Sage Journals: Discover world-class research

Abstract

The use of psychedelic substances in both humanistic and mainstream clinical research has been increasing in the last decade. In particular, the practice of microdosing—ingesting sub-hallucinogenic doses of psychedelics—has been increasing in popularity, but large-scale qualitative analyses are still uncommon. This study attempted to recognize emergent themes in qualitative reports regarding the experience of microdosing to enrich the theoretical landscape in psychedelic research and propose future research directions for both basic and clinical research. Participants were people who reported microdosing at least once in the last year; they described their experiences using an online survey. Data from 118 informative responses suggested four main emergent themes: reasons for microdosing, the practice of microdosing itself, outcomes linked to microdosing, and meta-commentary about microdosing. We use meaning-making theory and propose that, even at low doses, psychedelic substances can provide a sense of meaning. Our results suggest that many of the reported benefits occur regardless of motivation to microdose and are likely due to the enhanced psychological flexibility and a sense of connectedness made possible due to the use of psychedelics. Double-blind, placebo-controlled experiments are required to substantiate these reports.

Keywords

meaning in life microdosing psilocybin psychedelic

Introduction

A new psychedelic praxis has emerged: psychedelic microdosing. Microdosing is the practice of ingesting psychedelic substance in very low doses, doses so low that any effects remain sub-hallucinogenic (Anderson, Petranker, Rosenbaum, et al., 2019). The qualitative experience of people engaged in psychedelic microdosing remains understudied, but the practice of microdosing psychedelics rests on plausible mechanisms of change. Among other benefits, psychedelics can enhance cognitive flexibility and openness, promote creative thinking and problem-solving, and provide uplifting mood enhancement (Anderson, Petranker, Rosenbaum, et al., 2019; Harman et al., 1966; MacLean et al., 2011; Prochazkova et al., 2018; Sessa, 2008; Tupper et al., 2015). These effects can be conceptualized from two perspectives: biochemical and phenomenological. From the biochemical perspective, psychedelics generate biochemical reactions in brain activity and metabolism, largely via 5-HT2a and 5-HT2c receptors (Krebs-Thomson et al., 1998; Krebs-Thomson & Geyer, 1996; Nichols, 2016; Vollenweider et al., 1998). From the phenomenological perspective, psychologically profound existential insights result from psychedelically altered perception and cognition, alterations that may culminate in mystical experiences and feelings of connection within oneself, others, and nature (Griffiths et al., 2008, 2011; Schmid et al., 2015; Studerus et al., 2011).

While potentially useful, mystical experiences induced by high-dose psychedelics drastically alter the acute perception of reality, seriously impeding normal functions during the experience. Activities of daily life—driving, working, or caregiving—are impeded or impossible while under the acute effects of high-dose psychedelics. In contrast to high doses, sub-hallucinogenic “microdoses” do not appear to impair normal functioning, yet users still report numerous benefits (Anderson, Petranker, Rosenbaum, et al., 2019; Petranker, Anderson, Maier, et al., 2020). Recent work suggests that, despite unaltered perception and lack of mystical experience, microdosing psilocybin or LSD may be associated with enhanced mood, creativity, focus, and may even provide social benefits (T. Anderson, Petranker, Rosenbaum, et al., 2019; Petranker, Anderson, Maier, et al.,; Polito & Stevenson, 2019; Prochazkova et al., 2018). There has even been a tremendous growth of online communities dedicated to microdosing. For example, membership in the Reddit microdosing community grew from 5,000 subscribers in 2016 to more than 170,000 subscribers as of September 2021 (Reddit.com/r/microdosing, for full discussion see Petranker, Anderson, & Farb, 2020).

Community forums and interpersonal support structures provide opportunities for social interactions and offer frameworks and strategies for meaning-making and developing a sense of purpose (Park, 2017; Pernice-Duca, 2010). As psychedelic communities grow, we and others wonder whether involvement in the paxis of such communities may provide social support that is otherwise lacking in contemporary society (Noorani, 2020). Psychedelic communities may provide opportunities for personal growth and social connection, which is of particular value in contemporary secular society where many people face ever-increasing feelings of isolation, disconnection, and meaninglessness (G. O. Anderson, 2010; Jenkins, 2018; Sliwa, 2017; Vervaeke & Miscevic, 2017). Indeed, some have declared a “loneliness epidemic” (Snell, 2017) and others have argued that the declining strength and prevalence of social ties likely contributes to society’s growing concern with mental health (Hartogsohn, 2018). Mental health is arguably the chief lens through which recent psychedelic research has been conducted and psychedelic research trials using high-dose psychedelics, in combination with therapy, have proven to be effective treatment options for some of these most recalcitrant mental health disorders (Carhart-Harris et al., 2017; Osorio et al., 2015).

Although most modern psychedelic research is framed in terms of mental health, this is not the only perspective. A limited amount of modern research focuses on the human flourishing side of psychedelics. Some of the earliest modern work from John Hopkins focused on mystical-type experiences induced by high-dose psilocybin (Griffiths et al., 2008, 2006; MacLean et al., 2011) and their recent work continues to explore such topics (Griffiths et al., 2018). Concerning microdosing, recent preregistered research has shown that people with experience microdosing present with higher wisdom and greater creativity (T. Anderson, Petranker, Rosenbaum, et al., 2019). Research also showed benefits reported to mood, focus, creativity, and other aspects of human flourishing, after which this research was re-validated in the largest sample of microdosers ever collected (T. Anderson, Petranker, Rosenbaum, et al., 2019; Petranker, Anderson, Maier, et al.,). While viewing psychedelic research through a lens of human flourishing was more openly endorsed during some earlier Western research (Passie, 2019), human flourishing likely plays a larger role in the private perspectives of psychedelic researchers than is widely known. This may owe to the fact that government agencies overseeing clinical trials typically require an explicitly medical-model approach to trials using psychedelic substances, a requirement that precludes framing such trials through the lens of human flourishing. Unsurprisingly then, the scientific literature lacks any comprehensive framework through which we understand psychedelics.

Present Project

Psychedelic microdosing lacks a theoretical framework. While it is possible that psychedelic microdosing is merely chemical, we sought to understand whether this practice serves a broader personal need in people that microdose. In the present study, we used data from an online survey. This survey included quantitative components, which have been published separately (Anderson, Petranker, Rosenbaum, et al., 2019; Rosenbaum et al., 2020). While the quantitative results are informative for their purposes, they fail to offer a first-person perspective on the reasons people start microdosing and the ongoing lived experience of people who microdose. In the present study, we analyzed a qualitative component of the same survey: free-text reports collected as part of the study. Our analyses searched for recurring narratives about the microdosing experience. The purpose of this study was to develop an understanding of the reasons for and uses of psychedelic microdosing in existing communities, thus no a priori hypotheses were posed prior to data analysis.

