deeper mathematical pattern in nature. I have found to be especially true with psilocybin mushrooms out in nature.

On the subject of MDMA, Harris cites several articles in his notes on the damage that MDMA can cause to the serotonergic system. However, he did not include the research showing that the damage is mitigated by the ingestion of alpha lipoic acid for 2 days and then 30 minutes prior to consuming the MDMA (emphasis added in the abstract):

Aguirre, Barrionuevo, Ramírez, Del Río, & Lasheras. (1999, Nov 26). "Alpha-lipoic acid prevents 3,4-methylenedioxy-methamphetamine (MDMA)-induced neurotoxicity." Neuroreport. 10(17):3675-80.

"A single administration of 3,4-methylenedioxymethamphetamine (MDMA, 20 mg/kg, i.p.), induced significant hyperthermia in rats and reduced 5-hydroxytryptamine (5-HT) content and [3H] paroxetine-labeled 5-HT transporter density in the frontal cortex, striatum and hippocampus by 40-60% 1 week later. MDMA treatment also increased glial fibrillary acidic protein (GFAP) immunoreactivity in the hippocampus. Repeated administration of the metabolic antioxidant alpha-lipoic acid (100 mg/kg, i.p., b.i.d. for 2 consecutive days) 30 min prior to MDMA did not prevent the acute hyperthermia induced by the drug; however, it fully prevented the serotonergic deficits and the changes in the glial response induced by MDMA. These results further support the hypothesis that free radical formation is responsible for MDMA-induced neurotoxicity."   

There is additional research suggesting that even moderate doses of vitamin C (1000 mg) taken for a few days before and then 30 minutes prior to ingestion can also mitigate the serotonergic damage. The smart drug user does his research before ingesting any of these chemicals.

Finally, there is one other argument that Harris makes with which I take exception.

If the brain were merely a filter on the mind, damaging it should increase cognition. In fact, strategically damaging the brain should be the most reliable method of spiritual practice available to anyone. In almost every case, loss of brain should yield more mind. But that is not how the mind works.

Some people try to get around this by suggesting that the brain may function more like a radio, a receiver of conscious states rather than a barrier to them. At first glance, this would appear to account for the deleterious effects of neurological injury and disease, for if one smashes a radio with a hammer, it will no longer function properly. There is a problem with this metaphor, however. Those who employ it invariably forget that we are the music, not the radio. If the brain were nothing more than a receiver of conscious states, it should be impossible to diminish a person’s experience of the cosmos by damaging her brain. She might seem unconscious from the outside—like a broken radio—but, subjectively speaking, the music would play on.

Now, I do not believe in the brain as receiver hypothesis, at least in terms of consciousness or of transpersonal states of consciousness. But the argument Harris makes here is flawed - he argues that it should be impossible to damage a person's experience of the cosmos by damaging her brain, and he bases this on the brain as radio receiver metaphor.

However, if you damage a radio (especially the antenna/reception portion of the radio), it is no longer capable of receiving the information (the radio signals), while the information continues to be broadcast (so to speak). Likewise, if we damage the brain in the right way (and this would essentially mean damaging the sensory perception/reception modules of the brain), the brain can no longer receive the (external) signal and will not experience whatever information is being broadcast.

However, if we assume that this damage occurs after many years of normal function, there may be enough residual signal left to create a minimal conscious state, even when the sensory reception apparatus is damaged or shut off. This may be what happens in some forms of catatonic autism and/or catatonic schizophrenia, where the sensory input is so overwhelming that the brain shuts it off and the person is so withdrawn as to be essentially encased in an invisible shell of silence.

I only argue this point because it represents for me some of the faulty logic Harris employs in other areas of his writing.

On the whole, however, this is an honest and useful piece from Harris - I'm sorry I missed it the first time he posted it. I can't imagine how much more limited by life would be if I had not spent a few years taking psychedelics and entheogens and observing the function and structure of my mind.

Drugs and the Meaning of Life

Sam Harris | July 4, 2011

(Photo by JB Banks)

(Note 6/4/2014: I have revised this 2011 essay and added an audio version.—SH)


Everything we do is for the purpose of altering consciousness. We form friendships so that we can feel certain emotions, like love, and avoid others, like loneliness. We eat specific foods to enjoy their fleeting presence on our tongues. We read for the pleasure of thinking another person’s thoughts. Every waking moment—and even in our dreams—we struggle to direct the flow of sensation, emotion, and cognition toward states of consciousness that we value.

