Domenick Sportelli D.O.Tom Draschil M.D.

The Mystical Experience and its Potential Role in Psychiatry

Learning Objectives1) Learn the core features of a mystical

experience.2) Understand its role in history and

potential therapeutic value.3) Learn about our research to establish a

non-pharmacological method for safely inducing a mystical experience.

ConsciousnessArnold M. Ludwig   (1966): ‘Altered states

of consciousness’ – any mental state induced by physiological, psychological, or pharmacological maneuvers or agents, which deviates from the normal waking state of consciousness (waking beta wave state).

a.k.a. “altered state of mind,” “altered state of awareness”

Altered States of Consciousness

ASCDeliriumDementiaDepersonalizationDissociative statesIctal/postictal statesAlcohol intoxication

DreamingMeditationRunner’s highPsychedelic statesHypnosis

NOSCASC – problematic as the word 'altered'

"suggests that these states represent a deviation from the way consciousness should be.

"Alternate" makes it clear that different states of consciousness prevail at different times for different reasons and that no one state is considered standard.” - Zinberg (1977)

Non-Ordinary States of Consciousness (NOSC)

Mystical ExperienceMysticism- the practice of religious

ecstasies (i.e. religious experiences during alternate states of consciousness) Encyclopæida Britannica

“…certain fundamental characteristics of the experience itself which are universal and not restricted to any particular religion or culture…” Panke (1967)

Mystical Experience“Fundamental,” “universal” characteristics:1. Unity (internal or external)2. Noetic quality3. Ineffability/paradoxically4. Sense of sacredness5. Positive mood6. Transcendence of time and spaceStace (1960)

Oceanic Boundlessness“By religious feeling, what I mean—altogether independently of any dogma, any Credo, any organization of the Church, any Holy Scripture, any hope for personal salvation, etc.—the simple and direct fact of a feeling of 'the eternal' (which may very well not be eternal, but simply without perceptible limits, and as if oceanic). This feeling is in truth subjective in nature. It is a contact.” - Romain Rolland December 5, 1927

Oceanic FeelingCivilization and Its Discontents - Freud

(1930)Freud locates the oceanic feeling within the

primitive ego.“An infant at the breast does not as yet

distinguish his ego from the external world as the source of sensations flowing in upon him.”

Freud argues that the religious feeling (or oceanic feeling) is a “preserved primitive ego feeling.”

Mystical ExperienceWilliam James’ The Varieties of Religious Experience (1902):1. Noetic – illuminations/revelations that carry with them a curious sense of authority. A state of knowing.2. Ineffable- defies expression. A state of feeling.             3. Transient – lasts for a short period of time.4. Passive - the experience happens to the individual, largely without conscious control.

Peak ExperiencesPeak experiences are joyous and exciting

moments in life, involving sudden feelings of intense happiness and well-being, wonder and awe, and possibly also involving an awareness of transcendental unity or knowledge of higher truth.

Peak-experiences can beconsidered a transient self-actualization of the person.

Maslow (1964)

Peak ExperiencesMaslow (1964) “Religion, values, and Peak Experience”“The very beginning, the intrinsic core, the

essence, the universal nucleus of every known high religion (unless Confucianism is also called a religion) has been the private, lonely, personal illumination, revelation, or ecstasy of some acutely sensitive prophet or seer.”

These revelations were “…perfectly natural, human peak-experiences…which were phrased in terms of whatever conceptual, cultural, and linguistic framework the particular seer had available.”

Core Features of the Mystical ExperienceW. T. Stace – Mysticism and Philosophy (1960)1. Unity (internal or external)2. Noetic Quality3. Ineffable4. Sacredness5. Positive Mood6. Transcendence of time and space

Internal Unity(The Unitary Consciousness)

"Suddenly…I felt the approach of the mood. Irresistibly it took possession of my mind and will, lasted what seemed an eternity, and disappeared in a series of rapid sensations which resembled the awakening from anesthetic influence. One reason why I disliked this kind of trance was that I could not describe it to myself. I cannot even now find words to render it intelligible. It consisted in a gradual but swiftly progressive obliteration of space, time, sensation, and the multitudinous factors of experience which seem to qualify what we are pleased to call our Self. In proportion as these conditions of ordinary consciousness were subtracted, the sense of an underlying or essential consciousness acquired intensity. At last nothing remained but a pure, absolute, abstract Self. The universe became without form and void of content.” -J. A. Symonds