Methods

Participants

Participants (170) were recruited mostly through posts on the online forum “reddit” (Reddit Inc., San Francisco, CA, USA). Links were posted under the username /u/oredna on the following subreddits: Microdosing, Nootropics, Psychonaut, RationalPsychonaut, Tryptonaut, Drugs, LSD, shrooms, DMT, researchchemicals, and SampleSize. Of these 170 participants who provided comments, a further 52 participants were excluded from analysis after the completion of coding: 28 for comments that consisted only of calls to legalize psychedelics or volunteering for future research, 16 for identifying themselves as non-microdosers, four for revealing through their comments that their microdosing experience was minimal, two for providing comments on answers to the survey in an inappropriate box, and two for providing other forms of irrelevant commentary. The final sample included 118 participants (Table 1).

Table 1.

Demographics of the Included 118 Participants.

Age (years)	M (SD)	27.58 (9.17)
	Median	25
	Range	17–65
	Prefer not to answer / NA	3
Gender
	Male	99
	Female	17
	Neither/nonbinary	1
	Prefer not to answer/NA	1
Sexual orientation
	Heterosexual	88
	Homosexual	3
	Bisexual/multisexual	24
	Asexual	1
	Prefer not to answer/NA	2
Ethnic heritage
	White/European	91
	Black	0
	East Asian	1
	Middle Eastern	1
	Hispanic or Latino	5
	Mixed	9
	Other	6
	Prefer not to answer/NA	5
Religious affiliation
	Nonreligious, atheist, or agnostic	64
	Judaism	4
	Christianity	5
	Islam	0
	Hinduism	1
	Buddhism	5
	Other religious affiliation	4
	Spiritual but nonreligious	32
	Prefer not to answer/NA	3
Social class
	Upper-middle class	16
	Middle-class	44
	Lower-middle class	24
	Skilled working class	10
	Working class	11
	Nonworking class (casual workers, pensioners, or dependents)	9
	Prefer not to answer/NA	4
Education
	Doctoral or equivalent	3
	Master or equivalent	17
	Bachelor or equivalent	37
	Short-cycle tertiary (associate degree, advanced diploma)	12
	Postsecondary nontertiary (certificates, diplomas, or partial completion of a degree)	23
	Upper secondary or less	27
	Prefer not to answer/NA	4

Participation was voluntary and participants were not paid for their participation. Not all participants who started the survey completed it: while 1390 respondents began the survey, 475 exited before responding, three requested that their responses be removed, and three responses were removed for intentionally factitious responding (“trolling”). Of the remaining 909 participants, 170 participants provided commentary relevant to the present study (as detailed below).

Materials and Procedures

The survey (described in detail in Anderson, Petranker, Christopher, et al., 2019) was in English and available only online. At the end of the survey, open-ended commentary regarding microdosing was solicited from participants, using the prompt, “If there are any other comments you would like to leave about microdosing please share them here!” The present study focuses only on the data obtained in response to this prompt, and results from the rest of the data set collected in this survey have been published (Anderson, Petranker, Christopher, et al., 2019; Rosenbaum et al., 2020). Twenty-eight participants were excluded from the present analysis for providing commentary consisting only of a call for the legalization of psychedelics, volunteering for participation in further research, or both. As we are interested in participants’ experience of microdosing itself, these comments were considered unsuitable to the present analysis and therefore excluded, leaving 142 participants.

Data Analysis

Data were exported to a spreadsheet and two relevant columns were extracted: participant ID and the column containing responses to the above prompt. These remaining reports were compiled into a single document and imported into QSR’s NVivo 12 Plus (QSR International Pty Ltd).

Coding was conducted by the second author, a researcher in life span developmental psychology trained in qualitative analysis and previously unfamiliar with research literature on psychedelics to avoid potential bias. This would allow the first and third authors, established microdosing researchers, to confirm independent replication of previously appearing themes in microdosing research in the current data set upon completion of analysis. Coding proceeded following the methods of interpretive phenomenological analysis (IPA; Smith et al., 2009). Due to the unconstrained method of data collection giving participants freedom to report whatever they felt was most important to say, as well as the interest of the present paper in capturing the lived experience of microdosing, IPA was considered the most appropriate method to use to best analyze participants’ reports. Following Smith et al.’s (2009) guidelines for IPA with larger sample sizes, the analysis focused on understanding commonalities among participants’ experience of their microdosing.

Analysis began with a thorough reading of participants’ reports, noting patterns, and similarities between reports. In keeping with the methods of IPA, particular notice was taken of reports wherein participants described using microdosing to seek a change in their experience, why they sought such change, and how microdosing was used to leverage such change. On the second readthrough, units of text identified as descriptive of participant experience with microdosing were tagged as open codes. Coding categories emerged through a process of abstraction with NVivo used to manually sort open-coded units, into groups of similar topics or themes. Progressively higher order coding categories emerged from these lower order categories as thematic groups were themselves filed into groups. These groups were ordered into categories pertaining to the nature of the commentary, which serve as the primary themes uncovered (see Table 2). Themes were finalized in consultation with the first and third authors, to confirm consistency with both their own interpretation of the data, as well as pre-existing literature.

Table 2.

Number of Participants and Total References Per Theme, With Major Subthemes.

Theme	Participants	Total references	Subtheme	Participants	Total references
Reasons for microdosing	28	46	Clinical purposes	21	31
Reasons for microdosing	28	46	Productivity purposes	3	3
Practice of microdosing	47	61	Information about dose and timing	23	23
			Microdosing schedule	16	17
			Use in combination	10	14
Outcomes of microdosing	62	124	Existential effects	35	45
			Clinical effects	26	33
			Cognitive effects	15	19
			Performance effects	10	13
			Interpersonal effects	10	10
Meta-commentary on microdosing	27	32	Pessimism	11	12

Note. Responses that had <5 instances did not receive a subheading.

Analysis of the 118 included participants produced 123 individual themes, which were then grouped into primary themes and a number of subheadings within each (see Table 2). Participants who provided relevant commentary generally reported on one or more of four aspects of their experience of microdosing: their reasons and motivations for microdosing, the technical details of their microdosing practice, reported outcomes from microdosing, and meta-commentary on microdosing in general. These have been organized for presentation below in the above order, rather than by frequency, to better approximate a narrative format conducive to understanding the experience of microdosing psychedelics.

Results

The main four themes in our respondents’ comments were their reasons for microdosing, their practice of microdosing, the outcomes of microdosing, and meta-commentary on microdosing. According to our sample, the first broad reason people started microdosing was to reduce clinical symptoms (i.e., microdosing conceived as self-medication for pain or mental health). The other broad reason people started microdosing was to enhance their life (i.e., microdosing conceived as a part of self-improvement). Both intentions appear to precipitate an increased sense of connectedness.