Drugs are another means toward this end. Some are illegal; some are stigmatized; some are dangerous—though, perversely, these sets only partially intersect. Some drugs of extraordinary power and utility, such as psilocybin (the active compound in “magic mushrooms”) and lysergic acid diethylamide (LSD), pose no apparent risk of addiction and are physically well-tolerated, and yet one can still be sent to prison for their use—whereas drugs such as tobacco and alcohol, which have ruined countless lives, are enjoyed ad libitum in almost every society on earth. There are other points on this continuum: MDMA, or Ecstasy, has remarkable therapeutic potential, but it is also susceptible to abuse, and some evidence suggests that it can be neurotoxic.^[1]

One of the great responsibilities we have as a society is to educate ourselves, along with the next generation, about which substances are worth ingesting and for what purpose and which are not. The problem, however, is that we refer to all biologically active compounds by a single term, drugs, making it nearly impossible to have an intelligent discussion about the psychological, medical, ethical, and legal issues surrounding their use. The poverty of our language has been only slightly eased by the introduction of the term psychedelics to differentiate certain visionary compounds, which can produce extraordinary insights, from narcotics and other classic agents of stupefaction and abuse.

However, we should not be too quick to feel nostalgia for the counterculture of the 1960s. Yes, crucial breakthroughs were made, socially and psychologically, and drugs were central to the process, but one need only read accounts of the time, such as Joan Didion’s Slouching Towards Bethlehem, to see the problem with a society bent upon rapture at any cost. For every insight of lasting value produced by drugs, there was an army of zombies with flowers in their hair shuffling toward failure and regret. Turning on, tuning in, and dropping out is wise, or even benign, only if you can then drop into a mode of life that makes ethical and material sense and doesn’t leave your children wandering in traffic.

Drug abuse and addiction are real problems, of course, the remedy for which is education and medical treatment, not incarceration. In fact, the most abused drugs in the United States now appear to be oxycodone and other prescription painkillers. Should these medicines be made illegal? Of course not. But people need to be informed about their hazards, and addicts need treatment. And all drugs—including alcohol, cigarettes, and aspirin—must be kept out of the hands of children.

I discuss issues of drug policy in some detail in my first book, The End of Faith, and my thinking on the subject has not changed. The “war on drugs” has been lost and should never have been waged. I can think of no right more fundamental than the right to peacefully steward the contents of one’s own consciousness. The fact that we pointlessly ruin the lives of nonviolent drug users by incarcerating them, at enormous expense, constitutes one of the great moral failures of our time. (And the fact that we make room for them in our prisons by paroling murderers, rapists, and child molesters makes one wonder whether civilization isn’t simply doomed.)

I have two daughters who will one day take drugs. Of course, I will do everything in my power to see that they choose their drugs wisely, but a life lived entirely without drugs is neither foreseeable nor, I think, desirable. I hope they someday enjoy a morning cup of tea or coffee as much as I do. If they drink alcohol as adults, as they probably will, I will encourage them to do it safely. If they choose to smoke marijuana, I will urge moderation.^[2]  Tobacco should be shunned, and I will do everything within the bounds of decent parenting to steer them away from it. Needless to say, if I knew that either of my daughters would eventually develop a fondness for methamphetamine or crack cocaine, I might never sleep again. But if they don’t try a psychedelic like psilocybin or LSD at least once in their adult lives, I will wonder whether they had missed one of the most important rites of passage a human being can experience.

This is not to say that everyone should take psychedelics. As I will make clear below, these drugs pose certain dangers. Undoubtedly, some people cannot afford to give the anchor of sanity even the slightest tug. It has been many years since I took psychedelics myself, and my abstinence is born of a healthy respect for the risks involved. However, there was a period in my early twenties when I found psilocybin and LSD to be indispensable tools, and some of the most important hours of my life were spent under their influence. Without them, I might never have discovered that there was an inner landscape of mind worth exploring.

There is no getting around the role of luck here. If you are lucky, and you take the right drug, you will know what it is to be enlightened (or to be close enough to persuade you that enlightenment is possible). If you are unlucky, you will know what it is to be clinically insane. While I do not recommend the latter experience, it does increase one’s respect for the tenuous condition of sanity, as well as one’s compassion for people who suffer from mental illness.

