Mindfulness-based therapy could offer an alternative to antidepressants

Mindfulness-based therapy could offer an alternative to antidepressants for preventing depression relapse
Mindfulness-based cognitive therapy (MBCT) could provide an alternative non-drug treatment for people who do not wish to continue long-term antidepressant treatment, suggests new research published in The Lancet.

According to Professor Kuyken, "Whilst this study doesn't show that mindfulness-based cognitive therapy works any better than maintenance antidepressant medication in reducing the rate of relapse in depression, we believe these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions. "

Study participant Mr Nigel Reed from Sidmouth, Devon, UK, comments that, "Mindfulness gives me a set of skills which I use to keep well in the long term. Rather than relying on the continuing use of antidepressants mindfulness puts me in charge, allowing me to take control of my own future, to spot when I am at risk and to make the changes I need to stay well." Source: MedicalXpress

Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial.
Kuyken W, Hayes R, Barrett B, Byng R, Dalgleish T, Kessler D, Lewis G, Watkins E, Brejcha C, Cardy J, Causley A, Cowderoy S, Evans A, Gradinger F, Kaur S, Lanham P, Morant N, Richards J, Shah P, Sutton H, Vicary R, Weaver A, Wilks J, Williams M, Taylor RS, Byford S.
Lancet. 2015 Apr 20. pii: S0140-6736(14)62222-4. doi: 10.1016/S0140-6736(14)62222-4. [Epub ahead of print]
PMID: 25907157
(PDF)
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Article from Forbes discusses this research:
Mindfulness May Match Meds For Preventing Depression Relapse
“Compared to other skills that we train in,” says Madhav Goyal, author of this earlier study, “the amount of training received by the participants in the trials was relatively brief. Yet, we are seeing a small but consistent benefit for symptoms of anxiety, depression, and pain. So you wonder whether we might see larger effects with more training, practice, and skill.” Forbes 4/21/2015

Set and Setting, a view from Joseph Campbell

The psilocybin study treatment room at Johns Hopkins University

Set and Setting. Set refers to ones mindset. Why are you taking psilocybin? If it is just to get high, just for kicks, or to escape reality then forget it because "the magic is not going to work". If you are taking it to grow spiritually, to feel connected to those around you, to deal with an existential crisis or for an addiction problem
then you may be on the right path. Setting is the environment both social and physical that you will be in while the psilocybin is having its effect. Having a supportive environment that is familiar and relatively free of extraneous stressors with the presence of a spiritual guide or trained therapist is important.

Below is a conversation between journalist Bill Moyers and mythologist Joseph Campbell. Their enlightening discussions was made into a PBS series titled Joseph Campbell and the Power of Myth in 1988. A book, the Power of Myth followed.

In the course of their discussion, Joseph came to describe the peyote ritual found amongst Native Americans in north-western Mexico. Keep in mind that there are 3 main classes of psychedlics that work on the 5-HT2A receptors. The 3 classes are represented by psilocybin, peyote and LSD.

CAMPBELL: These missions are mystical journeys with all of the details of the typical mystical journey. First, there is disengagement from secular life. Everybody who is going to go on this expedition has to make a complete confession of all the faults of his or her recent living. And if they don't, the magic is not going to work. Then they start on the journey. They even speak a special language, a negative language. Instead of saying yes, for example, they say no, or instead of saying, "We are going," they say, "We are coming." They are in another world. Then they come to the threshold of the adventure. There are special shrines that represent stages of mental transformation on the way. And then comes the great business of collecting the peyote. The peyote is killed as though it were a deer. They sneak up on it, shoot a little arrow at it, and then perform the ritual of collecting the peyote. The whole thing is a complete duplication of the kind of experience that is associated with the inward journey, when you leave the outer world and come into the realm of spiritual beings. They identify each little stage as a spiritual transformation. They are in a sacred place all the way.

MOYERS: Why do they make such an intricate process out of it?

CAMPBELL: Well, it has to do with the peyote being not simply a biological, mechanical, chemical effect but one of spiritual transformation. If you undergo a spiritual transformation and have not had preparation for it, you do not know how to evaluate what has happened to you, and you get the terrible experiences of a bad trip, as they used to call it with LSD. If you know where you are going, you won't have a bad trip.

MOYERS: So this is why it is a psychological crisis if you are drowning in the water where --

CAMPBELL: -- where you ought to be able to swim, but you weren't prepared. That is true of the spiritual life, anyhow. It is a terrifying experience to have your consciousness transformed.

MOYERS: You talk a lot about consciousness.

CAMPBELL: Yes.

MOYERS: What do you mean by it?

CAMPBELL: It is a part of the Cartesian mode to think of consciousness as being something peculiar to the head, that the head is the organ originating consciousness. It isn't. The head is an organ that inflects consciousness in a certain direction, or to a certain set of purposes. But there is a consciousness here in the body. The whole living world is informed by consciousness. I have a feeling that consciousness and energy are the same thing somehow. Where you really see life energy, there's consciousness. Certainly the vegetable world is conscious. And when you live in the woods, as I did as a kid, you can see all these different consciousnesses relating to themselves. There is a plant consciousness and there is an animal consciousness, and we share both these things. You eat certain foods, and the bile knows whether there's something there for it to go to work on. The whole process is consciousness. Trying to interpret it in simply mechanistic terms won't work.

MOYERS: How do we transform our consciousness?