Reasons for Microdosing

The most common reasons given for taking up microdosing were clinical in nature, especially for mood disorders. Addiction treatment, suicidality, trauma, chronic pain, and intrusive thoughts were all also reported as reasons for microdosing. Four participants explicitly noted that they microdosed psychedelics as a substitute for conventional medicine.

“Charlie”: Want to point out that I started my microdosing experiment with psilocybin mushrooms and therein got relief from depression and alcoholism. I microdosed every fourth day for three months, then continued occasionally as needed for re-emerging symptoms of depression for nearly a year. I recently switched to LSD in hopes of increased energy as well as antidepressant effect. I prefer LSD because of the increased energy it gives me and intend to continue microdosing LSD indefinitely.

The next most commonly reported reasons for microdosing were for productivity and to facilitate novel or creative thought. Schoolwork was explicitly noted by two participants. Participants also reported using microdosing to effect more permanent changes in their perspectives than single bursts of novelty, seeking to improve their ability to take other perspectives, change their personalities, or grow as people. Others used microdosing to improve their social aptitude or gain a deeper “insight into life.” Interestingly, only one participant explicitly stated that they microdosed for fun. Though hedonistic themes do arise in participants’ comments, they are mentioned largely as a possible side effect or result of difficulties calculating proper doses.

“Skylar”: I have never microdosed on a schedule (i.e., every four days) but do it either as a study/work enhancer if I know I have a lot to do in a day (which is often as a student) such as before exams or when I know I am going to have a very enjoyable day doing things I already love like biking and hiking to add to the experience. Tomorrow is a combination where I have a lot of work in the morning, and a fun bike ride planned in the afternoon. I will be microdosing. I have tried prescription study drugs, and although there is more energy with those like Adderall, they make me feel jumpy and my mind feels fuzzy and out of focus. Microdosing is far better for me.

This pattern of microdosing to improve one’s experience of life, either due to symptom amelioration or to achieve a fuller, more varied perspective, will re-emerge when discussing participants’ reported outcomes of microdosing.

Practice of Microdosing

The most frequently provided commentary regarding participants’ microdosing practice involved the doses of various substances and the timing of their administration. The former was particularly emphasized as participants repeatedly described the difficulty of calculating the correct dose for their height, weight, and tolerance that would provide positive effects without resulting in hallucinogenic effects. In some cases, this would prove so difficult that participants report giving up microdosing. One participant reported having microdosed for 4 months, combined with meditation and therapy, and not finding any effects. This may be due to miscalculation of dose, resulting in negligible or no effects at all.

“Alex”: I gave an estimate for how frequently I dose (once per week), but it is not so regular. Sometimes I go for months without, and sometimes I microdose twice in a week. But I usually go through periods where I microdose more frequently, and during those periods I would say once per week is about right.

“Blair”: I am sad to report that after 4 months of following Fadiman’s protocol, and in addition to daily meditation and weekly therapy, I have not noticed any benefits, neither has my wife of 26 years.

The use of microdosing in combination with other practices or substances was also a common theme when reporting on participants’ practices, with 10 participants reporting microdosing in combination with other practices. Microdosing was often reported as being used in combination with meditation, exercise, therapy, dietary changes, or a combination of the above as part of a self-improvement regimen. In contrast, microdosing was sometimes combined with other performance-enhancing substances, such as caffeine, ephedrine, marijuana, or Noopept (N-phenylacetyl-l-prolylglycine ethyl ester, a synthetic nootropic molecule), especially when aims were specific to clinical or productivity-related domains rather than major life changes. One participant instead reported reduced effects when microdosing under the influence of marijuana.

“Casey”: I had tremendous success in recently treating decades of aftermath of long term abuse, trauma and loss with full dose psychedelic medicines. I am microdosing now for maintenance in conjunction with talk therapy and it has been nothing short of miraculous for me.

Concerning timing, the majority of participants who discussed the scheduling of their microdoses reported taking them irregularly, usually as they felt they needed a boost to mood or performance. Participants who reported a regular dosing schedule ranged from approximately every other day to weekly; in particular, participants reported not microdosing every day. Avoiding daily microdosing could be a preventive measure to avoid building tolerance to the substance. As one participant noted, tolerance to microdosing can be built rather quickly, which is in agreement with the literature (Nichols, 2016). In addition, any increase in tolerance would exacerbate reported difficulties in calculating useful doses.

Finally, four participants observed that the results of a microdose can be strongly tied to one’s mindset, with one additional participant noting the importance of a supportive environment for a successful practice. This finding is in agreement with the emphasis in lay and scientific contexts on “set and setting” (Hartogsohn, 2016, p. 1260). These participants reported that microdosing opened and amplified their experience of the world, but any insights drawn had to be under the person’s own power:

“Finley”: I feel that microdosing has a lot to do with how you feel inside at the moment and/or what you wish to achieve at the moment. I feel that psychedelics amplify, in a way, our current feelings/needs/wants. SO if people are feeling depressed or anxious, I believe that they shouldn’t do it if they don’t know what they are getting into, because for some weak hearted, it might trigger something that will be beyond their control. Although overall I am definitely convinced of the therapeutic power of psychedelics, psilocybin mushrooms to be exact, but I also know that some people cannot handle them.

Outcomes of Microdosing

Consistent with reasons for microdosing, participants frequently reported clinical benefits, particularly regarding mood disorders, stress, and addiction.

“Devon”: The best period of my life seemed while I microdosed semi-frequently. my psychiatric problems (depression, anxiety and drug mis-use) were diminished. I stayed sober, active, happy and created a lot.

Interestingly, despite optimistic reports of microdosing having no negative side effects, some participants reported that microdosing caused or exacerbated clinical symptoms, particularly anxiety and depersonalization. Two participants reported “come-down effects,” one participant decreased motivation, and two increases in stress. It should be acknowledged that such reports were proportionally in the minority and seem to resonate with the above warnings regarding the importance of one’s mindset when microdosing.

“Jamie”: I am a grad student who works in a lab, and have md’d [author’s note: “md” means microdosed/microdosing] on days where I was doing rote tasks. I found md to make these tasks a little more enjoyable, likely due to my overall mood increase. One day while I was md, something unexpected happened that required more critical thinking and dexterity than a typical lab day. I found that things were amplified now in a more negative way—I was more stressed about the event, and more anxious about making mistakes.

“Ashleigh”: Psychedelics tended to make me depersonalized long after I took them. Even in microdoses.

Benefits to performance, or to cognitive capacities in general, were also reported, again in keeping with some of the stated reasons participants practiced microdosing. A clearer mind, improved focus, and greater creativity were some of the more common such benefits, although the above-quoted participant noted impairment to critical thinking skills when placed in an unexpected and stressful situation (see quote above, “Jamie”). More specific enhancements included reading comprehension, spatial awareness, and abstract comprehension, along with one participant noting significantly improved athletic prowess while microdosing.