Human beings have ingested plant-based psychedelics for millennia, but scientific research on these compounds did not begin until the 1950s. By 1965, a thousand studies had been published, primarily on psilocybin and LSD, many of which attested to the usefulness of psychedelics in the treatment of clinical depression, obsessive-compulsive disorder, alcohol addiction, and the pain and anxiety associated with terminal cancer. Within a few years, however, this entire field of research was abolished in an effort to stem the spread of these drugs among the public. After a hiatus that lasted an entire generation, scientific research on the pharmacology and therapeutic value of psychedelics has quietly resumed.

Psychedelics such as psilocybin, LSD, DMT, and mescaline all powerfully alter cognition, perception, and mood. Most seem to exert their influence through the serotonin system in the brain, primarily by binding to 5-HT_2A receptors (though several have affinity for other receptors as well), leading to increased activity in the prefrontal cortex (PFC). Although the PFC in turn modulates subcortical dopamine production—and certain of these compounds, such as LSD, bind directly to dopamine receptors—the effect of psychedelics seems to take place largely outside dopamine pathways, which could explain why these drugs are not habit-forming.

The efficacy of psychedelics might seem to establish the material basis of mental and spiritual life beyond any doubt, for the introduction of these substances into the brain is the obvious cause of any numinous apocalypse that follows. It is possible, however, if not actually plausible, to seize this evidence from the other end and argue, as Aldous Huxley did in his classic The Doors of Perception, that the primary function of the brain may be eliminative: Its purpose may be to prevent a transpersonal dimension of mind from flooding consciousness, thereby allowing apes like ourselves to make their way in the world without being dazzled at every step by visionary phenomena that are irrelevant to their physical survival. Huxley thought of the brain as a kind of “reducing valve” for “Mind at Large.” In fact, the idea that the brain is a filter rather than the origin of mind goes back at least as far as Henri Bergson and William James. In Huxley’s view, this would explain the efficacy of psychedelics: They may simply be a material means of opening the tap.

Huxley was operating under the assumption that psychedelics decrease brain activity. Some recent data have lent support to this view; for instance, a neuroimaging study of psilocybin suggests that the drug primarily reduces activity in the anterior cingulate cortex, a region involved in a wide variety of tasks related to self-monitoring. However, other studies have found that psychedelics increase activity throughout the brain. Whatever the case, the action of these drugs does not rule out dualism, or the existence of realms of mind beyond the brain—but then, nothing does. That is one of the problems with views of this kind: They appear to be unfalsifiable.^[3]

We have reason to be skeptical of the brain-as-barrier thesis. If the brain were merely a filter on the mind, damaging it should increase cognition. In fact, strategically damaging the brain should be the most reliable method of spiritual practice available to anyone. In almost every case, loss of brain should yield more mind. But that is not how the mind works.

Some people try to get around this by suggesting that the brain may function more like a radio, a receiver of conscious states rather than a barrier to them. At first glance, this would appear to account for the deleterious effects of neurological injury and disease, for if one smashes a radio with a hammer, it will no longer function properly. There is a problem with this metaphor, however. Those who employ it invariably forget that we are the music, not the radio. If the brain were nothing more than a receiver of conscious states, it should be impossible to diminish a person’s experience of the cosmos by damaging her brain. She might seem unconscious from the outside—like a broken radio—but, subjectively speaking, the music would play on.

Specific reductions in brain activity might benefit people in certain ways, unmasking memories or abilities that are being actively inhibited by the regions in question. But there is no reason to think that the pervasive destruction of the central nervous system would leave the mind unaffected (much less improved). Medications that reduce anxiety generally work by increasing the effect of the inhibitory neurotransmitter GABA, thereby diminishing neuronal activity in various parts of the brain. But the fact that dampening arousal in this way can make people feel better does not suggest that they would feel better still if they were drugged into a coma. Similarly, it would be unsurprising if psilocybin reduced brain activity in areas responsible for self-monitoring, because that might, in part, account for the experiences that are often associated with the drug. This does not give us any reason to believe that turning off the brain entirely would yield an increased awareness of spiritual realities.