Stace (1960)

External Unity (all things are One)

"In that time the consciousness of God's nearness came to me sometimes. I say God, to describe what is indescribable. A presence, I might say, yet that is too suggestive of personality, and the moments of which I speak did not hold the consciousness of a personality, but something in myself made me feel myself a part of something bigger than I that was controlling. I felt myself one with the grass, the trees, birds, insects, everything in Nature. I exulted in the mere fact of existence, of being a part of it all—the drizzling rain, the shadows of the clouds, the tree-trunks, and so on.” - Edwin Starbuck

Stace (1960)

Core Features of the Mystical Experience1. Unity (internal or external)2. Noetic Quality3. Ineffable4. Sacredness5. Positive Mood6. Transcendence of time and space

Stace (1960)

Transcendence of time and space“…Characteristic disorientation in time and space, or even the lack of consciousness of time and space. Phrased positively, this is like experiencing universality and eternity . . . The person in the peak-experiences may feel a day passing as if it were minutes or also a minute so intensely lived that it might feel like a day or a year or an eternity even. He may also lose his consciousness of being located in a particular place.” Maslow (1964)

The search for the Mystical Experience

“The deepest need of man, then, is to overcome his separateness, to leave the prison of his aloneness. The panic of complete isolation can be overcome only by such a radical withdrawal from the world outside that the feeling of separation disappears – because the world outside, from which one is separated, has disappeared.”

Erich Fromm

The search for the mystical experience.Work with breath

Pranayama, Buddhist fire breath, sufi breathing

SoundDrumming,

rattling, gongs, chanting, mantras

Sensory deprivationVision quests,

desert, caves

Sensory overloadAboriginal ritualsExtreme pain

PhysiologicalFastingSleep deprivation

Meditation Zen, yogas, tibetan

dzogchen

Psychedelic substancesEntheogennoun1. a chemical substance, typically of plant origin, that is ingested to produce a non ordinary state of consciousness for religious or spiritual purposes. -oxford dictionary

HashishPeyoteOloliuquiAyahuascaEbogaPsilocybin

mexicanaPsilocybe

azurescens

Hawaiian woodroseSecretion form the

toad bufu alvariusPacific fish kyphosus

fuscus

Mans search for the mystical experience• Major role in human history– Principle vehicle in the ritual/spiritual life

• Meditation– 1500BC hindu traditions of vedantism – 6th 5th centuries Taoist China Buddhist India– 8th century Japanese Budhism and Zen

• Current; Mantra meditation, relaxation response, mindfulness, zen, TM…

• Commonality: Focused attention

Carl Jung “Active Imagination”

An “inner dialogue” used and developed by Carl Jung as a way of establishing a deeper dialogue with the unconscious. • The term “self” was used by Jung to designate

a “transpersonal” center or “totality” of the human psyche… A greater objective personality

• “ego” describes the “lesser”subjective personality of theeveryday self

Carl Jung-Active Imagination• Like all the Jungian archetypes the “Self” is never

completely “knowable” and can be experienced an re-experienced in many different ways.

1) Being alone by oneself and settling the thoughts of the ego; Consciousness giving space to the Unconscious

2) Make contact with the unconscious, in the form of images, fantasies and emotions; these are written down, drawn or painted to give an external form

3) The ego reacts by confronting the emerging material

4) Conclusions are drawn and enacted in life

Man’s Search for the Experience

• Vision Quest (Rite of Passage)– Among the Plains Indians the vision quest was the primary

means of establishing a link with the spirit world (Sander 1996)

– Teenage years; communion for self identity– Isolation, secluded in nature– Preceded by sweat lodge, sleep deprivation and Fasting for

up to 4 days– Expectation to communicate

with a spirit guide• Set and setting to pursue vision

Psilocybin200 species of mushroom

Psilocin; euphoria, VH, change perception, spiritual experiences, altered sense of time

Murals dated 9000-7000 BC Sahara Desert and Alegeria6000 year old pictographs Spanish village Villar del Humo

identified as Psilocybe hispanicaMayan language teonanactatl’ “gods flesh”Partial Agonist with high affinity for 5HT2a, less tightly to

