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LSDs initial use in psychotherapy was not one without valid grounds. Although it was, and still is largely not understood how LSD causes the “Trip” it has shown efficacy in treating a small array of mental disorders. There has been experimentation conducted in its applicability to allieviating addiction, namely alcohol and nicotine. Because of its long standing status as a schedule I drug, getting federal grants to conduct experiments is a long hurdle, as well as the small test groups allowed to participate in studies. However, among multiple studies conducted in a 15 person trial, there was approximately 80% (12/15) patients who abstained from addictive behavior for 3 months after their initial (and only) dose. The hypothesis behind this may be sceudoscientific in that neurologist believe the LSD experience to be so powerful, mystical, and even spiritual; that it allows the individual to reconnect with themselves, their goals and priorities. In doing so, there is an epiphany which is regarded to be the reason there can be such rapid changes in personality, or behavior.
As neuroscience has developed so has our understanding of the brain. It was initially thought that the brain ceases to develop further past the ages of 21-25. However we have recently discovered that neurons are continually generated throughout ones life and more importantly, the signals fired between these signals, reinforces the strength of connections. This is a concept known as neuroplasticity, where it is often said, “neurons that fire together, wire together”. To further break down this concept into layman’s terms, imagine a dirt road in a forest; the more foot traffic the trail receives, the more visible, and engraved it becomes in the forest. The brain, and neurons work remarkably similar to this, and are continually changing due to all thoughts, emotions, and experiences in life.
The hypothesis of using LSD to induce neuroplasticity in patients is not as wild as it may sound. Again, restating that the mechanism of how the trip is not entirely understood, however, what is known through FMRI is that LSD causes regions of the brain which don’t or rarely communicate, a free flow of information. One region that is stimulated is in the back of the brain, at the visual cortex. In this we see communications with regions of the brain not normally stimulated at the same time. A very interesting example of this, is the newly forged connection between the visual cortex and the somatosensory cortex. In this connection, there is the merging of vision and other senses; this leads to an experience known as synesthesia. This allows a person to experience things in ways never before thought of, where a person can taste the color blue, or see the vibrations of music.
The last hypothesis as to why hallucinations are experienced is due to the global dysregulation of the brain, placing it in a state of mayhem; and that the brain tries to make sense of the world by connecting patterns, which is hypothesized to be the kaleidoscopic hallucinations that are often referenced. To revisit the concept of neuroplasticity, it might be good to talk about the development of the brain from childhood to adulthood. In this process, the brain is initially a free flowing connection of information. This is largely due to kids experiencing the world with so much unknown, and a genuine curiosity. Experiencing all of life until adulthood begins to constrain the brain and compartmentalize our way of thinking. This is referred to as your Default Mode Network, and is described as having three main functions. This is the region of the brain engaged in passive rest and during mind wandering; the neurological basis of self, where you think about others, and remember the past and prepare for the future.
LSD works by separating these networks and breaking down their constrictions, allowing a more unified and integrated brain. In many ways, LSD allows the brain to revisit the state it was in as an infant, free and unconstrained. This then leads to the newly emerging concept of microdosing which argues that by taking a sub perceptual dose of LSD (1/10 typical dose) the serotonergic receptors will be activated and allow the free flow of information, without the hallucinogenic effects. Emerging science has estimated it takes on average 2 months before a new behavior becomes automatic. This is something that can be easily developed with will power in the sense of many mechanical skills where you are learning something. However, for many who struggle with mental illness such as depression or anxiety, the solution is not so straight forward. It is argued that one of the main reasons LSD works in psychotherapy is that it treats the underlying cause or context of a person’s problem, and not just the illness as in the case of SSRI’s or other antidepressants. In this argument, it is said that hallucinogens have to do a level of therapy within one’s mind, this allows the confrontation of things such as childhood trauma, struggles in relationships, or one’s view of their worth.
The treatment of LSD in psychotherapy can be viewed in two ways, having a full hallucinogenic experience which may be powerful enough to induce immediate change within a patient; or through the continual use of microdosing. The logic behind microdosing is to allow the free flow of information on a regular basis. This lets neuroplasticity really refine which pathways are underutilized in certain individuals, which may be responsible for certain neurological deficiencies. The proposed medicinal usage does not stop at psychotherapy and its applications to depression and anxiety. In large, a further understanding of the serotonergic receptor interactions are demanded as it has been shown that a defect in the 5HT receptors leads to schizophrenia like symptoms through excessive serotonergic stimulation, but is still far from being understood. Furthermore in a condition such as PTSD, there are changes in the pathways that connect the brains stress response, namely the hippocampus, amygdala, and medial prefrontal cortex all responsible for response of emotion and memory.
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