However, the brain does exclude an extraordinary amount of information from consciousness. And, like many who have taken psychedelics, I can attest that these compounds throw open the gates. Positing the existence of a Mind at Large is more tempting in some states of consciousness than in others. But these drugs can also produce mental states that are best viewed as forms of psychosis. As a general matter, I believe we should be very slow to draw conclusions about the nature of the cosmos on the basis of inner experiences—no matter how profound they may seem.

One thing is certain: The mind is vaster and more fluid than our ordinary, waking consciousness suggests. And it is simply impossible to communicate the profundity (or seeming profundity) of psychedelic states to those who have never experienced them. Indeed, it is even difficult to remind oneself of the power of these states once they have passed.

Many people wonder about the difference between meditation (and other contemplative practices) and psychedelics. Are these drugs a form of cheating, or are they the only means of authentic awakening? They are neither. All psychoactive drugs modulate the existing neurochemistry of the brain—either by mimicking specific neurotransmitters or by causing the neurotransmitters themselves to be more or less active. Everything that one can experience on a drug is, at some level, an expression of the brain’s potential. Hence, whatever one has seen or felt after ingesting LSD is likely to have been seen or felt by someone, somewhere, without it.

However, it cannot be denied that psychedelics are a uniquely potent means of altering consciousness. Teach a person to meditate, pray, chant, or do yoga, and there is no guarantee that anything will happen. Depending upon his aptitude or interest, the only reward for his efforts may be boredom and a sore back. If, however, a person ingests 100 micrograms of LSD, what happens next will depend on a variety of factors, but there is no question that something will happen. And boredom is simply not in the cards. Within the hour, the significance of his existence will bear down upon him like an avalanche. As the late Terence McKenna^[4]  never tired of pointing out, this guarantee of profound effect, for better or worse, is what separates psychedelics from every other method of spiritual inquiry.

Ingesting a powerful dose of a psychedelic drug is like strapping oneself to a rocket without a guidance system. One might wind up somewhere worth going, and, depending on the compound and one’s “set and setting,” certain trajectories are more likely than others. But however methodically one prepares for the voyage, one can still be hurled into states of mind so painful and confusing as to be indistinguishable from psychosis. Hence, the terms psychotomimetic and psychotogenic that are occasionally applied to these drugs.

I have visited both extremes on the psychedelic continuum. The positive experiences were more sublime than I could ever have imagined or than I can now faithfully recall. These chemicals disclose layers of beauty that art is powerless to capture and for which the beauty of nature itself is a mere simulacrum. It is one thing to be awestruck by the sight of a giant redwood and amazed at the details of its history and underlying biology. It is quite another to spend an apparent eternity in egoless communion with it. Positive psychedelic experiences often reveal how wondrously at ease in the universe a human being can be—and for most of us, normal waking consciousness does not offer so much as a glimmer of those deeper possibilities.

People generally come away from such experiences with a sense that conventional states of consciousness obscure and truncate sacred insights and emotions. If the patriarchs and matriarchs of the world’s religions experienced such states of mind, many of their claims about the nature of reality would make subjective sense. A beatific vision does not tell you anything about the birth of the cosmos, but it does reveal how utterly transfigured a mind can be by a full collision with the present moment.

However, as the peaks are high, the valleys are deep. My “bad trips” were, without question, the most harrowing hours I have ever endured, and they make the notion of hell—as a metaphor if not an actual destination—seem perfectly apt. If nothing else, these excruciating experiences can become a source of compassion. I think it may be impossible to imagine what it is like to suffer from mental illness without having briefly touched its shores.

At both ends of the continuum, time dilates in ways that cannot be described—apart from merely observing that these experiences can seem eternal. I have spent hours, both good and bad, in which any understanding that I had ingested a drug was lost, and all memories of my past along with it. Immersion in the present moment to this degree is synonymous with the feeling that one has always been and will always be in precisely this condition. Depending on the character of one’s experience at that point, notions of salvation or damnation may well apply. Blake’s line about beholding “eternity in an hour” neither promises nor threatens too much.

In the beginning, my experiences with psilocybin and LSD were so positive that I did not see how a bad trip could be possible. Notions of “set and setting,” admittedly vague, seemed sufficient to account for my good luck. My mental set was exactly as it needed to be—I was a spiritually serious investigator of my own mind—and my setting was generally one of either natural beauty or secure solitude.

