- Studies done wrong? - Studies don’t have enough statistical power? - Something with confounding and Simpson’s paradox? Maybe there’s a particular subgroup in the population where psychedelic use correlates negatively with likelihood of mental health issues within this subgroup, or a subgroup where there is more psychedelic use and simultaneously lower likelihood of mental health issues on average across the subgroup? - Psychedelics impart mental well-being and resilience to some people to such a degree that it cancels out the negative mental health effects in other people, so that in expectation psychedelics wouldn’t affect your mental health negatively?
This study at least didn’t ask about the length of the psychotic episode, so it seems compatible with the users having had short-term psychotic episodes that didn’t cause long-term damage.
Speculatively, a short-term psychosis could even be part of what causes long-term mental health benefits, if e.g. psychedelics do it via a relaxing of priors and the psychotic episode is the moment when they are the most relaxed before stabilizing again, in line with the neural annealing analogy:
The hypothesized flattening of the brain’s (variational free) energy landscape under psychedelics can be seen as analogous to the phenomenon of simulated annealing in computer science—which itself is analogous to annealing in metallurgy, whereby a system is heated (i.e., instantiated by increased neural excitability), such that it attains a state of heightened plasticity, in which the discovery of new energy minima (relatively stable places/trajectories for the system to visit/reside in for a period of time) is accelerated (Wang and Smith, 1998). Subsequently, as the drug is metabolized and the system cools, its dynamics begin to stabilize—and attractor basins begin to steepen again (Carhart-Harris et al., 2017). This process may result in the emergence of a new energy landscape with revised properties.
A relevant-seeming comparison is that there are meditation traditions that basically hold that you are expected to go through what are something like psychotic episodes before you get better, on the theory that reconfiguring your brain to more clearly see reality will break some existing setups and require time to find a new workable configuration.
Alternatively, the psychotic episodes themselves may be part of what helps convey useful information to your brain: they are a very visceral indication of the fact that your experience is internally constructed. If something totally crazy may seem like an absolute truth during the trip/meditation experience, then that helps highlight the fact that even things that feel like absolute truths to you can be false. “Getting a visceral understanding of how your mind creates your subjective reality” is sometimes understood to be one of the goals of enlightenment, and it can also make it easier to discard incorrect emotional schemas that some part of your mind has so far taken as absolute ttruths and which have caused what we would ordinarily call mental health problems.
At the same time this also risks some craziness if you don’t already have good epistemology. One with the right background may end up thinking “okay so that was a really visceral indication of my mind being generated by a piece of fallible software, I’ll be much less sure about all of my beliefs now and try extra hard to test them against reality”. But someone else could interpret exactly the same experiences to imply “well apparently everything I took to be certain is bunk, that includes all that previous stuff about science that I once thought to be true, now I know that my mind creates reality so this has to mean that there’s no objective reality and I can make anything true just by believing in it!”.
My mental model for the difference between the two results is based on the following: 1) the studies by Krebs and Johansen are analysis based on the “National Survey on Drug Use and Health (...), randomly selected to be representative of the adult population in the United States”. 2) ACX readers population is not representative of the US population, in fact, it might be skewed in some dimensions that are very relevant here. 3) there are significant differences in the fraction of each sample that report psychedelic use 3.1) in the case of Krebs and Johansen (2013, 2015), it is ~13% reporting lifetime psychedelic use, while in the subsample of ACX readers survey considered in this report it is ~100%.
One important aspect here tying this together is that I would assume ACX readers do not have the same distribution of genes associated with intelligence as the general population, and there has been evidence that there is an overlap of those genes and the genes associated with bipolar disorder (https://www.med.uio.no/norment/english/research/news-and-events/news/2019/genetic-overlap-bipolar-disorder-intelligence.html). This genetic overlap can explain a higher susceptibility of psychotic-like experiences with higher intelligence, even if there is no particular diagnose. Furthermore, by considering the multiple types of psychotic disorder, https://pubmed.ncbi.nlm.nih.gov/17199051/ has found the prevalence in the general population to be ~3%, which does not fall too far from the 4.5% that responded a firm “yes” to the survey.
>in the case of Krebs and Johansen (2013, 2015), it is ~13% reporting lifetime psychedelic use, while in the ACS readers survey it is ~100%.
Just to be clear to casual readers, this wasn’t the whole ACX Readers Survey, I just only looked at the subset that filled out my psychedelic survey and seemed to have actually done psychedelics (i.e. the conclusion “all ACX readers do psychedelics” would be very incorrect). I don’t know what fraction of ACX readers have done psychedelics.
