How would you summarize your study for a lay audience?
Our team has been investigating unusual mental and somatic experiences that occur in intensive meditative, spiritual and contemplative practice, such as:
- The sense that the world is a dream or cartoon
- An absorbing sense of unity with God
- Ecstatic thrills running through the body
- Unusually vivid perceptions
- Out of body experiences
- Perceptions of non-physical lights.
In a previous study, we found these experiences were surprisingly widespread in general populations, and that while they are usually followed by positive changes to wellbeing, sometimes they lead to clinically relevant suffering.
In this study, we applied epidemiological techniques to identify risk factors for the occurrence of these unusual experiences and subsequent suffering.
We found clear results that can help to predict when these phenomena might emerge in individuals, guide practitioners seeking to obtain or avoid these experiences, and enable clinicians to better differentiate between psychosis and events more often associated with contemplative or spiritual practice.
What methods or approach did you use?
We used an expert panel to develop a questionnaire that measured past occurrence of these events and subsequent suffering, as well as a variety of potential covariates including spiritual or contemplative practice histories, personal characteristics, and demographics.
We gathered data through three surveys of general populations across two countries (total study participants = 3133) and applied logistic regression to identify risk factors.
What did you find?
While unusual mental and somatic experiences are well known amongst contemplative and spiritual practitioners, they are usually reported by anecdote rather than formal measurement. They are understudied in the scientific literature and under-represented in both the DSM and clinician training.
In our study, we found very high increases in risk for these experiences associated with past psychedelic use, reality distorting practices (divine or occult practices, and contemplation of mysteries) and the total hours spent in spiritual or meditative practice outside retreats.
There were lesser but still considerable effects for other variables, including having had a traumatic or spiritually powerful childbirth experience and past diagnosis of mental illness.
For occurrence alone, but not for subsequent suffering, some traditional eastern meditative practices were risk factors while prayer was a protective factor.
What are the implications?
Clinicians can use these results to assist in the diagnosis; the presence or absence of relevant risk factors may help to distinguish between spiritual difficulties and psychosis, better guiding treatment response to patients.
For those promoting the use of psychedelics for contemplative practice or medical intervention, these results provide the first direct evidence of links to the potential for subsequent suffering. Psychedelic research protocols ought to take account of these longer-term risks to participants.
What are the next steps?
We hope our findings will contribute to the formation of the next set of DSM guidelines.
We are open to working with clinicians, as well as contemplative and spiritual teachers, to translate our results into practical guidelines for managing risk factors, diagnosing associated suffering, and treatment of symptoms.
We will also extend our work to investigate the risk factors for positive changes to wellbeing, as these are the more commonly reported aftereffects of unusual mental and somatic experiences.
As the research has been conducted on cross-sectional data, it would be useful to undertake longitudinal studies to better investigate causal links between the factors and outcomes that we have studied.
