Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings
BackgroundPsychedelic drug experiences are shaped by current-moment contextual factors, commonly categorized as internal (set) and external (setting). Potential influences of past environments, however, have received little attention.AimsTo investigate how previous environmental stimuli shaped the e...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Human Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2023.1200393/full |
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| author | Nicolas Garel Julien Thibault Lévesque Dasha A. Sandra Justin Lessard-Wajcer Elizaveta Solomonova Elizaveta Solomonova Michael Lifshitz Michael Lifshitz Stéphane Richard-Devantoy Stéphane Richard-Devantoy Kyle T. Greenway Kyle T. Greenway Kyle T. Greenway |
| author_facet | Nicolas Garel Julien Thibault Lévesque Dasha A. Sandra Justin Lessard-Wajcer Elizaveta Solomonova Elizaveta Solomonova Michael Lifshitz Michael Lifshitz Stéphane Richard-Devantoy Stéphane Richard-Devantoy Kyle T. Greenway Kyle T. Greenway Kyle T. Greenway |
| author_sort | Nicolas Garel |
| collection | DOAJ |
| description | BackgroundPsychedelic drug experiences are shaped by current-moment contextual factors, commonly categorized as internal (set) and external (setting). Potential influences of past environments, however, have received little attention.AimsTo investigate how previous environmental stimuli shaped the experiences of patients receiving ketamine for treatment-resistant depression (TRD), and develop the concept of “imprinting” to account for such time-lagged effects across diverse hallucinogenic drugs.MethodsRecordings of treatment sessions and phenomenological interviews from 26 participants of a clinical trial investigating serial intravenous ketamine infusions for TRD, conducted from January 2021 to August 2022, were retrospectively reviewed. A broad literature search was undertaken to identify potentially underrecognized examples of imprinting with both serotonergic and atypical psychedelics, as well as analogous cognitive processes and neural mechanisms.ResultsIn naturalistic single-subject experiments of a 28-year-old female and a 34-year-old male, subjective ketamine experiences were significantly altered by varying exposures to particular forms of digital media in the days preceding treatments. Higher levels of media exposure reduced the mystical/emotional qualities of subsequent psychedelic ketamine experiences, overpowering standard intention-setting practices and altering therapeutic outcomes. Qualitative data from 24 additional patients yielded eight further spontaneous reports of past environmental exposures manifesting as visual hallucinations during ketamine experiences. We identified similar examples of imprinting with diverse psychoactive drugs in past publications, including in the first-ever report of ketamine in human subjects, as well as analogous processes known to underly dreaming.Conclusions/interpretationPast environmental exposures can significantly influence the phenomenology and therapeutic outcomes of psychedelic experiences, yet are underrecognized and understudied. To facilitate future research, we propose expanding the contextual model of psychedelic drug actions to incorporate imprinting, a novel concept that may aid clinicians, patients, and researchers to better understand psychedelic drug effects.Clinical trial registrationClinicalTrials.gov, identifier NCT04701866. |
| first_indexed | 2024-03-12T23:09:43Z |
| format | Article |
| id | doaj.art-87c7c237a44249e3a5ca91999d6d40a8 |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-03-12T23:09:43Z |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-87c7c237a44249e3a5ca91999d6d40a82023-07-18T08:21:31ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612023-07-011710.3389/fnhum.2023.12003931200393Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settingsNicolas Garel0Julien Thibault Lévesque1Dasha A. Sandra2Justin Lessard-Wajcer3Elizaveta Solomonova4Elizaveta Solomonova5Michael Lifshitz6Michael Lifshitz7Stéphane Richard-Devantoy8Stéphane Richard-Devantoy9Kyle T. Greenway10Kyle T. Greenway11Kyle T. Greenway12Department of Psychiatry, McGill University, Montreal, QC, CanadaLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, CanadaDepartment of Psychology, McGill University, Montreal, QC, CanadaIntegrated Program in Neurosciences, McGill University, Montreal, QC, CanadaDepartment of Psychiatry, McGill University, Montreal, QC, CanadaNeurophilosophy Lab, Department of Philosophy, McGill University, Montreal, QC, CanadaDepartment of Psychiatry, McGill University, Montreal, QC, CanadaLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, CanadaDepartment of Psychiatry, McGill University, Montreal, QC, CanadaMcGill Group for Suicide Studies, Douglas Mental Health University Institute, LaSalle, QC, CanadaDepartment of Psychiatry, McGill University, Montreal, QC, CanadaLady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, CanadaDepartment of Medicine, Centre for Psychedelic Research, Imperial College London, London, United KingdomBackgroundPsychedelic drug experiences are shaped by current-moment contextual factors, commonly categorized as internal (set) and external (setting). Potential influences of past environments, however, have received little attention.AimsTo investigate how previous environmental stimuli shaped the experiences of patients receiving ketamine for treatment-resistant depression (TRD), and develop the concept of “imprinting” to account for such time-lagged effects across diverse hallucinogenic drugs.MethodsRecordings of treatment sessions and phenomenological interviews from 26 participants of a clinical trial investigating serial intravenous ketamine infusions for TRD, conducted from January 2021 to August 2022, were retrospectively reviewed. A broad literature search was undertaken to identify potentially underrecognized examples of imprinting with both serotonergic and atypical psychedelics, as well as analogous cognitive processes and neural mechanisms.ResultsIn naturalistic single-subject experiments of a 28-year-old female and a 34-year-old male, subjective ketamine experiences were significantly altered by varying exposures to particular forms of digital media in the days preceding treatments. Higher levels of media exposure reduced the mystical/emotional qualities of subsequent psychedelic ketamine experiences, overpowering standard intention-setting practices and altering therapeutic outcomes. Qualitative data from 24 additional patients yielded eight further spontaneous reports of past environmental exposures manifesting as visual hallucinations during ketamine experiences. We identified similar examples of imprinting with diverse psychoactive drugs in past publications, including in the first-ever report of ketamine in human subjects, as well as analogous processes known to underly dreaming.Conclusions/interpretationPast environmental exposures can significantly influence the phenomenology and therapeutic outcomes of psychedelic experiences, yet are underrecognized and understudied. To facilitate future research, we propose expanding the contextual model of psychedelic drug actions to incorporate imprinting, a novel concept that may aid clinicians, patients, and researchers to better understand psychedelic drug effects.Clinical trial registrationClinicalTrials.gov, identifier NCT04701866.https://www.frontiersin.org/articles/10.3389/fnhum.2023.1200393/fullpsychedelicsketamineset and settinghallucinationsimprintingextra-pharmacological model |
| spellingShingle | Nicolas Garel Julien Thibault Lévesque Dasha A. Sandra Justin Lessard-Wajcer Elizaveta Solomonova Elizaveta Solomonova Michael Lifshitz Michael Lifshitz Stéphane Richard-Devantoy Stéphane Richard-Devantoy Kyle T. Greenway Kyle T. Greenway Kyle T. Greenway Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings Frontiers in Human Neuroscience psychedelics ketamine set and setting hallucinations imprinting extra-pharmacological model |
| title | Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings |
| title_full | Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings |
| title_fullStr | Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings |
| title_full_unstemmed | Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings |
| title_short | Imprinting: expanding the extra-pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings |
| title_sort | imprinting expanding the extra pharmacological model of psychedelic drug action to incorporate delayed influences of sets and settings |
| topic | psychedelics ketamine set and setting hallucinations imprinting extra-pharmacological model |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2023.1200393/full |
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