CAMPBELL: That's a matter of what you are disposed to think about. And that's what meditation is for. All of life is a meditation, most of it unintentional. A lot of people spend most of life in meditating on where their money is coming from and where it's going to go. If you have a family to bring up, you're concerned for the family. These are all very important concerns, but they have to do with physical conditions, mostly. But how are you going to communicate spiritual consciousness to the children if you don't have it yourself? How do you get that?  What the myths are for is to bring us into a level of consciousness that is spiritual.

FYI: 35th Telluride Mushroom Festival August 13-16th, 2015

Telluride is one of the most beautiful places on earth. To some, it is a sacred place. I had attended a BlueGrass Festival at Telluride many years ago. Now, after hearing of the 35th Telluride Mushroom Festival, there is good reason to return.

Guest speakers who may speak on the role of psilocybin in medicine include:

Eugenia Bone, Author
Besides being a renowned food journalist and author, Eugenia wrote a very honest and moving piece for the New York Times titled "Can Mushrooms Treat Depression".

Fred Barrett, PhD
Frederick has done post-doc work at Johns Hopkins with Roland Griffiths.  Two of his publications includes:

• The challenging experience questionnaire: Characterization of acute adverse reactions to psilocybin
• Survey study of challenging experiences after ingesting psilocybin mushrooms: Demographics and phenomenology 

Mary Cosimano, MSW
Mary has served as study guide and research coordinator for the psilocybin studies at Johns Hopkins for 15 years. Her talk will be based on the her article: “Love: The Nature of our True Self: My Experience as a Guide in the Johns Hopkins Psilocybin Research Project".

Psilocybin use leads to increase in openness

Although the study below has been published a few years ago, I'm referencing it now as a result of re-reading Chapter 16 of Lao Tzu's Tao Te Ching translated by Witter Bynner*:

Be utterly humble
And you shall hold to the foundation of peace, 
Be at one with all those living things which, having arisen and flourished,
Return to the quiet whence they came,
Like a healthy growth of vegetation
Falling back upon the root,
Acceptance of this return to the root has been called 'quietism,'
Acceptance of quietism has been condemned as 'fatalism,'
But fatalism is acceptance of destiny
And to accept destiny is to face life with open eyes,
Whereas not to accept destiny is to face death blindfolded,
He who is open-eyed is open-minded,
He who is open-minded is open-hearted,
He who is open-hearted is kingly,
He who is kingly is godly,
He who is godly is useful,
He who is useful is infinite,
He who is infinite is immune,
He who is immune is immortal. 
   *A gift to me from Brian Simpson in 1994

Mystical experiences occasioned by the hallucinogen psilocybin lead to increases in the personality domain of openness. (PDF)
MacLean KA, Johnson MW, Griffiths RR. J Psychopharmacol. 2011 Nov;25(11):1453-61. Epub 2011 Sep 28. 
PMID: 21956378
Abstract 
A large body of evidence, including longitudinal analyses of personality change, suggests that core personality traits are predominantly stable after age 30. To our knowledge, no study has demonstrated changes in personality in healthy adults after an experimentally manipulated discrete event. Intriguingly, double-blind controlled studies have shown that the classic hallucinogen psilocybin occasions personally and spiritually significant mystical experiences that predict long-term changes in behaviors, attitudes and values. In the present report we assessed the effect of psilocybin on changes in the five broad domains of personality - Neuroticism, Extroversion, Openness, Agreeableness, and Conscientiousness. Consistent with participant claims of hallucinogen-occasioned increases in aesthetic appreciation, imagination, and creativity, we found significant increases in Openness following a high-dose psilocybin session. In participants who had mystical experiences during their psilocybin session, Openness remained significantly higher than baseline more than 1 year after the session. The findings suggest a specific role for psilocybin and mystical-type experiences in adult personality change.
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The psychedelic state induced by ayahuasca modulates the activity and connectivity of the default mode network.

The use of Ayahuasca for treating PTSD has been deservingly placed into public awareness thanks to Lisa Ling's episode "Jungle Fix" of This is Life.  The "Jungle Fix" follows a group of veterans, and others, to a remote location in the Peruvian jungles to take Ayahuasca as a treatment for PTSD due to having received no effective treatment from traditional medicine in the States.  Their results appear to be positive but you must ask why do those suffering from PTSD have to go through such extreme measures for effective treatment.

The psychedelic state induced by ayahuasca modulates the activity and connectivity of the default mode network.
Palhano-Fontes F, Andrade KC, Tofoli LF, Santos AC, Crippa JA, Hallak JE, Ribeiro S, de Araujo DB. PLoS One. 2015 Feb 18;10(2):e0118143.
PMID: 25693169
PDF
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From abstract:
Ayahuasca caused a significant decrease in activity through most parts of the default mode network, including its most consistent hubs: the Posterior Cingulate Cortex (PCC)/Precuneus and the medial Prefrontal Cortex (mPFC). Functional connectivity within the PCC/Precuneus decreased after Ayahuasca intake.

As with psilocybin, the effect of ayahuasca on the brain appears to be by decreasing activity in the default mode nework.  However, there are differences mentioned in this article:

• Although overall similar to the changes observed for psilocybin, the changes induced by Ayahuasca did not find a significant reduced coupling between PCC and mPFC, as observed after psilocybin intake [16]. Again, although Ayahuasca and psilocybin have much in common, the uniqueness of the experience brought by each substance should be remarked. The Ayahuasca experience usually involves much stronger somatic and sedation effects. From the neuropharmacology perspective, psilocybin acts almost exclusively on the serotonergic system, while Ayahuasca is linked to a rich combination of neurochemical mechanisms: DMT is a trace amine with affinities to sigma-1, monoaminergic, and trace amine-associated receptors [5,8,49,50]. Furthermore, Ayahuasca contains inhibitors of mono-amino-oxidases, which prevents the degradation of monoamine neurotransmitters and thus increase their levels.