5HT1a,1d,2cPsychotomimetic properties can be blocked in a dose dependant

fashion by 5HTa2 antagonist ketanserin and risperdone Vollenweider 1998

“radical withdrawal from the world outside that the feeling of separation disappears…”

Peyote (mescaline)2-3,4,5 trimethoxyphenethylamineAgonist 5-HT2a,cCora, Huichol, Kiowa, Comanche and

Tarahumera Indians, Native American Church Ceremonies vary from tribe to tribe

Celebrate birth of child, naming of baby, doctoring ceremonies, service for the dead, Easter, New year

Singing, Drumming, ChantingA “sacrament”, induced well being and

visions, a “messenger” enabling the individual to communicate with God (Shultes 1992)

“…radical withdrawal from the world outside that the feeling of separation disappears…”

N,N - DimethyltryptamineAyahuasca (vine of the souls)

Utlilized by indigenous populations of the amazon basinEvidence in the form of pottery vessels,

anthropomorphic figurines, snuffing trays date plant hallucinogen use in the Ecuadorian Amazon by 1500 -2000 BC (Mckenna 1998)

Boiling/soaking components Banisteriopsis cappi (Potient MAO-A inhibitors)Psychotria viridis (N,N- Dimethlytryptamine)*DMT alone is not orally active without this potent

MAOI Agonist properties of N,N-dimethyltryptamine at serotonin 5-HT2A and

5-HT2C receptors. Smith et al,, 1998

• DMT– Rick Strassman, M.D.

Administered approximately 400 doses of DMT to 60 human volunteers. Of the 60 human volunteers who've ingested DMT, more than half reported

similar experiences. These experiences ranged from profound encounters/interaction with non-human beings to observing highly

detailed, self-transforming geometric patterns and other things of similar nature.

– Dose response study of N,N Dimethyltryptamine in Humans; Strassman et al. Archives of General Psychiatry, 1994

• “There was a movement of color, the colors were words, I heard what they were saying to me. I was trying to look out but the colors were saying “God is IN every cell of your body” and I was feeling it, The colors kept telling me things, but I also felt it, I say felt it but it was more like “knowing” that God is in everything and that we are all connected.”– Several days later this subject wrote: I am changed and will never be

the same, I don’t think anyone reading this can truly grasp what I felt, can really understand it completely. The euphoria goes on into eternity, and I am part of that eternity

Mans search for the mystical experience

“No matter how close each of us becomes to another, there remains a final unbridgeable gap; each of us enters existence alone and must depart from it alone. The existential conflict is thus the tension between our awareness of our absolute isolation and our wish to be part of a larger whole”

Irvin Yalom

Hard Wired?• In 2011, Nicholas V. Cozzi, of the University of Wisconsin

School of Medicine and Public Health, concluded that INMT, an enzyme that associated with the biosynthesis of DMT and endogenous hallucinogens, is present in the primate (rhesus macaque) pineal gland, retinal ganglion and spinal cord

>>>New data now establish that the enzyme actively produces DMT in the pineal.

• In 2013 Rick Strassman et al,– LC/MS/MS analysis of the endogenous dimethyltryptamine

hallucinogens, their precursors, and major metabolites in rat pineal gland microdialysate • Steven A. Barkera*, Jimo Borjiginb,

Izabela Lomnickaa and Rick Strassman ;Biomedical Chromatography, 2013

Rhesus macaque pineal gland

Biosynthesis of Psilocybin

Serotonin

Can this experience be therapeutic?• A RCCT: The effect of a mindfulness

meditation based stress reduction program on mood and symptoms of stress in CA outpatients– Speca et al; Psychosomatic medicine, 2000• Effective in decreasing mood disturbance and stress

symptoms• Spirituality influences health related quality

of life in men with prostate cancer– Krupski et al; Psycho-oncology, 2006• Low spirituality was associated with significantly

worse physical and mental health, sexual function

Therapeutic?Psilocybin can occasion mystical-type

experiences having substantial and sustained personal meaning and spiritual significance R. R. Griffiths & W. A. Richards & U. McCann

& R. Jesse, Johns Hopkins Med School. 2006– Thirty volunteers received orally administered

psilocybin or methylphenidate active placebo – Volunteers completed questionnaires assessing drug

effects and mystical experience immediately after and 2 months after sessions.

