Ayahuasca’s ‘afterglow’: improved mindfulness and cognitive flexibility in ayahuasca drinkers

Rationale: There is a growing body of evidence demonstrating the therapeutic potential of ayahuasca for treating depression and anxiety. However, the mechanisms of action involved in ayahuasca’s therapeutic effects are unclear. Mindfulness and cognitive flexibility may be two possible psychological mechanisms. Like other classic psychedelics, ayahuasca also leads to an 'afterglow' effect of improved subjective wellbeing that persists after the acute effects have subsided. This period may offer a window of increased therapeutic potential. Objective: to explore changes in mindfulness and cognitive flexibility before, and within 24 hours after ayahuasca use. Methods: Forty-eight participants (54% female) were assessed on measures of mindfulness (Five Facets Mindfulness Questionnaire, FFMQ), decentering (Experiences Questionnaire, EQ) and cognitive flexibility (Cognitive Flexibility Scale, CFS), and completed the Stroop and Wisconsin Picture Card Sorting Task (WPCST) before drinking ayahuasca, and again within 24-hours. Results: Mindfulness (FFMQ total scores and four of the five mindfulness facets; Observe, Describe, Act with Awareness and Non-reactivity) and decentering (EQ) significantly increased in the 24 hours after ayahuasca use. Cognitive flexibility (CFS and WPCST) significantly improved in the 24 hours after ayahuasca use. Changes in both mindfulness and cognitive flexibility were not influenced by prior ayahuasca use. Conclusions: The present study supports ayahuasca’s ability to enhance mindfulness and further reports changes in cognitive flexibility in the 'afterglow' period occur, suggesting both could be possible psychological mechanisms concerning the psychotherapeutic effects of ayahuasca. Given psychological gains occurred regardless of prior ayahuasca use suggests potentially therapeutic effects for both naïve and experienced ayahuasca drinkers

Estimating the Cost of Executive Stock Options: Evidence from Switzerland

It is often argued that Black-Scholes (1973) values overstate the subjective NEWLINE value of stock options granted to risk-averse and under-diversified executives. NEWLINE We construct a “representative” Swiss executive and extend the certainty- NEWLINE equivalence approach presented by Hall and Murphy (2002) to assess NEWLINE the value-cost wedge of executive stock options. Even with low coefficients NEWLINE of relative risk aversion, the discount can be above 50% compared to the NEWLINE Black-Scholes values. Regression analysis reveals that the equilibrium level NEWLINE of executive compensation is explained by economic determinant variables NEWLINE such as firm size and growth opportunities, whereas the managers’ pay-forperformance NEWLINE sensitivity remains largely unexplained. Firms with larger NEWLINE boards of directors pay higher wages, indicating potentially unresolved NEWLINE agency conflicts. We reject the hypothesis that cross-sectional differences in NEWLINE the amount of executive pay vanish when risk-adjusted values are used as NEWLINE the dependent variable

Myth or Memory? Recollections of Penal Times in Irish Folklore

Stories of priests being hunted down and murdered at Mass Rocks by priest catchers and soldiers during the Penal era in Ireland persist to the present day. Using Ó Ciosáin’s (2004) tripartite taxonomy of memory this paper explores the reasons why these images continue to dominate and reflect persecuted nature of Catholicism

ARC: a framework for Access, Reciprocity and Conduct in psychedelic therapies

The field of Psychedelic Assisted Therapy (PAT) is growing at an unprecedented pace. The immense pressure that this places on those operating in this space has already begun to raise important questions about risk and responsibility. It is imperative that the development of a safe and equitable infrastructure for psychedelic care is prioritised, and we utilise this unique opportunity to shape a new chapter in bio-psycho-socio-spiritual approaches to healing and wellbeing. Here we present ARC; a framework for a culturally informed ethical infrastructure for Access, Reciprocity and Conduct in psychedelic therapies. The three parallel yet interdependent pillars of ARC provide the bedrock for an infrastructure that respects the cultural roots of these medicines, protects the safety of those delivering and receiving these treatments, and prioritizes and empowers the communities most in need. In the development of ARC, we are taking a novel dual-phase co-design approach. The first phase involves co-development with relevant stakeholders from research, industry, therapeutic, community, and indigenous contexts. A second phase will draw upon the collective wisdom of the wider psychedelic community. By presenting ARC at this early stage, we hope to inspire the open dialogue and collaboration upon which the process of co-design depends, and that together, we can ensure a safe, and equitable future for PAT

Therapeutic alliance and rapport modulate responses to psilocybin assisted therapy for depression

Background: Across psychotherapeutic frameworks, the strength of the therapeutic alliance has been found to correlate with treatment outcomes; however, its role has never been formally assessed in a trial of psychedelic-assisted therapy. We aimed to investigate the relationships between therapeutic alliance and rapport, the quality of the acute psychedelic experience and treatment outcomes. Methods: This 2-arm double-blind randomized controlled trial compared escitalopram with psychedelic-assisted therapy for moderate-severe depressive disorder (N=59). This analysis focused on the psilocybin condition (n=30), who received two oral doses of 25 mg psilocybin, three-weeks apart, with psychological preparation, in-session support, and integration therapy. A new psychedelic therapy model, called ‘Accept-Connect-Embody’ (ACE), was developed in this trial. The primary outcome was depression severity six weeks post treatment (Quick Inventory of Depressive Symptomatology, QIDS-SR-16). Path analyses tested the hypothesis that therapeutic alliance (Scale To Assess the Therapeutic Relationship Patient Version, STAR-P) would predict depression outcomes via its influence on the acute psychedelic experience, specifically emotional-breakthrough (EBI) and mystical-type experiences (MEQ). The same analysis was performed on the escitalopram arm to test specificity. Results: The strength of therapeutic alliance predicted pre-session rapport, greater emotional-breakthrough and mystical-type experience (maximum EBI and MEQ scores across the two psilocybin sessions) and final QIDS scores (β = -0.22, R2 = 0.42 for EBIMax; β = -0.19, R2 = 0.32 for MEQMax). Exploratory path models revealed that final depression outcomes were more strongly affected by emotional breakthrough during the first, and mystical experience during the second session. Emotional breakthrough, but not mystical experience, during the first session had a positive effect on therapeutic alliance ahead of the second session (β = 0.79, p < .0001). Therapeutic alliance ahead of the second session had a direct impact on final depression scores, not mediated by the acute experience, with a weaker alliance ahead of the second psilocybin session predicting higher absolute depression scores at endpoint (β = -0.49, p < .001). Discussion: Future research could consider therapist training and characteristics; specific participant factors, e.g., attachment style or interpersonal trauma, which may underlie the quality of the therapeutic relationship, the psychedelic experience and clinical outcomes; and consider how therapeutic approaches might adapt in cases of weaker therapeutic alliance