“Lee”: Microdosing LSD worked incredibly well playing rugby. Lightning fast reflexes, on-point ball-flight-path calculations and strategic insight like Lord Admiral Nelson was whispering directions into my ear.

Interestingly, two participants noted the effects of microdosing on the vividness of dreams, with one participant reporting taking it as an aid to lucid dreaming practice. Improvements in motivation and enjoyment of work were also mentioned. Participants also reported improvements in interpersonal interaction, finding social functioning more fluid, with a deeper sense of interpersonal connection.

“Mackenzie”: Microdosing is a pretty good way to get out of your shell and socialize with people, in my opinion. I’m not usually the one to drive conversation out of people, but on LSD it’s almost too easy not to.

While many reports were in keeping with reported reasons for microdosing—symptom reduction, productivity, or general enhancement—the largest share of reported experiences (45) concerned the existential effects of microdosing. Participants reported a generally improved quality of life as a result of microdosing, greater self-acceptance, and a deeper appreciation of life. Participants reported an increased sense of awareness of themselves and their relationship to both others and the world, while finding it easier to live in the moment and let things go. In addition, reports of a feeling of calm, connection, and self-acceptance were common when describing the experience of microdosing.

“Morgan”: I believe the greatest thing I learnt from microdosing was to stop trying to solve problems I perceived about myself and just accept them for what they were. Accept myself for who I am, relax, stop overthinking everything because at the end of the day none of this matters so you may as well enjoy yourself however you see fit.

Meta-Commentary on Microdosing

The larger share of meta-comments about microdosing was reserved or skeptical about the benefits with 11 participants providing negative commentary. They reported that the effects of microdosing psychedelics were minimal, lacking the effects found at higher doses, or that microdosing was not for everyone. One participant observed caffeine had a greater effect on them. Another warned that microdosers risk feeling too good, that is, indulging in hedonism rather than increasing productivity.

“Kadin”: Microdosing can provide some mild effects, both positive and negative. After experimenting with it a little bit, I’m not very impressed. Caffeine is much more useful for providing the benefits often attributed to microdosing psychedelics.

“Harley”: One of the “dangers” of microdosing is that you feel so good that you think “I have to use this, I want to do more fun things than study.” Another is that your mind gets too far open and you start to become so sad when thinking about the state of the world and all the suffering everywhere.

Contrasting these concerns was nearly as many expressions of optimism regarding microdosing, with ten participants providing positive comments. These participants asserted that benefits could be long-lasting and that negative side effects were few, making them possibly safer than higher doses, despite the acknowledged loss of some of the effects of a higher dose. Two participants expressed a hope that education regarding effective microdosing would one day become more widespread.

“Cameron”: Microdosing is a powerful tool to gain insight on your life as well as re-program aspects of you [sic] personality in a way that causes no side effects other than increased tolerance to the drug of choice. I highly recommend everyone try it.

“Taylor”: Microdosing is definitely a very beneficial thing that nearly anyone in a position to take advantage of its creative potential, whether for work or personal expression. It should be respected and not over-used or leaned upon but used as a tool of productivity and stretcher of personal potential. I believe some day we’ll look at microdosing in a similar way that we do today with coffee. Enjoyable and a productivity enhancer.

Where participants discussed using more than a single type of psychedelic compound, particularly LSD or psilocybin-containing mushrooms, they would often note differing effects. In particular, LSD was observed to be more stimulating, leading to increased energy, focus, and creativity, whereas psilocybin was reported to facilitate greater openness and calm. These differences were occasionally experienced negatively, particularly in the case of one participant who reported that the only effect psilocybin had on them was drowsiness. Finally, a few participants made comparisons between the effects of microdosing psychedelics and other commonly used stimulants: coffee (caffeine) or Adderall.

Discussion

We have extrapolated across themes present in participant reports to assemble an overarching descriptive narrative of common reasons to start microdosing. The main four themes in our respondents’ comments were their reasons for microdosing, their practice of microdosing, the outcomes of microdosing, and meta-commentary on microdosing. Our findings suggest two complementary narratives: a clinical narrative, which frames microdosing as a form of self-medication for pain or mental health complaints, and a flourishing narrative, which frames microdosing as part of a regimen for self-improvement. These two narratives presage two different framings of acute reported benefits (Figure 1).

Figure 1.

Narrative Pathways From Initial Motivations Through Microdosing to Acute and Cumulative Outcomes.

Microdosing was reported to be a response to various mental health issues or to enhance creativity and productivity. Specifically, reasons for microdosing were most often symptomatically motivated—for example, for depression, anxiety, low mood, or pain—or as part of an overall program wherein participants were trying to improve their lives beyond healthy levels. Curiously, outcomes of microdosing were often broader in scope: providing greater perspective, increased sense of connection to others, or a sense of calm and self-acceptance. Microdosers started for one reason, but they report getting broader benefits than initially intended.

Acute reported benefits are in accordance with the existing literature with the coexistence of clinical and flourishing narratives acting as a common theme during the first wave of psychedelic research in the 1950s and 1960s (Grinspoon & Bakalar, 1979). Our sample also hints that both symptom reduction and self-improvement may share a cumulative distal outcome of enhanced sense of connectedness with others. This unanticipated outcome reflects a shared benefit reported across both the clinical and flourishing narratives.

Two Narratives

Considering first the clinical narrative, we note that microdosers were motivated to self-treat their mental health concerns, including anxiety, depression, suicidality, or social anxiety. Participants largely reported being successful in their self-treatment goals with many reporting reduced depression and anxiety, though not universally as some reported increased anxiety, especially related to dose inaccuracy. Psychedelics at higher doses show promise as effective treatment options for mood disorders (e.g., depression (Carhart-Harris et al., 2017), obsessive-compulsive disorder (Moreno et al., 2006), anxiety disorders (dos Santos et al., 2018), and substance use disorders (Bogenschutz et al., 2015; Johnson et al., 2014)) when taken in a controlled environment. Our findings suggest that beneficial treatment options may also exist even at the level of a microdose, while decreasing the risk of the “bad trip” (Carbonaro et al., 2016) and significantly lowering the costs related to long, in-patient sessions with up to two therapists at once, which would make microdosing much more financially feasible than high-dose psychedelic psychotherapy. Indeed, taking the participants at face value, the most common negative outcome with psychedelic microdosing was that nothing happened. Most negative reactions were paired with dosing inaccuracy, either too high or too low, which could be alleviated by proper experimental control and/or legal regulation. Curiously, self-medication research reports that most proponents of self-medication for mood and anxiety disorders are young white men (Turner et al., 2018), a demographic which also forms the majority of respondents to the present study and that may be underserved by the present clinical treatment model for one reason or another.

