The General Medical Council and Royal College of Psychiatrists (RCPsych) have guidelines
for doctors to keep up to date with their knowledge. New research is constantly expanding
our knowledge, but may not permeate into understanding, innovation and change if we do not
explore the attitudes and prejudices that work to dismiss new information and integrate
knowledge into practice. This article was targeted at training and established psychiatrists in
the hope that they may give themselves permission to engage in conversations on some of the
most progressive new treatments that we may be on the cusp of embracing, in order to keep
up to date in our profession.
The 5th biannual Breaking Conventions 2019 conference on psychedelics at Greenwich
University continues to pull together an international mix of: academics, researchers,
psychonauts (users), psychologists, alternative practitioners, mental health workers and a
great many open-minded psychiatrists, for a very dense and rich three-day event.
The recreational and medical use of psychedelics in the 1950s and 60s and their noted effects
on consciousness, self-awareness and altered perceptions, led them to be quickly considered
as therapeutic tools in psychiatric practice (Sessa, 2017). Naivety, prejudice and political
stigma may have all played a role in the global censorship of psychedelics.
My belief is that the research and potential therapeutic application of these drugs in
clinical practice has been held in a liminal space.
Breaking Conventions has provided a UK stage to champion the therapeutic use of
psychedelic drugs. Senior psychedelic researchers and advocates such as Rick Doblin,
Founder of the Multidisciplinary Association for Psychedelic Studies, Amanda Feilding,
Founder of the Beckley Foundation and Professor Nutt Director of
Neuropsychopharmacology at Imperial College contributed to the generous programme. The
collective efforts of this strong community has contributed to the overturning of 50-year ban
on psychedelic research.
With large institutions like Imperial College, Bristol University and Johns Hopkins
University proudly announcing their presence at the dawn of the new renaissance of
psychedelics for mental health, even our RCPsych openly invited discussion on this topic in
the October 2019 Presidents lecture.
We must start by judiciously re-examining how our current assumptions may ultimately limit
our understanding to their potential therapeutic benefits for patients. (Meyer & Land, 2003)
We must attempt to be open and curious to the emerging scientific research being undertaken
using the tools of neuroimaging and psychotherapy. These research findings support the large
body of anecdotal reports from psychedelic users, who argue that the therapeutic benefits of
psychedelics may be linked to their ability to induce self-awareness through spiritual
experiences. (Carhart-Harris, 2014)
Once this growing evidence is acknowledged and the group of drug labelled as psychedelics
are accepted as medicine, psychiatrists will be well placed to utilise and integrate their
benefits into our future practice of helping relieve the distress and suffering of our patients.
By educating ourselves, we may potentially begin to validate the benefits of these novel
therapeutic agents to help overcome the troublesome reputation of these reflective drugs. In
doing so, our community of psychiatrists may contribute to transformative changes in
psychiatric practice that could lead to a potential paradigm shift in our current model of
assessment, formulation and treatment towards healing.
As a profession, psychiatry may be on track in actualising the hopeful words of the
psychedelic Godfather, Stanislav Grof,
"It does not seem to be an exaggeration to say that psychedelics, used
responsibly and with proper caution, would be for psychiatry what the
microscope is for biology and medicine or the telescope is for astronomy."
References:
[1] Sessa, B. (2017) The Psychedelic Renaissance, Muswell Hill Press.
[2] Meyer, J. Land, R. (2003) ‘Threshold Concepts and Troublesome Knowledge 1 –
Linkages to Ways of Thinking and Practising’ in Improving Student Learning – Ten Years
On.
[3] Carhart-Harris, R. (2014) “ The entropic brain: a theory of conscious states
informed by neuroimaging research with psychedelic drugs, Frontiers In Human
Neuroscience, Feb 2014.
[4] https://metro.co.uk/2019/04/26/worlds-first-centre-psychedelic-research-launches-imperial-college-
london-9323774/
[5] https://www.theguardian.com/society/2019/aug/19/mdma-treatment-alcoholism-relapse-study
[6] https://www.nytimes.com/2019/09/04/science/psychedelic-drugs-hopkins-depression.html