Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression
Abstract
Objective: To identify patients’ perceptions of the value of psilocybin as a treatment for depression. Method: Twenty patients enrolled in an open-label trial of psilocybin for treatment-resistant depression participated in a semistructured interview at 6-month follow-up. Thematic analysis was used to identify patients’ experiences of the treatment and how it compared with previous treatments. Results: Two main change processes were identified in relation to the treatment. The first concerned change from disconnection (from self, others, and world) to connection, and the second concerned change from avoidance (of emotion) to acceptance. A third theme concerned comparison between psilocybin and conventional treatments. Patients reported that medications and some short-term talking therapies tended to reinforce their sense of disconnection and avoidance, whereas treatment with psilocybin encouraged connection and acceptance. Conclusions: These results suggest that psilocybin treatment for depression may work via paradigmatically novel means, antithetical to antidepressant medications, and some short-term talking therapies.
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A limitation of the CEQ is that it measures challenging emotions, memories, or both without addressing their potential resolution, and therefore cannot assess the potential value of overcoming emotional challenges experienced under psychedelics.
“A limitation of the CEQ is that it measures challenging emotions, memories, or both without addressing their potential resolution. Therefore, it cannot assess the potential value of overcoming any emotional challenges experienced under the influence of psychedelics (Watts et al., 2017).”
From Assessment of the acute subjective psychedelic experience: A review of patient-reported outcome measures in clinical research on classical psychedelics (2024) · cites this paper as Watts et al., 2017
Therapeutic outcomes of psychedelic-assisted therapies appear strongly influenced by psychological "set," environmental "setting," and structured post-session integration.
“Therapeutic outcomes appear strongly influenced by psychological “set” (mindset, expectations, preparation), environmental “setting,” and structured post-session integration (96, 99, 107, 108), highlighting the central role of context, support, and integration in optimizing benefit.”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [99]
In qualitative interviews, participants identified increased connectedness to oneself, others, and the world as a key element underlying the therapeutic effect of psychedelic-assisted therapy, including reduced craving and substance use in individuals with addiction.
“In qualitative interviews, participants identified this tri-dimensional factor as a key element underlying the therapeutic effect of PAT [61, 62], including reduced craving and substance use in individuals with addiction [62].”
These acute positive emotions largely cohered with previous observations in other psilocybin studies.
“These emotions largely cohered with previous observations in other psilocybin studies (36–42).”
Participants of clinical trials described a notable shift from emotional avoidance to acceptance after receiving psilocybin-assisted psychotherapy for treatment-resistant depression.
“These outcomes are in line with previous reports from participants of clinical trials, who described a notable shift from emotional avoidance to acceptance, after receiving psilocybin-assisted psychotherapy for treatment-resistant depression [57].”
From The psychological processes of classic psychedelics in the treatment of depression: a systematic review protocol (2022) · cites this paper as [57]
Psychedelic use can help individuals break through emotional barriers, confront past traumas, and develop a deeper sense of self-awareness and connection with others.
“Their use can help individuals break through emotional barriers, confront past traumas, and develop a deeper sense of self-awareness and connection with others (Watts et al. 2017;Carhart-Harris et al. 2018).”
From Authenticity and Love Drugs: Insights from Psychedelic Therapy (2026) · cites this paper as Watts et al. 2017
After psilocybin-assisted treatment, many patients reported being able to re-connect with family members, friends, strangers, and even people who had wronged them.
“After treatment, many reported to be able to “re-connect” with family members, friends, strangers, and even people who had wronged them.”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [32]
Patients identified increased connection as one of two main change processes in relation to treatment.
“Patients identified this increased connection as one of two main change processes in relation to treatment (32)”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [32]
The same patients reported that they experienced a sense of disconnection from others as particularly distressing before psilocybin-assisted treatment.
“Yet, the same patients reported that they experienced a sense of disconnection from others as particularly distressing before psilocybin-assisted treatment (32).”
From Modulation of Social Cognition via Hallucinogens and “Entactogens” (2019) · cites this paper as [32]
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- Authors
- Watts, R., Day, C., Krzanowski, J., Nutt, D., & Carhart-Harris, R.
- Affiliations
- Imperial College London (GB)
- Corresponding author
- Watts, Rosalind
- Venue
- Journal of Humanistic Psychology
- Publisher
- SAGE Publications
- Published
- 2017-06-19
- Volume
- 57
- Issue
- 5
- Pages
- 520-564
- ISSN
- 0022-1678 (ISSN-L)
- 1552-650X
- OpenAlex
- W2644260506
- Cited by
- 589
- References
- 54
- Citations by year
- 2026: 80 · 2025: 86 · 2024: 87 · 2023: 100 · 2022: 84 · 2021: 72 · 2020: 34 · 2019: 19 · 2018: 20 · 2017: 6
- FWCI
- 26.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Humanistic Psychology (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- psilocybin, treatment-resistant depression, patient experience, connectedness, acceptance, disconnection, emotional avoidance, antidepressants, psychotherapy, psychedelic therapy, mechanisms of change
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