Meeting Grandmother: Breakdown, breakthrough, and the fear of madness in psychedelic research

The authors argue that research into psychedelics and psychosis/madness must be not only expanded but also conducted wisely. They note increasing publications on psychedelic use by people who have experienced psychosis and present a narrative account of the lead author, who had a breakdown diagnosed as psychosis in 1989 and used psychedelics for healing in 2024. The paper connects current psychedelic-assisted therapy research with insights from critical, historical, user-led, participatory, and theoretical literatures on psychosis. It offers research questions and frameworks, highlighting the concept of 'integration' versus 'sealing over' from earlier psychosis research. The authors call for interdisciplinary, methodologically diverse research that avoids speaking 'for' subjects.

Study at a glance

Abstract

We take a wide view across the emerging research into psychedelics and psychosis/madness, to emphasize the need for not just more but also wise research at these intersections. We note the growing rate of publications on the use of psychedelics by people who have had experiences of psychosis/madness, and make our arguments around a narrative report of the lead author, who experienced a breakdown diagnosed as psychosis in 1989, and in 2024 used psychedelics for healing. In so doing, we bring current scientific research into psychedelic-assisted therapies into conversation with long-standing insights and concerns of critical, historical, user-led, participatory, and theoretical literatures on psychosis/madness. We offer key research questions, frameworks for inquiry, and challenges for this emerging subfield of psychedelics research to grapple with. In particular, we excavate and elaborate upon a concept of ‘integration’ in an earlier wave of psychosis research that contrasted it with the ‘sealing over’ of episodes of psychosis/madness. We call for research to be interdisciplinary, methodologically expansive, and take care when speaking ‘for’ the subjects of our studies. By so doing, both psychedelics and psychosis research stands to gain much from one another.