A related article from the journal European Neuropsychopharmacology was available online 16 January 2015 (In Press, Corrected Proof):

Long-term use of psychedelic drugs Is associated with differences in brain structure and personality in humans
Bouso JC, Palhano-Fontes F, Rodríguez-Fornells A, Ribeiro S, Sanches R, Crippa JA, Hallak JE, de Araujo DB, Riba J.
Eur Neuropsychopharmacol. 2015 Apr;25(4):483-92.
PMID: 25637267
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From Abstract:
Ayahuasca users showed significant CT differences in midline structures of the brain, with thinning in the posterior cingulate cortex (PCC), a key node of the default mode network. CT values in the PCC were inversely correlated with the intensity and duration of prior use of ayahuasca and with scores on self-transcendence, a personality trait measuring religiousness, transpersonal feelings and spirituality. Although direct causation cannot be established, these data suggest that regular use of psychedelic drugs could potentially lead to structural changes in brain areas supporting attentional processes, self-referential thought, and internal mentation. These changes could underlie the previously reported personality changes in long-term users and highlight the involvement of the PCC in the effects of psychedelics.

For those unfamiliar with the structural similarities between psilocybin, ayahuasca (active ingredient DMT or N,N-Dimethytryptamine) and serotonin a diagram is posted below:

Note: psilocybin is quickly metabolized into psilocin in the body by a dephosphorylation reaction.

The new study below demonstrates the antidepressant effect of ayahuasca.  Given the structural similarities and activity on the 5-HT2a receptors it shares with psilocybin, psilocybin may very well function effectively as an antidepressant as well.

Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression: A SPECT Study.
Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow. In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography. Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake. Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers. Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.
Sanches RF, de Lima Osório F, Dos Santos RG, Macedo LR, Maia-de-Oliveira JP, Wichert-Ana L, de Araujo DB, Riba J, S Crippa JA, Hallak JE.
J Clin Psychopharmacol. 2015 Dec 8. [Epub ahead of print]
PMID: 26650973

Yet another study has been published highlighting the antidepressant properties of ayahuasca:

Antidepressant Effects of a Single Dose of Ayahuasca in Patients With Recurrent Depression: A SPECT Study.
Ayahuasca is an Amazonian botanical hallucinogenic brew which contains dimethyltryptamine, a 5-HT2A receptor agonist, and harmine, a monoamine-oxidase A inhibitor. Our group recently reported that ayahuasca administration was associated with fast-acting antidepressive effects in 6 depressive patients. The objective of the present work was to assess the antidepressive potentials of ayahuasca in a bigger sample and to investigate its effects on regional cerebral blood flow. In an open-label trial conducted in an inpatient psychiatric unit, 17 patients with recurrent depression received an oral dose of ayahuasca (2.2 mL/kg) and were evaluated with the Hamilton Rating Scale for Depression, the Montgomery-Åsberg Depression Rating Scale, the Brief Psychiatric Rating Scale, the Young Mania Rating Scale, and the Clinician Administered Dissociative States Scale during acute ayahuasca effects and 1, 7, 14, and 21 days after drug intake. Blood perfusion was assessed eight hours after drug administration by means of single photon emission tomography. Ayahuasca administration was associated with increased psychoactivity (Clinician Administered Dissociative States Scale) and significant score decreases in depression-related scales (Hamilton Rating Scale for Depression, Montgomery-Åsberg Depression Rating Scale, Brief Psychiatric Rating Scale) from 80 minutes to day 21. Increased blood perfusion in the left nucleus accumbens, right insula and left subgenual area, brain regions implicated in the regulation of mood and emotions, were observed after ayahuasca intake. Ayahuasca was well tolerated. Vomiting was the only adverse effect recorded, being reported by 47% of the volunteers. Our results suggest that ayahuasca may have fast-acting and sustained antidepressive properties. These results should be replicated in randomized, double-blind, placebo-controlled trials.
Sanches RF, de Lima Osório F, Dos Santos RG, Macedo LR, Maia-de-Oliveira JP, Wichert-Ana L, de Araujo DB, Riba J, Crippa JA, Hallak JE.
J Clin Psychopharmacol. 2016 Feb;36(1):77-81. doi: 10.1097/JCP.0000000000000436.
PMID: 26650973
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Psychedelics not linked to mental health problems or suicidal behavior: A population study

Psychedelics not linked to mental health problems or suicidal behavior: A population study. 
Johansen PØ, Krebs TS.
J Psychopharmacol. 2015 Mar;29(3):270-9. Epub 2015 Mar 5.
PMID: 25744618 (PDF)
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This new article from the Journal of Psychopharmacology (5 March 2015) has the following points of interest beginning with the abstract:
Abstract
A recent large population study of 130,000 adults in the United States failed to find evidence for a link between psychedelic use (lysergic acid diethylamide, psilocybin or mescaline) and mental health problems. Using a new data set consisting of 135,095 randomly selected United States adults, including 19,299 psychedelic users, we examine the associations between psychedelic use and mental health. After adjusting for sociodemographics, other drug use and childhood depression, we found no significant associations between lifetime use of psychedelics and increased likelihood of past year serious psychological distress, mental health treatment, suicidal thoughts, suicidal plans and suicide attempt, depression and anxiety. We failed to find evidence that psychedelic use is an independent risk factor for mental health problems. Psychedelics are not known to harm the brain or other body organs or to cause addiction or compulsive use; serious adverse events involving psychedelics are extremely rare. Overall, it is difficult to see how prohibition of psychedelics can be justified as a public health measure.

