Expectancies for Cannabis-Induced Emotional Breakthrough, Mystical Experiences and Changes in Dysfunctional Attitudes: Perceptions of the Potential for Cannabis-Assisted Psychotherapy for Depression

Abstract

Psychedelic-assisted psychotherapy has established antidepressant effects. Cannabis users appear to expect high doses administered in a session much like psychedelic-assisted psychotherapy to create comparable subjective effects. The current studies explored expectations of antidepressant effects of such cannabis-assisted sessions to replicate and extend previous work. Users not only expected a cannabis-assisted psychotherapy session to decrease depression, but also to alter some of the same mediators of psychedelic or psychological treatments. Over 500 participants in Study I envisioned a cannabis-assisted therapy session akin to those used in psychedelic therapies and reported the effects that they expected on depression as well as relevant subjective reactions. A second sample of over 500 participants responded to identical measures and an index of dysfunctional attitudes that appears to mediate antidepressant effects of psychotherapy. Expectancies of cannabis-induced antidepressant effects covaried with expected psychedelic effects. Participants also envisioned that cannabis-assisted therapy would alter dysfunctional attitudes, which served as a separate, unique path to expected antidepressant effects unrelated to the subjective effects of psychedelics. These results add support to arguments for relevant clinical trials of cannabis-assisted psychotherapy and suggest that cannabis users would expect it to work in ways similar to psychedelics as well as cognitive therapy.

The psychedelic effects of cannabis: A review of the literature

“…As many of the studies cited in this review did not involve standardized doses, study participants could very well have been using cannabis at levels too low to generate a psychedelic experience. This supposition is supported by a recently published study of cannabis users' beliefs regarding cannabis-guided psychotherapy (Earleywine et al, 2022). Results illustrated an expectation that cannabis could produce psychedelic effects when administered at an unspecified "ideal dose."…”

“…As many of the studies cited in this review did not involve standardized doses, study participants could very well have been using cannabis at levels too low to generate a psychedelic experience. This supposition is supported by a recently published study of cannabis users’ beliefs regarding cannabis-guided psychotherapy (Earleywine et al, 2022). Results illustrated an expectation that cannabis could produce psychedelic effects when administered at an unspecified “ideal dose.” Differences in the patterns of therapeutic use between cannabis and classic psychedelics—with classic psychedelics typically administered over the course of a few intensive therapy sessions and cannabis used more frequently and independent of therapy sessions—may also explain why cannabis has not been more frequently associated with psychedelic experiences (Johnstad, 2020).…”

Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report

“…For instance, understanding whether CAP is preferentially suited for treating D-PTSD, assuming that all assisted forms of psychedelics are available. A recent cross-sectional study, investigating expectations for CAP, showed comparable beliefs to psilocybin-assisted therapy among two samples of cannabis users ( 58 ). Participants believed that CAP, when administered at an ideal dose, could elicit mystical and emotional experiences, as well as alter dysfunctional attitudes.…”

Chronic cannabis use in everyday life: Emotional, motivational, and self-regulatory effects of frequently getting high

“…Moving beyond good or bad moods, here we wonder how cannabis changes people's discrete emotions (Fredrickson, 2009)-for example, awe, gratitude, love, etc. By appreciating the emotional profile of frequent cannabis intoxication, we might better understand what drives use and possibly identity novel applications for cannabis, say in therapeutic contexts (Earleywine et al, 2022).…”