Positive psychology in the investigation of psychedelics and entactogens: A critical review

RATIONALE: We reviewed the concepts and empirical findings in studies with psychedelics and entactogens related to positive psychology - the study of healthy human functioning, well-being and eudaemonia. It is an unresolved question how beneficial effects of psychedelics and entactogens are related to the potential risks of these substances - particularly in non-clinical settings. METHODS: We searched in PubMed, PsychINFO and the Cochrane Library for controlled clinical and epidemiological studies which applied concepts from positive psychology. We included N = 77 eligible studies with 9876 participants published before November 1st, 2017: (1) quantitative studies (N = 54), (2) preliminary or exploratory studies and reviews not including meta-analyses (N = 17), and (3) studies evidencing primarily negative results (N = 6). RESULTS: Positive psychology concepts have been applied for measuring effects of clinical trials, recreational and ceremonial use of psychedelics and entactogens. Psychedelics and entactogens were shown to produce acute and long-term effects on mood, well-being, prosocial behaviours, empathy, cognitive flexibility, creativity, personality factors like openness, value orientations, nature-relatedness, spirituality, self-transcendence and mindfulness-related capabilities. CONCLUSIONS: There is preliminary evidence for beneficial effects of psychedelics and entactogens on measures of positive psychology in clinical and healthy populations, however their sustainability remains largely unresolved. The reported results must be considered preliminary due to methodological restrictions. Since longitudinal data on both positive and adverse effects of psychedelics are lacking, more rigorous and standardized measures from positive psychology should be applied in less biased populations with prospective longitudinal designs to carefully assess the benefit-risk-ratio. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'

Decreased CO2 saturation during circular breathwork supports emergence of altered states of consciousness

Altered states of consciousness (ASCs), induced e.g. during psychedelic-augmented therapy, show great potential to treat highly prevalent mental health disorders like depression and posttraumatic stress disorder. However, such treatment approaches are not widely accessible due to legal, medical, and financial limitations. In this study, we explore the potential of circular breathwork to serve as a non-pharmacological and hence more easily accessible alternative to engage similar therapeutic processes. Scientific studies investigating the effects of breathwork on mental health are only just emerging and the underlying physiological and psychological mechanisms are largely unknown. In this study, we aim to address these questions by for the first time tracking physiological and experiential dynamics throughout the time course of a breathwork session, comparing two popular forms of breathwork: Holotropic Breathwork® and Consciously-Connected breathwork. We show that a reduction in end-tidal CO2 pressure due to deliberate hyperventilation is instrumental in catalyzing ASCs during breathwork. The ASCs evoked by breathwork were comparable to those produced by psychedelics, and their depth predicted psychological and physiological follow-on effects, including improved well-being and a reduction of depressive symptoms. Further analysis showed that different breathwork traditions impacted physiological markers as well as experiential and psychological outcomes in a similar way. Our findings identify physiological boundary conditions in which ASCs can arise in a non-pharmacological context, offering insights into the functional mechanisms of breathwork as well as its potential as a psychotherapeutic tool