A similar 2013 study published in PLoS One by the same authors found the 'associations between psilocybin use and lower likelihood of past year serious psychological distress, inpatient mental health treatment and psychiatric medication prescription were statistically significant both in this study (aOR 0.9, p = 0.007; aOR 0.7, p = 0.0004; aOR 0.8, p = 0.002, respectively) and in our previous study (aOR 0.8, p = 0.009; aOR 0.8, p = 0.04; aOR 0.8, p = 0.00008, respectively)' (Krebs and Johansen, 2013b (PDF)).

The studies authors have been quoted as saying “Concerns have been raised that the ban on use of psychedelics is a violation of the human rights to belief and spiritual practice, full development of the personality, and free-time and play” (National Monitor March 8, 2015).

It is deeply troubling to read an interview with John Ehrlichman, advisor to US President Richard Nixon, in which he explains that the War on Drugs was not to protect the American public but was ‘really about’ hurting ‘the antiwar Left, and black people’, and openly admits, ‘Did we know we were lying about the drugs? Of course we did’ (Baum, 2012).

Finally, below is a chart showing the Active/Lethal Dose Ratio and Dependence Potential of Psychoactive Drugs. Data source is Gable, R. S. (2006). Acute toxicity of drugs versus regulatory status. In J. M. Fish (Ed.), Drugs and Society: U.S. Public Policy, pp.149-162, Lanham, MD: Rowman & Littlefield Publishers.

Notice how psilocybin appears as the least harmful on this graph, much less than tobacco or alcohol which are not illegal and are seen in advertisements across the United States. It has been know for some time that psilocybin is less toxic than caffeine. Currently psilocybin is classified as a Schedule 1 drug (high potential for abuse, no currently accepted medical use in treatment in the United States, lack of accepted safety for use of the drug or other substance under medical supervision) while more harmful substances get off with a less restrictive Schedule or none at all. Incidentally, psilocybin is showing promise in the treatment of PTSD, suicidal behavior, addictions, depression, anxiety, OCD, and existential distress in cancer patients.

New Yorker article by Michael Pollan hits home

The Trip Treatment
By Michael Pollan
The New Yorker 9 February 2015

Michael Pollan's poignant article really hit home for me as it follows a cancer patient's healing journey with his diagnosis following psilocybin treatment as part of a Clinical Trial at New York University.  54 year old Patrick Mettes participated in the research at NYU after battling bile duct cancer for 3 years.  The experience with the therapeutic use of psilocybin was obviously beneficial to Patrick and offered him something no current drug in any doctors arsenal could have provided.  That this simple fungus that grows out in the real world is illegal for any patient is unfathomable.

The importance of this article and the psilocybin research for patients battling cancer can not be over-stated as a new report published in the Annals of Internal Medicine (02/03/2015) indicates suffering at the end of life (pain and depression) has increased significantly since the last study 15 years ago by the Institute of Medicine.

Our daughter also fought a courageous battle with cancer and was accepted into a similar Clinical Trial at Johns Hopkins.  Unfortunately she was offered her first professional position at the same time which made for a very difficult decision on her part.  With reservation, she choose to accept the position only to have her neoplasm return 4 months later.  Had she participated in the Hopkins study, her passing may be been easier, as it was for Patrick.

Michael's article not only provides an compassionate account of Patrick Mettes therapeutic experience with psilocybin at N.Y.U. but also provides a detailed history of the early studies involving the therapeutic use of psychedelics but also the background and motivations of the current researchers in this field.  Since this is a very comprehensive article, I will attempt to summarize what were, for me, some key points:

• The therapeutic sessions took place in a very safe, controlled environment with supportive staff available if needed.  Set and setting are key.
• In the 1950's and 60's, some of the best minds in Psychiatry conducted studies on the therapeutic potential of psychedelics with government funding.
• Cancer patients receiving just a single dose of psilocybin experienced immediate and dramatic reductions in anxiety and depression, improvements that were sustained for at least six months. People who had been palpably scared of death—they lost their fear. The fact that a drug given once can have such an effect for so long is an unprecedented finding. We have never had anything like it in the psychiatric field.”
• “We ended up demonizing these compounds. Can you think of another area of science regarded as so dangerous and taboo that all research gets shut down for decades? It’s unprecedented in modern science.”
• Griffiths (Dr. Roland Griffiths from Johns Hopkins) believes that the long-term effectiveness of the drug is due to its ability to occasion such a transformative experience, but not by changing the brain’s long-term chemistry, as a conventional psychiatric drug like Prozac does.
• Griffiths likens the therapeutic experience of psilocybin to a kind of “inverse P.T.S.D.”—“a discrete event that produces persisting positive changes in attitudes, moods, and behavior, and presumably in the brain.”
• Existential distress at the end of life bears many of the psychological hallmarks of a hyperactive default-mode network, including excessive self-reflection and an inability to jump the deepening grooves of negative thought. The ego, faced with the prospect of its own dissolution, becomes hypervigilant, withdrawing its investment in the world and other people. It is striking that a single psychedelic experience—an intervention that Carhart-Harris calls “shaking the snow globe”—should have the power to alter these patterns in a lasting way.
• “If we limit psychedelics just to the patient, we’re sticking with the old medical model,” she said. “But psychedelics are so much more radical than that. I get nervous when people say they should only be prescribed by a doctor.”
• “This culture has a fear of death, a fear of transcendence, and a fear of the unknown, all of which are embodied in this work.” Psychedelics may be too disruptive for our society and institutions ever to embrace them.
• “We still had our arguments,” Lisa (Patrick's wife) recalled. “And we had a very trying summer,” as they endured a calamitous apartment renovation. But Patrick “had a sense of patience he had never had before, and with me he had real joy about things,” she said. “It was as if he had been relieved of the duty of caring about the details of life. Now it was about being with people, enjoying his sandwich and the walk on the promenade. It was as if we lived a lifetime in a year.”
• “We are all terminal,” Griffiths said. “We’re all dealing with death. This will be far too valuable to limit to sick people.”

