Shame, guilt and psychedelic experience: Results from a prospective, longitudinal survey of real-world psilocybin use
David S. Mathai, Daniel E. Roberts, Sandeep M. Nayak, Nathan D. Sepeda, Amy Lehrner, Matthew W. Johnson, Matthew X. Lowe, Heather Jackson, Albert Garcia‐romeu
October 14, 2023 preprint DOI: 10.31234/osf.io/hm6jn_v1 via OpenAlex
Summary
AI-generated from the abstractA longitudinal study of 679 adults planning to use psilocybin in naturalistic settings found that while most users (89.7%) described the experience as positive, acute feelings of shame or guilt were commonly reported (68.2% of users) and difficult to predict. The ability to constructively work through these feelings predicted wellbeing 2-4 weeks after use. Psilocybin produced a small but significant average decrease in trait shame that lasted 2-3 months, but trait shame increased in a notable minority (29.8%) of participants. The activation of shame-related experiences with psychedelics may pose a unique learning condition for both therapeutic and detrimental forms of memory reconsolidation.
Study at a glance
| Characteristics | Prospective longitudinal study |
|---|---|
| Sample size | 679 |
| Population | Primarily college-educated, White adults residing in the United States with a prior history of psilocybin use; mean age 38.9-41 years |
| Intervention | Psilocybin |
| Duration | 2-4 week follow-up for wellbeing; 2-3 month follow-up for trait shame |
| Topics | Psilocybin |
| Keywords | Shame Psychoanalysis Hallucinogen Psychotherapist |
| Key finding | Acute feelings of shame or guilt were commonly reported during psilocybin use and the ability to work through these feelings predicted subsequent wellbeing, while psilocybin produced a small average decrease in trait shame that was maintained for 2-3 months, though shame increased in a notable minority of participants. |
Abstract
Introduction: The classic psychedelic psilocybin has attracted special interest across clinical and non-clinical settings as a potential tool for mental health. However, despite increasing attention to challenging psychedelic experiences, few studies have explored the relevance of emotionally painful, shame-related processes with psychedelic use. Methods: This prospective, longitudinal study involved sequential, automated, web-based surveys that collected data from 679 adults planning to use psilocybin in naturalistic settings at timepoints before and after psilocybin use. State and trait shame and feelings of guilt were collected using validated measures and assessed alongside other measurements of psychological health. Results: Participants were primarily college-educated, White individuals residing in the United States with a prior history of psilocybin use; mean age = 38.9-41 years. Most users (89.7%) described their experience of psilocybin as positive, though acute feelings of shame or guilt were commonly reported (i.e., 68.2% of users) and difficult to predict. Ratings of participant ability to constructively work through these feelings predicted wellbeing 2-4 weeks after psilocybin use. Psilocybin on average produced a small but significant decrease in trait shame that was maintained 2-3 months after use (Cohen’s dz = 0.37; adjusted p <0.001). Trait shame increased in a notable minority (29.8%) of participants. Discussion: The experience of self-conscious emotions with psychedelics has been explored minimally, but further study in this area may have far-reaching implications for psychological health. The activation of shame-related experiences with psychedelics may pose a unique and context-dependent learning condition for both therapeutic and detrimental forms of shame-related memory reconsolidation.