– When administered under supportive conditions, psilocybin occasioned experiences similar to spontaneously occurring mystical experiences. The ability to occasion such experiences prospectively will allow rigorous scientific investigations of their causes and consequences.

– At 2 months, the volunteers rated the psilocybin experience as having substantial personal meaning and spiritual significance and attributed to the experience sustained positive changes in attitudes and behavior consistent with changes rated by community observers.

Therapeutic?• Psilocybin and the treatment of alcoholism– University of New Mexico• Open label pilot study• Psilocybin plus MET

• Use of psilocybin to reduce psycho-spiritual anxiety, depression and physical pain of terminal CA patients– Harbor, UCLA

• Hopkins- Psilocybin and Spirituality– Ongoing, Roland Griffiths

Safety and Efficacy of LSD Assisted Psychotherapy for Anxiety Associated with Life Threatening DiseasesGasser et al, 2014; Journal of Nervous and

Mental Disease.Demonstrated safety in 22 psychotherapy sessions

assisted by 200mcg of LSD with no drug related adverse events

Positive trends in reduction of anxiety after 2 sessions

How to Quantify the Experience• Mystical Experience Questionnaire– Developed by Pahnke (1963, 1969) as a tool for the

evaluation of single mystical experiences occasioned by hallucinogens.• Pahnke, Walter. The Good Friday Experiment, Harvard U.• Based on Stace’s conceptual framework (1960)

– Covers the major dimensions of the classical mystical experience• Unity (internal/external)• Transcendence of time and space• Noetic quality• Sacredness• Positive mood• Inneffability/paridoxicality

REVISED MYSTICAL EXPERIENCE QUESTIONNAIREInstructions: Looking back on the entirety of your session, please rate the degree to which at any time during that session you

experienced the following phenomena. Answer each question according to your feelings, thoughts, and experiences at the time of the session. In making each of your ratings, use the following scale:

0 – none; not at all 3 – moderate1 – so slight cannot decide 4 – strong (equivalent in degree to any other strong experience)2 – slight 5 – extreme (more than any other time in my life and stronger than 4)

Factor 1: MysticalInternal Unity1) Freedom from the limitations of your personal self and feeling a unity or bond with what

was felt to be greater than your personal self.2) Experience of pure being and pure awareness (beyond the world of sense impressions).3) Experience of oneness in relation to an “inner world” within.4) Experience of the fusion of your personal self into a larger whole.5) Experience of unity with ultimate reality.6) Feeling that you experienced eternity or infinity.External Unity7) Experience of oneness or unity with objects and/or persons perceived in your

surroundings.8) Experience of the insight that “all is One”.9) Awareness of the life or living presence in all things.Noetic Quality10) Gain of insightful knowledge experienced at an intuitive level.11) Certainty of encounter with ultimate reality (in the sense of being able to “know” and

“see” what is really real at some point during your experience.12) You are convinced now, as you look back on your experience, that in it you encountered

ultimate reality (i.e., that you “knew” and “saw” what was really real).

REVISED MYSTICAL EXPERIENCE QUESTIONNAIRESacredness13) Sense of being at a spiritual height.14) Sense of reverence.15) Feeling that you experienced something profoundly sacred and holy.Factor 2: Positive Mood16) Experience of amazement.17) Feelings of tenderness and gentleness.18) Feelings of peace and tranquility.19) Experience of ecstasy.20) Sense of awe or awesomeness.21) Feelings of joy.Factor 3: Transcendence of Time and Space22) Loss of your usual sense of time.23) Loss of your usual sense of space.24) Loss of usual awareness of where you were.25) Sense of being “outside of” time, beyond past and future.26) Being in a realm with no space boundaries.27) Experience of timelessness.Factor 4: Ineffability28) Sense that the experience cannot be described adequately in words.29) Feeling that you could not do justice to your experience by describing it in words.30) Feeling that it would be difficult to communicate your own experience to others who have not had

similar experiences.

MEQSeveral studies have demonstrated the

sensitivity of the MEQ to the effects of psilocybin and other classic hallucinogensDoblin; 1991Pahnke; 1963, 1969Richards; 1977Griffiths; 2006, 2008, 2011

MEQ scores higher then active placeboFactor analysis of the Mystical Experience

Questionnaire. Maclean et al, 2012. Johns Hopkins School of

MedicineThe factor analysis results provide initial evidence of

the validity and reliability of the 30 item scale for measuring mystical experience.