Regarding the flourishing narrative, microdosers aimed at self-improvement, often with regards to creative output or productivity, and reported being successful in their attempts. Despite empirical limitations, a growing theoretical literature considers whether higher doses of psychedelics may improve well-being in nonclinical populations. For example, one theory paper suggested that psychedelics could enhance well-being following a similar mechanism to that of profound meditative experiences (Millière et al., 2018). Another line of inquiry has proposed that psychedelics may help shift subjective meaning-making foci (Hartogsohn, 2018). Finally, the REBUS model suggested that psychedelic use flattens the phenomenological landscape through which consciousness travels, enabling thinking in novel patterns (Carhart-Harris & Friston, 2019). All three theories hypothesize that using psychedelics would allow one to think more flexibly and creatively, which agrees with the scant empirical evidence available (T. Anderson, Petranker, Rosenbaum, et al., 2019; Prochazkova et al., 2018). In our sample, reported benefits of microdosing for flourishing purposes focused mostly on creativity and enhanced focused attention. These data do not appear to discriminate between the aforementioned theoretical accounts, which are not mutually exclusive. Future research on microdosing should not limit itself to clinical measures alone; measures of flourishing and “euthymia” (Fava & Bech, 2016) should be included to capture more rarefied benefits to human well-being.

Shared Benefits

Irrespective of whether their narrative was focused on clinical or flourishing benefits, participants reported microdosing was related to the ability to take their problems in perspective, decreased identification with thoughts and feelings, and paying attention to disparities between one’s values and behavior. These reported benefits correspond to some of the fundamental principles of Acceptance and Commitment Therapy (ACT), namely self-as-context, defusion, and value-oriented action, all a part of psychological flexibility (Hayes et al., 2011). ACT theory predicts that improvement on these dimensions should improve well-being trans-diagnostically, and recent meta-analyses suggested that this may indeed be the case (A-Tjak et al., 2015; Ruiz, 2012). ACT also provided foundational inspiration for the therapeutic protocols used most commonly in laboratory-based, high-dose psychedelic research, suggesting that psychedelics may enhance psychological flexibility, which in turn improves well-being (Watts & Luoma, 2020). The theory explaining the usefulness of ACT for high-dose psychedelics may also be relevant for microdosing, and specifically for the shared benefits reported regardless of clinical or flourishing narratives.

In our sample, participants reported increased psychological flexibility after microdosing without ACT or any other kind of therapy. Examples of benefits reported include a broader perspective wherein little problems are less troublesome; less overthinking; and an awareness of choices and their alignment with personal values. Similar benefits have been described for high-dose psychedelics (Carhart-Harris et al., 2018) and microdosing (Lea et al., 2019). Recent research has found that psychological flexibility mediates the effects of psychedelics on anxiety and depression (Davis et al., 2021), but a fleshed-out theoretical account of psychedelics causing psychological flexibility remains missing. For example, the REBUS model suggests that the use of psychedelics enhances psychological flexibility, but draws exclusively on studies that included high-dose psychedelics primarily in the context of therapy. In our sample, however, psychological flexibility was reported to be enhanced by microdoses without therapy. This finding leaves two questions open: first, is therapy necessary for psychological flexibility brought about by psychedelics? Second, could microdosing over time be as effective as single high doses in increasing psychological flexibility? Psychedelic therapy could be far less onerous to implement if hallucinogenic doses and/or therapy are not necessary to increase psychological flexibility, especially if psychological flexibility proves to be a primary moderator of improved well-being as predicted by the ACT model. Future research could examine whether a purely pharmacological intervention also improves well-being in clinical and nonclinical populations. Another potential research avenue would involve strict ACT therapy, which focuses on increasing psychological flexibility, rather than an ACT-inspired perspective. Future research could examine these hypotheses about the shared benefits experienced by microdosers.

Connectedness and Sense of Meaning

We speculate that the aforementioned shared benefits could be indications of an increased sense of meaning, purpose, or goal-directedness in life (Carhart-Harris et al., 2018; Costin & Vignoles, 2020). While mystical experiences are hypothesized to be a primary mediator of the increased sense of meaning and purpose following higher psychedelic doses (Hendricks, 2018), it is of note that similar gains appear to be possible through microdosing, which does not give rise to the same phenomenological effects (Haijen, 2018; Yaden et al., 2017).

Microdosing may not have these effects for everyone. Some individual differences could be useful in predicting who would be more likely to benefit from microdosing. One promising individual difference is trait absorption, which positively predicts a search for meaning in life (Steger et al., 2008) and predicts both likelihood of mystical experiences and well-being improvement following ingestion of higher doses of psychedelic compounds (Haijen et al., 2018). Those high on trait absorption and a search for meaning in life may benefit more from using psychedelics. Mystical experiences themselves are also correlated to experiencing meaning in life (Kim & Vervaeke, 2019). We recommend measuring the effect of trait absorption in future research on psychedelic microdosing.

The benefit of feeling an increased sense of connectedness is particularly important in this historical moment. According to the World Health Organization, prevalence of depression and anxiety disorders globally increased by 18.6% and 14.9% between 2005 and 2015 (World Health Organization, 2017). While one possible explanation for this is technology- and urbanization-driven changes in global lifestyle leading to physiological symptoms that overlap with stress, such as cardiovascular disease and fatigue (A- et al., 2015), there is an increase in major depressive episodes, suicide, and suicide attempts since 2014, in the generation born during the 1990s as well as those of the “Boomer” generation born in the 1950s (Twenge et al., 2019). The last century presented a marked increase in the proportion of people living alone and a corresponding increase in the prevalence of feelings of loneliness, isolation, and disconnection (Snell, 2017). More recently, society has seen a decrease in the amount of in-person social interaction and concomitant increase in the amount of social media use, particularly in the generation born in the 1990s. Feelings of loneliness and isolation are strongest in those high in social media use and low in in-person interaction (Twenge et al., 2019).

Accompanying the increase in single-person households and decline of in-person interaction has been a decline in membership to religious communities, (Franck & Iannaccone, 2014; Twenge et al., 2016), which have historically provided environments supporting in-person interactions and socially sanctioned pathways to meaning (Park et al., 2013). Eberstadt (2013) has argued that the decline of religion and the rise in single-person households are intimately connected but reverse the more common narrative of a decline in religion leading to a decline in traditional family structure. Rather, Eberstadt argued that the changing social landscape of the last several centuries has resulted in people increasingly living apart from family, and that this change in family structure was instrumental in the decline in religious participation. Without the supporting structure of family tradition to reinforce it, religious practice falls away, and with the loss of both family- and religion-based social connections comes the increase in feelings of loneliness, isolation, and disconnection (Bonn & Taferodi, 2013).