The article by Michael Pollan above was followed up by an article in The Week:

Why the government should be funding mass scientific studies of Ecstasy, magic mushrooms, and LSD
By Ryan Cooper
The Week 5 Feb 2015

"In a sane world, with substances as promising as the above psychedelics, the government would simply fund the research itself and be done with it. Only an increasingly anachronistic brand of drug warrior politics stands in the way. But with something like 22 veterans per day committing suicide, any treatment with a potential 60+ percent long-tem cure rate for PTSD ought to be jammed through mass trials at the highest possible speed."

Cancer patients and those with PTSD can both experience a common psychological trauma which produces an existential distress (crisis).  Psilocybin's clinical effect most likely works to help heal this trauma.

Recent studies supporting Mindfulness Therapy for PTSD

As pointed out in a previous post, Mindfulness Meditation and psilocybin work on the same part of the brain, the posterior cingulate cortex (PCC).  The PCC is considered by some to be the hub of the ego. Quieting the PCC may lead to a greater sense of connectedness, more of the feeling of oneness with all things which is a common goal of Yoga which means "to unite".

An Overview of the Research on Mindfulness-Based Interventions for Treating Symptoms of Posttraumatic Stress Disorder: A Systematic Review
OBJECTIVE: This systematic review aimed to collate and evaluate the existing research for the use of mindfulness-based approaches to treat posttraumatic stress disorder (PTSD). Our primary objectives were to explore the effects of mindfulness-based approaches on PTSD symptoms and associated psychological distress, with secondary objectives to explore the attrition rate, adverse effects, resource implications, and long-term effects of such interventions.
METHOD: We systematically searched research databases, EMBASE, OVID MedLine, Psycinfo, CINAHL, and PILOTS, contacted relevant authors in the field, and conducted a hand search of relevant papers.
RESULTS: The search resulted in 12 studies that met eligibility criteria, many of which studies lacked methodological rigor. The majority of the studies indicated positive outcomes with improvements in PTSD symptoms, particularly in reducing avoidance.
CONCLUSIONS: The preliminary evidence for the use of mindfulness-based approaches to treat PTSD symptoms is encouraging, although further studies with a more robust research design are required.
Banks K, Newman E, Saleem J.
J Clin Psychol. 2015 Jul 20. doi: 10.1002/jclp.22200. [Epub ahead of print]
PMID: 26192755

Reductions in cortisol associated with primary care brief mindfulness program for veterans with PTSD.
Analyses revealed that significant changes in cortisol were associated with PCbMP treatment engagement and dosing (number of mindfulness program sessions completed). Veterans completing 4 mindfulness-based meditation sessions significantly reduced their cortisol awakening response (P≤0.05); and had significant changes in cortisol area under the curve increase compared with TAU participants (P≤0.05). Results indicate that PCbMP has a beneficial physiological impact on veterans with PTSD with a minimum of 4 weeks of practice.
Bergen-Cico D, Possemato K, Pigeon W.
Med Care. 2014 Dec;52(12 Suppl 5):S25-31. doi: 10.1097/MLR.0000000000000224.
PMID: 25397819
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Mindful attention increases and mediates psychological outcomes following mantram repetition practice in veterans with posttraumatic stress disorder.
The MRP intervention and specifically, mantram practice, improved mindful attention in veterans with PTSD, yielding improved overall psychological well-being. MRP may be a beneficial adjunct to usual care in veterans with PTSD.
Bormann JE, Oman D, Walter KH, Johnson BD.
Med Care. 2014 Dec;52(12 Suppl 5):S13-8. doi: 10.1097/MLR.0000000000000200.
PMID: 25397817
Cited by (Google Scholar)

Examining mechanisms of change in a yoga intervention for women: the influence of mindfulness, psychological flexibility, and emotion regulation on PTSD symptoms.
Preliminary findings suggest that yoga may reduce expressive suppression and may improve PTSD symptoms by increasing psychological flexibility. More research is needed to replicate and extend these findings.
Dick AM, Niles BL, Street AE, DiMartino DM, Mitchell KS.
J Clin Psychol. 2014 Dec;70(12):1170-82. doi: 10.1002/jclp.22104. Epub 2014 May 28.
PMID: 24888209
Cited by (Google Scholar)

Psilocybin and other psychedelics may help prevent suicide

New research from Johns Hopkins and the University of Alabama. As it is well known that individuals with PTSD are more prone to suicidal behavior, this study adds convincing evidence that psilocybin must be high on the list of those researchers looking for promising treatments for PTSD and/or suicide.

Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population.
Mental health problems are endemic across the globe, and suicide, a strong corollary of poor mental health, is a leading cause of death. Classic psychedelic use may occasion lasting improvements in mental health, but the effects of classic psychedelic use on suicidality are unknown. We evaluated the relationships of classic psychedelic use with psychological distress and suicidality among over 190,000 USA adult respondents pooled from the last five available years of the National Survey on Drug Use and Health (2008-2012) while controlling for a range of covariates. Lifetime classic psychedelic use was associated with a significantly reduced odds of past month psychological distress (weighted odds ratio (OR)=0.81 (0.72-0.91)), past year suicidal thinking (weighted OR=0.86 (0.78-0.94)), past year suicidal planning (weighted OR=0.71 (0.54-0.94)), and past year suicide attempt (weighted OR=0.64 (0.46-0.89)), whereas lifetime illicit use of other drugs was largely associated with an increased likelihood of these outcomes. These findings indicate that classic psychedelics may hold promise in the prevention of suicide, supporting the view that classic psychedelics' most highly restricted legal status should be reconsidered to facilitate scientific study, and suggesting that more extensive clinical research with classic psychedelics is warranted.
Hendricks PS, Thorne CB, Clark CB, Coombs DW, Johnson MW. 
J Psychopharmacol. 2015 Jan 13. [Epub ahead of print] 
PMID: 25586402
Cited by (Google Scholar)

A write-up in AL.com features lead author Peter Hendricks, a professor of Clinical Psychology at the University of Alabama Birmingham who elaborates on the research design and results:

Magic Mushrooms, LSD and other psychedelics might protect against depression and suicide

• Researchers culled the data from almost 200,000 responses to the National Survey on Drug Use and Health.
• People who said they used psychedelic drugs at least once in their life reported better mental health and fewer suicide attempts. 
• The results set psychedelics apart from other drugs. Lifetime users of substances such as cocaine, marijuana and heroin reported poorer mental health and a higher frequency of suicidal thoughts.
• After controlling for other variables, the research showed a strong correlation between use of psychedelics and better mental health.
• He would like to see the legal classification changed to Schedule 3 or 4, which would make it easier to study the substances in the lab.
• Hendricks said he thinks the improvement in mental health could come from the spiritual nature of the psychedelic experience.
• "Despite advances in mental health treatment, suicide rates have not declined," Hendricks said. "We have a problem with suicide and we don't seem to be getting better at preventing self-harm. It's exciting to think that this could be one of the interventions that could make a difference."
• Psychedelics could prove to be a one-time treatment with the possibility to change the lives of those suffering from mental illness.
• The drugs need to be administered in a controlled environment with medical supervision.

Below is a study that was posted previously and gives much support to the above article:

Psychedelics and mental health: a population study. 
Results: 21,967 respondents (13.4% weighted) reported lifetime psychedelic use. There were no significant associations between lifetime use of any psychedelics, lifetime use of specific psychedelics (LSD, psilocybin, mescaline, peyote), or past year use of LSD and increased rate of any of the mental health outcomes. Rather, in several cases psychedelic use was associated with lower rate of mental health problems. 
Krebs TS, Johansen PØ. 
PLoS One. 2013 Aug 19;8(8):e63972. doi: 10.1371/journal.pone.0063972. 
PMID: 23976938 
(PDF)
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Psilocybin in the news

An article published yesterday (11/29/2014) in the Opinion section of the New York Times (NYT) titled "Can Mushrooms Treat Depression?" revealed how wide-spread and excepted the current research involving the use "magic mushrooms" and other psychedelic substances has become by the general public.  The use of psilocybin to treat PTSD has come a long way since 2008, when I first attempted to discuss it with some of the leading DoD Psychiatrists only to be dismissed with a snicker.  On one occasion, while bringing the subject up to a DoD civilian PhD Psychologist he frantically looked over both shoulders and whispered "we can't talk about that around here".

I sincerely doubt that any of them had actually read any of the medical literature on the subject at that time but hopefully that has changed.  That environment is, unfortunately, a tough nut to crack, at the expense of those suffering from PTSD, forcing them take extreme measures such as dangerous expeditions to the jungles of Peru (Lisa Ling - A Jungle Fix) in an attempt to get effective treatment.

The NYT article published yesterday by Eugenia Bone brings up a very important issue, the classification of psilocybin as a Schedule 1 drug and how that makes medically relevant research on its use in areas such as addiction treatment, cancer related anxiety, PTSD and depression extremely difficult at the expense of those suffering from those afflictions.

This needs to change and it will eventually. Show those suffering from PTSD as a result of serving their country that you really do care.  Of course Lawmakers main concern is in not offending any of their supporters, not losing any votes in the next election.  Not to worry, the public's attitude has changed, thanks to the responsible, ethical research being carried out at Johns Hopkins, New York University, the Imperial College London, and elsewhere.  So, lets make it happen.

New Post 1/26/2015 regarding recent article from Newsweek that is not afraid to say the obvious, that there is a role for classic psychedelics in medicine:

Day Tripping: Benefits Seen in Psychedelics
Culturally, psychedelics bear quite a bit of baggage: Timothy Leary’s call to “turn on, tune in and drop out” became a countercultural slogan in the 1960s, and proved damaging to potential research on utilizing the drug to improve mental health for more than three decades. Perhaps this study will be a turning point in how our culture regards psychedelics and mental health. "I know scientists are supposed to be objective and dispassionate," Hendricks says. "But I'm excited and hopeful. I've seen the data -- it seems to me that psychedelics hold tremendous therapeutic potential."