Does anyone have a good model of how do they reconcile
1) a pretty large psychosis rate in this survey, a bunch of people in https://www.lesswrong.com/posts/MnFqyPLqbiKL8nSR7/my-experience-at-and-around-miri-and-cfar-inspired-by-zoe saying that their friends got mental health issues after using psychedelics, anecdotal experiences and stories about psychedelic-induced psychosis in the general cultural field
and
2) Studies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3747247/ https://journals.sagepub.com/doi/10.1177/0269881114568039 finding no correlation, or, in some cases, negative correlation between psychedelic consumption and mental health issues?
- Studies done wrong?
- Studies don’t have enough statistical power?
- Something with confounding and Simpson’s paradox? Maybe there’s a particular subgroup in the population where psychedelic use correlates negatively with likelihood of mental health issues within this subgroup, or a subgroup where there is more psychedelic use and simultaneously lower likelihood of mental health issues on average across the subgroup?
- Psychedelics impart mental well-being and resilience to some people to such a degree that it cancels out the negative mental health effects in other people, so that in expectation psychedelics wouldn’t affect your mental health negatively?
This study at least didn’t ask about the length of the psychotic episode, so it seems compatible with the users having had short-term psychotic episodes that didn’t cause long-term damage.
Speculatively, a short-term psychosis could even be part of what causes long-term mental health benefits, if e.g. psychedelics do it via a relaxing of priors and the psychotic episode is the moment when they are the most relaxed before stabilizing again, in line with the neural annealing analogy:
A relevant-seeming comparison is that there are meditation traditions that basically hold that you are expected to go through what are something like psychotic episodes before you get better, on the theory that reconfiguring your brain to more clearly see reality will break some existing setups and require time to find a new workable configuration.
Alternatively, the psychotic episodes themselves may be part of what helps convey useful information to your brain: they are a very visceral indication of the fact that your experience is internally constructed. If something totally crazy may seem like an absolute truth during the trip/meditation experience, then that helps highlight the fact that even things that feel like absolute truths to you can be false. “Getting a visceral understanding of how your mind creates your subjective reality” is sometimes understood to be one of the goals of enlightenment, and it can also make it easier to discard incorrect emotional schemas that some part of your mind has so far taken as absolute ttruths and which have caused what we would ordinarily call mental health problems.
At the same time this also risks some craziness if you don’t already have good epistemology. One with the right background may end up thinking “okay so that was a really visceral indication of my mind being generated by a piece of fallible software, I’ll be much less sure about all of my beliefs now and try extra hard to test them against reality”. But someone else could interpret exactly the same experiences to imply “well apparently everything I took to be certain is bunk, that includes all that previous stuff about science that I once thought to be true, now I know that my mind creates reality so this has to mean that there’s no objective reality and I can make anything true just by believing in it!”.
My mental model for the difference between the two results is based on the following:
1) the studies by Krebs and Johansen are analysis based on the “National Survey on Drug Use and Health (...), randomly selected to be representative of the adult population in the United States”.
2) ACX readers population is not representative of the US population, in fact, it might be skewed in some dimensions that are very relevant here.
3) there are significant differences in the fraction of each sample that report psychedelic use
3.1) in the case of Krebs and Johansen (2013, 2015), it is ~13% reporting lifetime psychedelic use, while in the subsample of ACX readers survey considered in this report it is ~100%.
One important aspect here tying this together is that I would assume ACX readers do not have the same distribution of genes associated with intelligence as the general population, and there has been evidence that there is an overlap of those genes and the genes associated with bipolar disorder (https://www.med.uio.no/norment/english/research/news-and-events/news/2019/genetic-overlap-bipolar-disorder-intelligence.html). This genetic overlap can explain a higher susceptibility of psychotic-like experiences with higher intelligence, even if there is no particular diagnose. Furthermore, by considering the multiple types of psychotic disorder, https://pubmed.ncbi.nlm.nih.gov/17199051/ has found the prevalence in the general population to be ~3%, which does not fall too far from the 4.5% that responded a firm “yes” to the survey.
>in the case of Krebs and Johansen (2013, 2015), it is ~13% reporting lifetime psychedelic use, while in the ACS readers survey it is ~100%.
Just to be clear to casual readers, this wasn’t the whole ACX Readers Survey, I just only looked at the subset that filled out my psychedelic survey and seemed to have actually done psychedelics (i.e. the conclusion “all ACX readers do psychedelics” would be very incorrect). I don’t know what fraction of ACX readers have done psychedelics.
To avoid such misunderstanding I edited the original comment with “subsample of ACX readers survey considered in this report (...)”