Considering the reports of an increased sense of connectedness to themselves and to others following microdosing, it seems that some people find microdosing may alleviate some of the apparent societal loss of connection and meaning. As argued by Hartogsohn (2018), psychedelics have historically been a powerful tool for altering the perception of meaning. Hartogsohn argued that the phenomenology of psychedelics stands in direct contrast to current first-line antidepressants in that they amplify, rather than dampen, the intensity of experience. This experience-amplifying function appears to be at the core of their role in spiritual, therapeutic, and creative work: the increased vividness that accompanies psychedelic experiences allows for positive re-evaluation of existing social connections and realizing new meaning in old ideas or phenomena. Psychedelics, even at low doses, may help promote new ways of thinking about and looking at the world and one’s place within it.

Limitations

It is important that we qualify the limits of the present study, most importantly by attending to possible bias in either the researchers or the sample. The first and third authors, who designed the original survey, did so by drawing on findings from mainstream research with full doses of classical psychedelics, and recruited participants from open online fora. It is possible that either the original framing of the survey, or the participant populations, may have biased responses toward a particular framing of microdosing. The second author, who was not involved in the original study or in psychedelic research prior to the present study, was responsible for the qualitative analysis specifically to allow for a more open-minded approach to the data. Finally, the data were collected as a serendipitous addition to a predominately quantitative survey on participants’ experience with microdosing and possible benefits to creativity, mental health, and the cultivation of wisdom. It is possible that this context shaped participants’ responses to the final, more open-ended question. Nevertheless, given convergence with other lines of research on both microdosing and high-dose psychedelics, we believe that the present analysis represents an important step in understanding the motives and perspectives of psychedelic microdosers.

Conclusion

In our sample, microdosing psychedelics was often driven by a will to self-treat clinical issues or to enhance flourishing. While most participants approached microdosing with the intention of either addressing clinical symptoms or improving specific life-enhancement, many reported more global benefits such as an increased sense of connectedness. Judging from this sample and the growing literature on microdosing, it is plausible that psychedelics, taken at lower doses over time and situated within a context of the active pursuit of personal development, may have similar beneficial effects as higher doses taken infrequently, all with decreased risk of adverse reaction. Future research should investigate the potential of lower doses of psychedelics, assess the potential challenges associated with using these substances in low doses, and explore ways to optimize the potential benefits reaped from using psychedelic substances.

Footnotes

Declaration of Conflicting Interests

The author(s) declared the following potential conflicts of interest with respect to the research,authorship,and/or publication of this article: Rotem Petranker and Thomas Anderson co-own a consulting company named the Canadian Centre for Psychedelic Science. This company was engaged by Energia Holding Corporation at the time of the publication of this paper,but the engagement had no relationship with the content of the publication or the authors’ commitment to Open Science.

Funding

The author(s) received no financial support for the research,authorship,and/or publication of this article.

Ethics Approval

Ethics approval was obtained from the University of Toronto and participants consented to have their responses used for research

ORCID iDs

Rotem Petranker

Juensung Kim

Author Biographies

Rotem Petranker’s main research interests are sustained attention,emotional regulation,and creativity,all of which may be affected by psychedelics. He is passionate about establishing a rigorous framework for the study of psychedelics using the principles of Open Science. His clinical interests include disorders amenable to psychedelic psychotherapy,including mood disorders and OCD. For more about Rotem please see his website:

Juensung Kim is a PhD candidate at the Ontario Institute for Studies in Education at the University of Toronto. He received his Honours Bachelor of Arts in cognitive science and philosophy at UofT in 2016,and his MA in developmental psychology and education in 2017. His research focuses on investigating tools,practices,and experiences that facilitate intentional self-transformation,particularly the cultivation of wisdom and self-transcendence.

Thomas Anderson is a PhD candidate at the University of Toronto studying meta-awareness. He is the co-founder of the Psychedelic Studies Research Program and Canadian Centre for Psychedelic Science pioneering research on psychedelic microdosing. His side-projects include work on mediation,creativity,wisdom,and attention. He has a strong focus on methodological rigor and transparency and is a proponent of Open Science. Thomas Anderson does not want to have his photograph on the paper.

References

Anderson

G. O.

(2010, September). Loneliness among older adults: A national survey of adults 45+. AARP. https://doi.org/10.26419/res.00064.001

Anderson

Petranker

Christopher

Rosenbaum

Weissman

Dinh-Williams

L.-A.

Hui

Hapke

(2019). Psychedelic microdosing benefits and challenges: An empirical codebook. Harm Reduction Journal, 16(1), 1–10.

Anderson

Petranker

Rosenbaum

Weissman

C. R.

Dinh-Williams

L.-A.

Hui

Hapke

Farb

N. A. S.

(2019). Microdosing psychedelics: Personality, mental health, and creativity differences in microdosers. Psychopharmacology, 236(2), 731–740. https://doi.org/10.1007/s00213-018-5106-2

A-Tjak

J. G. L.

Davis

M. L.

Morina

Powers

M. B.

Smits

J. A. J.

Emmelkamp

P. M. G.

(2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30–36. https://doi.org/10.1159/000365764

Bogenschutz

M. P.

Forcehimes

A. A.

Pommy

J. A.

Wilcox

C. E.

Barbosa

P. C. R.

Strassman

R. J.

(2015). Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. Journal of Psychopharmacology, 29(3), 289–299.

Bonn

Tafarodi

R. W.

(2013). Visualizing the good life: A cross-cultural analysis. Journal of Happiness Studies, 14(6), 1839–1856. doi:10.1007/s10902-012-9412-9

Carbonaro

T. M.

Bradstreet

M. P.

Barrett

F. S.

MacLean

K. A.

Jesse

Johnson

M. W.

Griffiths

R. R.

(2016). Survey study of challenging experiences after ingesting psilocybin mushrooms: Acute and enduring positive and negative consequences. Journal of Psychopharmacology (Oxford, England), 30(12), 1268–1278. https://doi.org/10.1177/0269881116662634

Carhart-Harris

R. L.

Erritzoe

Haijen

Kaelen

Watts

(2018). Psychedelics and connectedness. Psychopharmacology, 235(2), 547–550. https://doi.org/10.1007/s00213-017-4701-y

Carhart-Harris

R. L.

Friston

K. J.

(2019). REBUS and the anarchic brain: Toward a unified model of the brain action of psychedelics. Pharmacological Reviews, 71(3), 316–344. https://doi.org/10.1124/pr.118.017160

10.

Carhart-Harris

R. L.

Roseman

Bolstridge

Demetriou

Pannekoek

J. N.

Wall

M. B.

Tanner

Kaelen

McGonigle

Murphy

Leech

Curran

H. V.

Nutt

D. J.

(2017). Psilocybin for treatment-resistant depression: FMRI-measured brain mechanisms. Scientific Reports, 7(1), 13187. https://doi.org/10.1038/s41598-017-13282-7

11.

Costin

Vignoles

V. L.

(2020). Meaning is about mattering: Evaluating coherence, purpose, and existential mattering as precursors of meaning in life judgments. Journal of Personality and Social Psychology, 118(4), 864–884. https://doi.org/10.1037/pspp0000225

12.

