Hallucinations that help: Psychedelics, psychiatry, and freedom from the self

Dr. Chris Letheby, a pioneer in the philosophy of psychedelics, is looking at a chair. He is taking in its individuated properties – its colour, its shape, its location – and all the while, his brain is binding these properties together, making them parts of a collective whole.

This, Letheby explains, is also how we process the self. We know that there are a number of distinct properties that make us who we are: the sensation of being in our bodies, the ability to call to mind our memories or to follow our own trains of thought. But there is a kind of mental glue that holds these sensations together, a steadfast, mostly uncontested belief in the concrete entity to which we refer when we use the word “me.”

“Binding is a theoretical term,” Letheby explains. “It refers to the integration of representational parts into representational wholes. We have all these disparate representations of parts of our bodies and who we were at different points at time and different roles we occupy and different personality traits. And there’s a very high-level process that binds all of these into a unified representation; that makes us believe these are all properties and attributes of one single thing. And different things can be bound to this self model more tightly.”

Freed from the Self

So what happens when these properties become unbound from one another – when we lose a cohesive sense of who we are? This, after all, is the sensation that many experience when taking psychedelic drugs. The “narrative self” – the belief that we are an individuated entity that persists through time – dissolves. We can find ourselves at one with the universe, deeply connected to those around us.

Perhaps this sounds vaguely terrifying – a kind of loss. But as Letheby points out, this “ego dissolution” can have extraordinary therapeutic results in those who suffer from addiction, or experience deep anxiety and depression.

“People can get very harmful, unhealthy, negative forms of self-representation that become very rigidly and deeply entrenched,” Letheby explains.

“This is very clear in addiction. People very often have all sorts of shame and negative views of themselves. And they find it very often impossible to imagine or to really believe that things could be different. They can’t vividly imagine a possible life, a possible future in which they’re not engaging in whatever the addictive behaviours are. It becomes totally bound in the way they are. It’s not experienced as a belief, it’s experienced as reality itself.”

This, Letheby and his collaborator Philip Gerrans write, is key to the ways in which psychedelics can improve our lives. “Psychedelics unbind the self model,” he says. “They decrease the brain’s confidence in a belief like, ‘I am an alcoholic’ or ‘I am a smoker’. And so for the first time in perhaps a very long time [addicts] are able to not just intellectually consider, but to emotionally and experientially imagine a world in which they are not an alcoholic. Or if we think about anxiety and depression, a world in which there is hope and promise.”

A comforting delusion?

Letheby’s work falls into a naturalistic framework: he defers to our best science to make sense of the world around us. This is an unusual position, given some philosophers have described psychedelic experiences as being at direct odds with naturalism. After all, a lot of people who trip experience what have been called “metaphysical hallucinations”: false beliefs about the “actual nature” of the universe that fly in the face of what science gives us reason to believe.

For critics of the psychedelic experience then, these psychedelic hallucinations can be described as little more than comforting falsehoods, foisted upon the sick – whether mentally or physically – and dying. They aren’t revelations. They are tricks of the mind, and their epistemic value remains under question.

But Letheby disagrees. He adopts the notion of “epistemic innocence” from the work of philosopher Lisa Bortolotti, the belief that some falsehoods can actually make us better epistemic agents. “Even if you are a naturalist or a materialist, psychedelic states aren’t as epistemically bad as they have been made out to be,” he says, simply. “Sometimes they do result in false beliefs or unjustified beliefs … But even when psychedelic experiences do lead to people to false beliefs, if they have therapeutic or psychological benefits, they’re likely to have epistemic benefits too.”

To make this argument, Letheby returns again to the archetype of the anxious or depressed person. This individual, when suffering from their illness, commonly retreats from the world, talking less to their friends and family, and thus harming their own epistemic faculties – if you don’t engage with anyone, you can’t be told that you are wrong, can’t be given reasons for updating your beliefs, can’t search out new experiences.

“If psychedelic states are lifting people out of their anxiety, their depression, their addiction and allowing people to be in a better mode of functioning, then my thought is, that’s going to have significant epistemic benefits,” Letheby says. “It’s going to enable people to engage with the world more, be curious, expose their ideas to scrutiny. You can have a cognition that might be somewhat inaccurate, but can have therapeutic benefits, practical benefits, that in turn lead to epistemic benefits.”

As Letheby has repeatedly noted in his work, the study of the psychiatric benefits of psychedelics is in its early phases, but the future looks promising. More and more people are experiencing these hallucinations – these new, critical beliefs that unbind the self – and more and more people are getting well. There is, it seems, a possible world where many of us are freed from the rigid notions of who we are and what we want, unlocked from the cage of the self, and walking, for the first time in a long time, in the open air.