Potential role of the mystical experience in psychiatry?

1. Mystical experience therapy - The experience in and of itself can be healing. (classic psychedelic psychotherapy).

2. Psycholytic -(literally, mind-loosening)– gives us insight to unconscious material we can use for processing in psychotherapy.

Make the unconscious conscious. Maslow (1964)Grinspoon L, & Doblin R (2001)

1) Prevent self destructive actions

Suicide Self Harm Substance Abuse/Addiction

2) “Abort existential meaningless”

3) “Death may lose its dread aspect”

Alcoholics Anonymous

Chronic illness – LSD, Psilocybin

End of life cancer study NYU psilocybin

How Do We Reliably Induce a Mystical Experience?1st problem: Establish a method of safely and reliably

inducing a mystical experience in a controlled clinical environment.

Psychedelic drugs: psilocybin, LSD, DMTSchedule I drugsSafety

Religion: Christianity, Sufism, Kabbalah, SanteríaUnethical Not-reliable (mystical experiences tend to be

spontaneous)Meditation/Yoga

Time. Often takes months to years.

Holotropic Breathwork• Developed by Stanislav and Christina Grof• A technique to induce Tx NOSC • Coined the term Holotropic

Neologism from Greek: ὅλος τρέπεινholos = whole trepein = moving toward or in the direction of

something.  Oriented toward wholeness – NOSC w/ healing

potential.Grof & Grof (2010)

Holotropic BreathworkHB sessions range 1-3 hours and are

terminated by the patient.Described as “industrial strength

meditation.”3 components:1. Prolonged hyperventilation (>20 min)2. Evocative music3. Body work

Hyperventilation• Physiological and cognitive changes associated

withHypocapniaRespiratory alkalosis

•Physical sx: dizziness, palpitations, and tingling/numbness of the extremities, carpopedal spasms.

Rhinewine & Williams (2007)

Hyperventilation – Cognitive Sx:

>8 min - ringing/roaring in the ears, clouded vision, and feelings of lightness, astonishment, and/or euphoria.

>15 min –perceptual distortions and subjective “visions”>20 minutes – holotropic state of consciousness. Can be

maintained by breathing.• Changes related to transient hypofrontality - a brief period of unusually

low activity in the frontal cortex.• Transient hypofrontality hypothesized to underlie a number of other altered

states of consciousness: Runner’s high Meditation Half-asleep states (hypnagogic and hypnopompic hallucinations) Hypnosis Some drug-induced NOSC (psilocybin, LDS).

Rhinewine & Williams (2007)

Holotropic Breathwork Session

1. Lasts 1-3 hours

2. Terminated by the client

3. Followed by integration worka) Mandela – patient’s paint, draw, or write about

their experience as a way to express the ineffable content of HB session.

b) Group sharing session

Research ProjectPurpose: Better understand the NOSC induced by

the voluntary hyperventilation procedure HB.Objective:

1) Describe the effects of Holotropic Breathwork on mood states (descriptive study)2) Determine how frequently a complete mystical experience is induced by the technique of Holotropic Breathwork.

Hypothesis: Holotrpoic Breathwork can induce a complete mystical experience (i.e. a score of 60% or higher on each subscale of the Revised Mystical Experience Questionnaire).

Research design and methods

N= 20-30subjects will be recruited from individuals who are previously and independently enrolled in privately affiliated Holotropic Breathwork workshops

3 Individual on site questionnairesDemographic Questionnaire- basic demographic

information (age, gender, race, marital status, education level, religious affiliation, and prior experience with Holotropic Breathwork). Pre session

Positive and Negative Affect Scale (PANAS) – 20 item questionnaire will be used to quantify the subjective mood and affect of the participants’ prior to and post HB session Pre session Post session

Revised Mystical Experience Questionnaire (MEQ). 32 item questionnaire used to identify the number of complete mystical experiences among the breathers. Post session

Summary

1. Mystical experiences core features:1. Unity (internal or external)2. Noetic quality3. Ineffability4. Sense of sacredness5. Positive mood6. Transcendence of time and space

2. Mystical experiences are measurable phenomenon that have played a significant role in human psychology.

3. HB can possibly induce a mystical experience in a safe, controlled environment.

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