One step away

A recent article in the Guardian announced the Imperial College London has plans to commence a study that will utilized psilocybin to treat individuals with clinical depression.  The pilot study will be conducted by Professor David Nutt and Dr Robin Carhart-Harris at Imperial College's Neuropsychopharmacology Centre in London on 12 patients who have failed to respond to conventional treatment.  Positive results from this difficult to treat patient population would provide provide compelling evidence of psilocybin's utility for treating various mental disorders. The Imperial College London is one of the top 10 ranked Universities in the world (ranked #2).

Carhart-Harris and Nutt have previously published 2 fMRI studies detailing psilocybin's effect on the brain and a recent theory of the entropic brain, the state of consciousness occasioned by the use of psychedelic substances.

Depression is common in men and women with post-traumatic stress disorder (PTSD). The trauma that caused PTSD also may cause depression (WebMD).  As of today, not a single pharmacological treatment has been developed specifically for PTSD (CNS Drugs. 2013 Mar;27(3):221-32).  A recent study that utilized an animal model of PTSD showed an extinction of "fear conditioning" and concluded that psilocybin "and similar agents, should be explored as potential treatments for post-traumatic stress disorder and related conditions" (Exp Brain Res. 2013 Aug;228(4):481-91). A study published in 1968 demonstrated the effectiveness of psilocybin for PTSD (Ind Med Surg. 1968 May;37(5):347-50).  Since publication of this 1968 study, new laws have made further research into the use of psychedelics nonexistent until recently.

Commenting on this situation, Dr Nutt, in the recent Guardian article referred to above, stated:

"It was unquestionably one of the most effective pieces of disinformation in the history of mankind," says Nutt. "It led to a lot of people believing these drugs were more harmful than they were. They are not trivial drugs, but in comparison with drugs that kill thousands of people a year, like alcohol, tobacco and heroin, they have a very safe track record and, as far as we know, no one has died."

There now exists an abundance of information to support and an abundance of need for a Clinical Trial utilizing psilocybin to treat PTSD.  The organizations that would be expected to take the lead in this research is logically the Department of Defense and the Veteran's Administration.

It is time for  the Department of Defense and the Veterans Administration ("We must do all we can to deliver the high-quality care our service members and veterans have earned and deserve.”) to stop talking the talk about trying to do everything they can to treat PTSD and to start walking the walk by leading the way in initiating Clinical Trials utilizing psilocybin in a therapeutic setting to treat PTSD.

Clinical Trials utilizing psilocybin

Currently there are 14 Clinical Trials listed in various stages of progress (below).  For a dynamic link to current psilocybin related Clinical Trials, click here.

UW Psilocybin Pharmacokinetics Study
The objective of this Phase I clinical trial is to determine the pharmacokinetics of oral doses of psilocybin in normal, healthy adults. The study is performed in support of Phase II and Phase III studies of psilocybin for the treatment of refractory anxiety associated with incurable cancer, as well as other possible indications. Psilocybin is at present not an FDA-approved drug.
University of Wisconsin

Effects of Psilocybin on Behavior, Psychology and Brain Function in Long-term Meditators
This is a double-blind placebo-controlled study investigating the acute and persisting effects of psilocybin on meditation, spirituality, health, well-being, prosocial attitudes, and brain functioning.
Johns Hopkins University

Psilocybin-facilitated Smoking Cessation Treatment: A Pilot Study 
We propose to examine psilocybin administration combined with a structured smoking cessation treatment program in nicotine dependent individuals in order to provide preliminary data on the efficacy of this combined treatment in smoking cessation treatment.
Johns Hopkins University

Pilot Study: Effects of Psilocybin on Behavior, Psychology and Brain Function in Long-term Meditators
This is a pilot study to finalize methods for a larger study being planned for the future. This research is being done to characterize performance of tasks, brain functioning, and the effects of psilocybin in individuals with a long-term meditation practice.
Johns Hopkins University

Effects of Psilocybin in Advanced-Stage Cancer Patients With Anxiety 
The Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center is conducting a study designed to measure the effectiveness of the novel psychoactive medication psilocybin on the reduction of anxiety, depression, and physical pain.
UCLA

Psilocybin-Assisted Psychotherapy for Anxiety in People With Stage IV Melanoma 
This study is to find out about whether two sessions of psilocybin-assisted psychotherapy are safe and will help people who are anxious as a result of having stage IV melanoma and will involve two sessions of psychotherapy combined with either 4 or 25 mg psilocybin.
MAPS

Effects and Therapeutic Potential of Psilocybin in Alcohol Dependence
This trial is an open-label pilot study (N = 10) designed to assess the effects of psilocybin in alcohol dependent participants, demonstrate the feasibility of the integrated behavioral/pharmacologic intervention, and provide preliminary outcome and safety data.
University of New Mexico

Psilocybin-facilitated Treatment for Cocaine Use 
The primary purpose of this study is to evaluate the feasibility and estimate the efficacy of psilocybin-facilitated treatment for cocaine use. We also will monitor the impact of psilocybin-facilitated treatment on the use of other drugs and outcomes relevant to cocaine involvement (e.g., criminal involvement).
University of Alabama at Birmingham

Psychopharmacology of Psilocybin in Cancer Patients 
This research is being done to study the psychological effects of psilocybin in cancer patients. Psilocybin is a naturally occurring substance found in some mushrooms that some cultures have used for centuries in religious practices.
Johns Hopkins University

Psilocybin Cancer Anxiety Study
The primary objective of this double-blind, placebo-controlled pilot study is to assess the efficacy of psilocybin administration (4-phosphoryloxy-N,N-dimethyltryptamine), a serotonergic psychoactive agent, on psychosocial distress, with the specific primary outcome variable being anxiety associated with cancer. Secondary outcome measures will look at the effect of psilocybin on symptoms of pain perception, depression, existential/psychospiritual distress, attitudes towards disease progression and death, quality of life, and spiritual/mystical states of consciousness.
New York University School of Medicine