Davis

A. K.

Barrett

F. S.

May

D. G.

Cosimano

M. P.

Sepeda

N. D.

Johnson

M. W.

Finan

P. H.

Griffiths

R. R.

(2021). Effects of psilocybin-assisted therapy on major depressive disorder: A randomized clinical trial. JAMA Psychiatry, 78(5), 481–489. https://doi.org/10.1001/jamapsychiatry.2020.3285

13.

dos Santos

R. G.

Bouso

J. C.

Alcázar-Córcoles

M. Á.

(2018). Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: A systematic review of systematic reviews. Expert Review of Clinical Pharmacology, 11(9), 889–902. https://doi.org/10.1080/17512433.2018.15114244

14.

Eberstadt

(2013). How the west really lost god: A new theory of secularization: Templeton Foundation Press.

15.

Fava

G. A.

Bech

(2016). The concept of euthymia. Psychotherapy and Psychosomatics, 85(1), 1–5. https://doi.org/10.1159/000441244

16.

Franck

Iannaccone

L. R.

(2014). Religious decline in the 20th century West: Testing alternative explanations. Public Choice, 159(3–4), 385–414.

17.

Griffiths

R. R.

Johnson

M. W.

Richards

W. A.

Richards

B. D.

McCann

Jesse

(2011). Psilocybin occasioned mystical-type experiences: Immediate and persisting dose-related effects. Psychopharmacology, 218(4), 649–665. https://doi.org/10.1007/s00213-011-2358-5

18.

Griffiths

R. R.

Johnson

M. W.

Richards

W. A.

Richards

B. D.

Jesse

MacLean

K. A.

Barrett

F. S.

Cosimano

M. P.

Klinedinst

M. A.

(2018). Psilocybin-occasioned mystical-type experience in combination with meditation and other spiritual practices produces enduring positive changes in psychological functioning and in trait measures of prosocial attitudes and behaviors. Journal of Psychopharmacology (Oxford, England), 32(1), 49–69. https://doi.org/10.1177/0269881117731279

19.

Griffiths

R. R.

Richards

W. A.

Johnson

McCann

Jesse

(2008). Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. Journal of Psychopharmacology, 22(6), 621–632. https://doi.org/10.1177/0269881108094300

20.

Griffiths

R. R.

Richards

W. A.

McCann

Jesse

(2006). Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance. Psychopharmacology, 187(3), 268–283. https://doi.org/10.1007/s00213-006-0457-5

21.

Grinspoon

Bakalar

J. B.

(1979). Psychedelic drugs reconsidered. Basic Books.

22.

Haijen

E. C. H.M.

Kaelen

Roseman

Timmermann

Kettner

Russ

Nutt

Daws

R. E.

Hampshire

A. D. G.

Lorenz

Carhart-Harris

R. L.

(2018). Predicting responses to psychedelics: A prospective study. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.00897

23.

Harman

W. W.

McKim

R. H.

Mogar

R. E.

Fadiman

Stolaroff

M. J.

(1966). Psychedelic agents in creative problem-solving: A pilot study. Psychological Reports, 19(1), 211–227. https://doi.org/10.2466/pr0.1966.19.1.211

24.

Hartogsohn

(2016). Set and setting, psychedelics and the placebo response: An extra-pharmacological perspective on psychopharmacology. Journal of Psychopharmacology, 30(12), 1259–1267. https://doi.org/10.1177/0269881116677852

25.

Hartogsohn

(2018). The meaning-enhancing properties of psychedelics and their mediator role in psychedelic therapy, spirituality, and creativity. Frontiers in Neuroscience, 12. https://doi.org/10.3389/fnins.2018.00129

26.

Hayes

S. C.

Strosahl

K. D.

Wilson

K. G.

(2011). Acceptance and commitment therapy, second edition: The process and practice of mindful change. Guilford Press.

27.

Hendricks

P. S.

(2018). Awe: A putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy. International Review of Psychiatry, 30(4), 331–342. https://doi.org/10.1080/09540261.2018.1474185

28.

Jenkins

(2018, January 5). Half of Americans feel lonely, study finds. Fortune. https://fortune.com/2018/05/01/americans-lonely-cigna-study/

29.

Johnson

M. W.

Garcia-Romeu

Cosimano

M. P.

Griffiths

R. R.

(2014). Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction. Journal of Psychopharmacology, 28(11), 983–992. https://doi.org/10.1177/0269881114548296

30.

Kim

J.J

Vervaeke

(August, 2019). Making sense: Coherency and religiosity predict meaning in life following mystical experience. Poster presented at the 2019 meeting of the American Psychological Association, Chicago, USA.

31.

Krebs-Thomson

Geyer

M. A.

(1996). The role of 5-HT(1A) receptors in the locomotor-suppressant effects of LSD: WAY-100635 studies of 8-OH-DPAT, DOI and LSD in rats. Behavioural Pharmacology, 7(6), 551–559.

32.

Krebs-Thomson

Paulus

M. P.

Geyer

M. A.

(1998). Effects of hallucinogens on locomotor and investigatory activity and patterns: Influence of 5-HT2A and 5-HT2C Receptors. Neuropsychopharmacology, 18(5), 339–351. https://doi.org/10.1016/S0893-133X(97)00164-4

33.

Lea

Amada

Jungaberle

(2019). Psychedelic microdosing: A subreddit analysis. Journal of Psychoactive Drugs, 52, 101–112. https://doi.org/10.1080/02791072.2019.1683260

34.

MacLean

K. A.

Johnson

M. W.

Griffiths

R. R.

(2011). Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. Journal of Psychopharmacology (Oxford, England), 25(11), 1453–1461. https://doi.org/10.1177/0269881111420188

35.

Millière

Carhart-Harris

R. L.

Roseman

Trautwein

F.-M.

Berkovich-Ohana

(2018). Psychedelics, Meditation, and Self-Consciousness. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.01475

36.

Moreno

F. A.

Wiegand

C. B.

Taitano

E. K.

Delgado

P. L.

(2006). Safety, tolerability, and efficacy of psilocybin in 9 patients with obsessive-compulsive disorder. The Journal of Clinical Psychiatry, 67(11), 1735–1740. https://doi.org/10.4088/jcp.v67n1110

37.

Osório

Sanches

R. F.

Macedo

L. R.

dos Santos

R. G.

Maia-de-Oliveira

J. P.

Wichert-Ana

de Araujo

D. B.

Riba

Crippa

J. A.

Hallak

J. E.

(2015). Antidepressant effects of a single dose of ayahuasca in patients with recurrent depression: A preliminary report. Brazilian Journal of Psychiatry, 37, 13–20. https://doi.org/10.1590/1516-4446-2014-1496

38.