I cannot account for why my adventures with psychedelics were uniformly pleasant until they weren’t, but once the doors to hell opened, they appeared to have been left permanently ajar. Thereafter, whether or not a trip was good in the aggregate, it generally entailed some excruciating detour on the path to sublimity. Have you ever traveled, beyond all mere metaphors, to the Mountain of Shame and stayed for a thousand years? I do not recommend it.

(Pokhara, Nepal)

On my first trip to Nepal, I took a rowboat out on Phewa Lake in Pokhara, which offers a stunning view of the Annapurna range. It was early morning, and I was alone. As the sun rose over the water, I ingested 400 micrograms of LSD. I was twenty years old and had taken the drug at least ten times previously. What could go wrong?

Everything, as it turns out. Well, not everything—I didn’t drown. I have a vague memory of drifting ashore and being surrounded by a group of Nepali soldiers. After watching me for a while, as I ogled them over the gunwale like a lunatic, they seemed on the verge of deciding what to do with me. Some polite words of Esperanto and a few mad oar strokes, and I was offshore and into oblivion. I suppose that could have ended differently.

But soon there was no lake or mountains or boat—and if I had fallen into the water, I am pretty sure there would have been no one to swim. For the next several hours my mind became a perfect instrument of self-torture. All that remained was a continuous shattering and terror for which I have no words.

An encounter like that takes something out of you. Even if LSD and similar drugs are biologically safe, they have the potential to produce extremely unpleasant and destabilizing experiences. I believe I was positively affected by my good trips, and negatively affected by the bad ones, for weeks and months.

Meditation can open the mind to a similar range of conscious states, but far less haphazardly. If LSD is like being strapped to a rocket, learning to meditate is like gently raising a sail. Yes, it is possible, even with guidance, to wind up someplace terrifying, and some people probably shouldn’t spend long periods in intensive practice. But the general effect of meditation training is of settling ever more fully into one’s own skin and suffering less there.

As I discussed in The End of Faith, I view most psychedelic experiences as potentially misleading. Psychedelics do not guarantee wisdom or a clear recognition of the selfless nature of consciousness. They merely guarantee that the contents of consciousness will change. Such visionary experiences, considered in their totality, appear to me to be ethically neutral. Therefore, it seems that psychedelic ecstasies must be steered toward our personal and collective well-being by some other principle. As Daniel Pinchbeck pointed out in his highly entertaining book Breaking Open the Head, the fact that both the Mayans and the Aztecs used psychedelics, while being enthusiastic practitioners of human sacrifice, makes any idealistic connection between plant-based shamanism and an enlightened society seem terribly naïve.

As I discuss elsewhere in my work, the form of transcendence that appears to link directly to ethical behavior and human well-being is that which occurs in the midst of ordinary waking life. It is by ceasing to cling to the contents of consciousness—to our thoughts, moods, and desires— that we make progress. This project does not in principle require that we experience more content.^[5]  The freedom from self that is both the goal and foundation of “spiritual” life is coincident with normal perception and cognition—though, admittedly, this can be difficult to realize.

The power of psychedelics, however, is that they often reveal, in the span of a few hours, depths of awe and understanding that can otherwise elude us for a lifetime. William James said it about as well as anyone:^[6]

One conclusion was forced upon my mind at that time, and my impression of its truth has ever since remained unshaken. It is that our normal waking consciousness, rational consciousness as we call it, is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different. We may go through life without suspecting their existence; but apply the requisite stimulus, and at a touch they are there in all their completeness, definite types of mentality which probably somewhere have their field of application and adaptation. No account of the universe in its totality can be final which leaves these other forms of consciousness quite disregarded. How to regard them is the question,—for they are so discontinuous with ordinary consciousness. Yet they may determine attitudes though they cannot furnish formulas, and open a region though they fail to give a map. At any rate, they forbid a premature closing of our accounts with reality.

(The Varieties of Religious Experience, p. 388)

I believe that psychedelics may be indispensable for some people—especially those who, like me, initially need convincing that profound changes in consciousness are possible. After that, it seems wise to find ways of practicing that do not present the same risks. Happily, such methods are widely available.

