Reduced precision underwrites ego dissolution and therapeutic outcomes under psychedelics

Abstract

Evidence suggests classic psychedelics reduce the precision of belief updating and enable access to a range of alternate hypotheses that underwrite how we make sense of the world. This process, in the higher cortices, has been postulated to explain the therapeutic efficacy of psychedelics for the treatment of internalising disorders. We argue reduced precision also underpins change to consciousness, known as ‘ego dissolution’, and that alterations to consciousness and attention under psychedelics have a common mechanism of reduced precision of Bayesian belief updating. Evidence connecting the role of serotonergic receptors to large-scale connectivity changes in the cortex suggests the precision of Bayesian belief updating may be a mechanism to modify and investigate consciousness and attention.

Psychedelic replications in virtual reality and their potential as a therapeutic instrument: an open-label feasibility study

“…There was a significant decrease in EST-Q2 scores at the two week follow-up (M = 10.73, SD = 3.66; paired samples t-test, t( 10 One important facet of subjective experiences that could be instrumental for therapeutic benefits is the insight experience 5,32,40,41 . The Psychological Insight Questionnaire 40 Another aspect of subjective experience that has been suggested to underlie the beneficial effects of psychedelic therapy is ego dissolution 32,38,114 , measured here by the Ego-Dissolution Inventory 109 (EDI). EDI scores increased from M = 34.81 (SD = 20.42) at baseline to M = 42.66 (SD = 28.23) post-experiment, but the change was not statistically significant (t(11) = 1.34, p = 0.207, Cohen's d = 0.39).…”

“…As the demonstrative VR was in a small room with a balcony view onto a mountain range the participant felt it to be very personally meaningful. Third, one of the potential mediators of the beneficial effects of psychedelic experiences as well as a crucial element of mystical experiences 32,38,114 egodissolution, might be induced to some degree in any VR experience with an altered image of the body 156,157 . While the EDI did not show a significant change from baseline, half of the participants showed relatively high (a score of over 40) results even after the demo experience on the first day and several participants mentioned alterations in their sense of self during the integrative sessions.…”

“…For instance, in Psyrreal it is possible to remove and add specific parts of the experience to customize the virtual reality experience for the specific participant and the circumstances. Third, virtual reality could have some advantages in regard to inducing ego-dissolution 53,122,156,159,160 which could be one of the mechanisms behind the therapeutic effects of psychedelics 32,38,114 . Fourth, virtual reality assisted therapeutic interventions have high satisfaction rates 161 and are often preferred by patients.…”

“…The alternative proposal is that subjective experiences hold the key to the success of psychedelic interventions 32,33 . According to the latter view, therapeutic success is caused by the subjective experiences elicited by these substances, such as mystical 8,34,35 , ego-dissolution 32,[36][37][38] or insight experiences 5,32,34,[39][40][41] . If psychedelic-induced subjective experiences underlie their therapeutic effects, then it should be possible to achieve at least some of the benefits of psychedelic therapy without the substances themselves 42 simply by emulating specific aspects of psychedelic experiences.…”