Nichols

D. E.

(2016). Psychedelics. Pharmacological Reviews, 68(2), 264–355. https://doi.org/10.1124/pr.115.011478

39.

Noorani

(2020). Making psychedelics into medicines: The politics and paradoxes of medicalization. Journal of Psychedelic Studies, 4(1), 34–39. https://doi.org/10.1556/2054.2019.018

40.

Park

C. L.

(2017). Religious cognitions and well-being: A meaning perspective. In Robinson

M. D.

Eid

(Eds.), The happy mind: Cognitive contributions to well-being (pp. 443–458). Springer International Publishing/Springer Nature. https://doi.org/10.1007/978-3-319-58763-9_24

41.

Park

C. L.

Edmondson

Hale-Smith

(2013). Why religion? Meaning as motivation. In Pargament

K. I.

Exline

J. J.

Jones

J. W.

(Eds.), APA handbook of psychology, religion, and spirituality (Vol. 1): Context, theory, and research (pp. 157–171). American Psychological Association. https://doi.org/10.1037/14045-008

42.

Passie

(2019). The science of microdosing psychedelics. Psychedelic Press.

43.

Petranker

Anderson

Farb

(2020). Psychedelic Research and the need for transparency: Polishing Alice’s looking glass. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.01681

44.

Pernice-Duca

(2010). Family network support and mental health recovery. Journal of Marital and Family Therapy, 36(1), 13–27. https://doi.org/10.1111/j.1752-0606.2009.00182.x

45.

Petranker

Anderson

Maier

L. J.

Barratt

M. J.

Ferris

J. A.

Winstock

A. R.

(2020). Microdosing psychedelics: Subjective benefits and challenges, substance testing behavior, and the relevance of intention. Journal of Psychopharmacology. Advance online publication. https://doi.org/10.1177/0269881120953994

46.

Polito

Stevenson

R. J.

(2019). A systematic study of microdosing psychedelics. PLOS ONE, 14(2), Article e0211023. https://doi.org/10.1371/journal.pone.0211023

47.

Prochazkova

Lippelt

D. P.

Colzato

L. S.

Kuchar

Sjoerds

Hommel

(2018). Exploring the effect of microdosing psychedelics on creativity in an open-label natural setting. Psychopharmacology, 235, 3401–3413. https://doi.org/10.1007/s00213-018-5049-7

48.

Rosenbaum

Weissman

Anderson

Petranker

Dinh-Williams

L.-A.

Hui

Hapke

(2020). Microdosing psychedelics: Demographics, practices, and psychiatric comorbidities. Journal of Psychopharmacology, 34(6), 612–622. https://doi.org/10.1177/0269881120908004

49.

Ruiz

F. J.

(2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology, 12, 333–357.

50.

Schmid

Enzler

Gasser

Grouzmann

Preller

K. H.

Vollenweider

F. X.

Brenneisen

Müller

Borgwardt

Liechti

M. E.

(2015). Acute effects of lysergic acid diethylamide in healthy subjects. Biological Psychiatry, 78(8), 544–553. https://doi.org/10.1016/j.biopsych.2014.11.015

51.

Sessa

(2008). Is it time to revisit the role of psychedelic drugs in enhancing human creativity? Journal of Psychopharmacology, 22(8), 821–827. https://doi.org/10.1177/0269881108091597

52.

Sliwa

(2017, August 5). So lonely i could die. https://www.apa.org/news/press/releases/2017/08/lonely-die

53.

Smith

J.A.

Flowers

Larkin

(2009). Interpretative phenomenological analysis: Theory, research, practice. London.

54.

Snell

K. D. M.

(2017). The rise of living alone and loneliness in history. Social History, 42(1), 2–28. https://doi.org/10.1080/03071022.2017.1256093

55.

Steger

M. F.

Kashdan

T. B.

Sullivan

B. A.

Lorentz

(2008). Understanding the search for meaning in life: Personality, cognitive style, and the dynamic between seeking and experiencing meaning. Journal of Personality, 76(2), 199–228. https://doi.org/10.1111/j.1467-6494.2007.00484

56.

Studerus

Kometer

Hasler

Vollenweider

F. X.

(2011). Acute, subacute and long-term subjective effects of psilocybin in healthy humans: A pooled analysis of experimental studies. Journal of Psychopharmacology (Oxford, England), 25(11), 1434–lp . https://doi.org/10.1177/0269881110382466

57.

Tupper

K. W.

Wood

Yensen

Johnson

M. W.

(2015). Psychedelic medicine: A re-emerging therapeutic paradigm. CMAJ: Canadian Medical Association Journal/Journal de l’association Medicale Canadienne, 187(14), 1054–1059. https://doi.org/10.1503/cmaj.141124

58.

Turner

Mota

Bolton

Sareen

(2018). Self-medication with alcohol or drugs for mood and anxiety disorders: A narrative review of the epidemiological literature. Depression and Anxiety, 35(9), 851–860. https://doi.org/10.1002/da.22771

59.

Twenge

J. M.

Sherman

R. A.

Exline

J. J.

Grubbs

J. B.

(2016). Declines in American adults’ religious participation and beliefs, 1972–2014. Sage Open, 6(1), 2158244016638133.

60.

Twenge

J. M.

Spitzberg

B. H.

Campbell

W. K.

(2019). Less in-person social interaction with peers among US adolescents in the 21st century and links to loneliness. Journal of Social and Personal Relationships, 36(6), 1892–1913.

61.

Vervaeke

Miscevic

C. M. F.

(2017). Zombies in Western culture: A twenty-first century crisis. Open Book Publishers. https://doi.org/10.11647/OBP.0113

62.

Vollenweider

F. X.

Vollenweider-Scherpenhuyzen

M. F.

Bäbler

Vogel

Hell

(1998). Psilocybin induces schizophrenia-like psychosis in humans via a serotonin-2 agonist action. Neuroreport, 9(17), 3897–3902. https://doi.org/10.1097/00001756-199812010-00024

63.

Watts

Luoma

J. B.

(2020). The use of the psychological flexibility model to support psychedelic assisted therapy. Journal of Contextual Behavioral Science, 15, 92–102. https://doi.org/10.1016/j.jcbs.2019.12.004

64.

World Health Organization. (2017). World Health Organization data, prevalence of depression and anxiety disorders increased by 18.6% and 14.9% globally between 2005 and 2015. https://apps.who.int/iris/bitstream/handle/10665/254610/WHO-MSD-MER-2017.2-eng.pdf

65.

Yaden

D. B.

Le Nguyen

K. D.

Kern

M. L.

Belser

A. B.

Eichstaedt

J. C.

Iwry

Smith

M. E.

Wintering

N. A.

Hood

R. W.

Newberg

A. B.

(2017). Of roots and fruits: A comparison of psychedelic and nonpsychedelic mystical experiences. Journal of Humanistic Psychology, 57(4), 338–353.