NOTES:

1. A wide literature now suggests that MDMA can damage serotonin-producing neurons and decrease levels of serotonin in the brain. Here is the tip of the iceberg: 1, 2, 3, 4, 5, and 6. There are credible claims, however, that many of these studies used poor controls or dosages in lab animals that were too high to model human use of the drug. ↩
2. What is moderation? Let’s just say that I’ve never met a person who smokes marijuana every day who I thought wouldn’t benefit from smoking less (and I’ve never met someone who has never tried it who I thought wouldn’t benefit from smoking more).↩
3. Physicalism, by contrast, could be easily falsified. If science ever established the existence of ghosts, or reincarnation, or any other phenomenon which would place the human mind (in whole or in part) outside the brain, physicalism would be dead. The fact that dualists can never say what would count as evidence against their views makes this ancient philosophical position very difficult to distinguish from religious faith.↩
4. Terence McKenna is one person I regret not getting to know. Unfortunately, he died from brain cancer in 2000, at the age of 53. His books are well worth reading, and I have recommended several below, but he was, above all, an amazing speaker. It is true that his eloquence often led him to adopt positions which can only be described (charitably) as “wacky,” but the man was undeniably brilliant and always worth listening to. ↩
5. I should say, however, that there are psychedelic experiences that I have not had, which appear to deliver a different message. Rather than being states in which the boundaries of the self are dissolved, some people have experiences in which the self (in some form) appears to be transported elsewhere. This phenomenon is very common with the drug DMT, and it can lead its initiates to some very startling conclusions about the nature of reality. More than anyone else, Terence McKenna was influential in bringing the phenomenology of DMT into prominence.
   DMT is unique among psychedelics for a several reasons. Everyone who has tried it seems to agree that it is the most potent hallucinogen available (not in terms of the quantity needed for an effective dose, but in terms of its effects). It is also, paradoxically, the shortest acting. While the effects of LSD can last ten hours, the DMT trance dawns in less than a minute and subsides in ten. One reason for such steep pharmacokinetics seems to be that this compound already exists inside the human brain, and it is readily metabolized by monoaminoxidase. DMT is in the same chemical class as psilocybin and the neurotransmitter serotonin (but, in addition to having an affinity for 5-HT_2A receptors, it has been shown to bind to the sigma-1 receptor and modulate Na+ channels). Its function in the human body remains mysterious. Among the many mysteries and insults presented by DMT, it offers a final mockery of our drug laws: Not only have we criminalized naturally occurring substances, like cannabis; we have criminalized one of our own neurotransmitters.
   Many users of DMT report being thrust under its influence into an adjacent reality where they are met by alien beings who appear intent upon sharing information and demonstrating the use of inscrutable technologies. The convergence of hundreds of such reports, many from first-time users of the drug who have not been told what to expect, is certainly interesting. It is also worth noting these accounts are almost entirely free of religious imagery. One appears far more likely to meet extraterrestrials or elves on DMT than traditional saints or angels. As I have not tried DMT, and have not had an experience of the sort that its users describe, I don’t know what to make of any of this. ↩
6. Of course, James was reporting his experiences with nitrous oxide, which is an anesthetic. Other anesthetics, like ketamine hydrochloride and phencyclidine hydrochloride (PCP), have similar effects on mood and cognition at low doses. However, there are many differences between these drugs and classic psychedelics—one being that high doses of the latter do not lead to general anesthesia. ↩

Recommended Reading:

• Huxley, A. The Doors of Perception and Heaven and Hell.
• McKenna, T. Food of the Gods: The Search for the Original Tree of Knowledge A Radical History of Plants, Drugs, and Human Evolution.
• McKenna, T. The Archaic Revival: Speculations on Psychedelic Mushrooms, the Amazon, Virtual Reality, UFOs, Evolution, Shamanism, the Rebirth of the Goddess, and the End of History.
• McKenna, T. True Hallucinations: Being an Account of the Author’s Extraordinary Adventures in the Devil’s Paradise.
• Pinchbeck, D. Breaking Open the Head: A Psychedelic Journey into the Heart of Contemporary Shamanism.
• Stevens, J. Storming Heaven: LSD and the American Dream.
• Ratsch, C. The Encyclopedia of Psychoactive Plants: Ethnopharmacology and Its Applications.
• Ott, J. Pharmacotheon: Entheogenic Drugs, Their Plant Sources and History.
• Strassman, R. DMT: The Spirit Molecule: A Doctor’s Revolutionary Research into the Biology of Near-Death and Mystical Experiences.