A Double-Blind Trial of Psilocybin-Assisted Treatment of Alcohol Dependence 
Several lines of evidence suggest that classic hallucinogens such as psilocybin can facilitate behavior change in addictions such as alcohol dependence. The proposed investigation is a multi-site, double-blind active-controlled trial (n = 180, 90 per group) contrasting the acute and persisting effects of psilocybin to those of diphenhydramine in the context of outpatient alcoholism treatment.
University of New Mexico

Psilocybin and Spiritual Practice 
This study will investigate the effects of psilocybin dose and the frequency and intensity of support activities for spiritual practice (e.g., meditation) on a battery of attitudinal and behavioral outcome measures in 75 healthy volunteers who are interested in pursuing a program of spiritual practices with the intention applying spiritual insights and knowledge to everyday life.
Johns Hopkins University

Effects of Psilocybin-facilitated Experience on the Psychology and Effectiveness of Professional Leaders in Religion 
The current protocol is a pilot study of the effects and possible utility of psilocybin-facilitated experiences for professional religious leaders.
Johns Hopkins University

Effects of Hallucinogens and Other Drugs on Mood and Performance 
This non-treatment study will investigate the effects on mood and performance caused by hallucinogens and other psychoactive compounds.
Johns Hopkins University

Psilocybin is not addicting. It can be used to treat addictions such as tobacco abuse.

A small pilot study at Johns Hopkins enable 12 of 15 (80%) subjects to remain tobacco free for 6 months as has been discussed in the press.  Prescription medications such as Chantix, the most potent aid for smoking cessation, have a success rate of about 35% at six months.  There are currently 2 other Clinical Trials utilizing psilocybin to treat addiction disorders: one for alcohol dependence and one for cocaine addiction.

• Magic mushrooms help smokers kick habit in small study (Bloomberg)
  All the volunteers returned two weeks later for another round with a higher dose of the drug. They were all offered a third experience, though several declined, Johnson said. The treatment doesn’t involve swapping one drug for another, said Johnson, who pointed out that hallucinogens aren’t addictive.

• Want to Quit Smoking? Eat a Magic Mushroom, New Study Says (Time)
  “Quitting smoking isn’t a simple biological reaction to psilocybin, as with other medications that directly affect nicotine receptors.” Instead, Johnson said, it was the subjective experience the smokers had when taking the psilocybin that changed them— more like a religious conversion than getting a shot of penicillin to cure an infection.

Below is the study from the Journal of Psychopharmacology:

Pilot study of the 5-HT2AR agonist psilocybin in the treatment of tobacco addiction
Abstract: Biomarkers assessing smoking status, and self-report measures of smoking behavior demonstrated that 12 of 15 participants (80%) showed seven-day point prevalence abstinence at 6-month follow-up. The observed smoking cessation rate substantially exceeds rates commonly reported for other behavioral and/or pharmacological therapies (typically < 35%).
Johansen PØ, Krebs TS. 
J Psychopharmacol. 2015 Mar;29(3):270-9.  Epub 2015 Mar 5. 
PMID: 25744618 
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Perhaps by more than plain chance, the article below was released on the same day in a different journal by different researchers.  Yet it helps explain how psilocybin works to break addictive habits.

Brain Regions Affected by Impaired Control Modulate Responses to Alcohol and Smoking Cues.
Conclusions: Our findings suggest that the posterior cingulate cortex (PCC) and right posterior insula, each playing a role in the salience network, are affected significantly by impaired control for alcohol and in turn influence brain responses to not only alcohol but also smoking cues, providing insight to neuronal mechanisms for concurrent use or comorbidity of alcohol and nicotine dependence.
Liu J, Claus ED, Calhoun VD, Hutchison KE.  
J Stud Alcohol Drugs. 2014 Sep;75(5):808-816. 
PMID: 25208199

Psilocybin works to decrease the positive coupling between the medial pre-frontal cortex (mPFC) and the posterior cingulate cortex (PCC,) both part of the the default mode network. (source)

A recent article in The Pharmaceutical Journal, 27 OCT 2014, Psychedelics: entering a new age of addiction therapy,  provides a good overview of the potential of psychedelics for various addictions, the effects of psilocybin on the brain, and the history of current upsurge in psilocybin research.  This is cutting edge research that shows great promise.

A 2014 article in the Journal of Psychopharmacology titled Hallucinogen use predicts reduced recidivism among substance-involved offenders under community corrections supervision concludes that naturistic hallucinogen use predicted a reduced likelihood of supervision failure (e.g. noncompliance with legal requirements including alcohol and other drug use) and suggests that hallucinogens may promote alcohol and other drug abstinence and prosocial behavior in a population with high rates of recidivism.
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A 2015 article in The British Journal of Psychiatry from researchers at Johns Hopkins states "After a 40-year hiatus there is now a revisiting of psychedelic drug therapy throughout psychiatry, with studies examining the drugs psilocybin, ketamine, ibogaine and ayahuasca in the treatment of drug dependence. Limitations to these therapies are both clinical and legal, but the possibility of improving outcomes for patients with substance dependency imposes an obligation to research this area."
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New article in Progress in Neuro-Psychopharmacology and Biological Psychiatry 14 March 2015 titled "Classic hallucinogens in the treatment of addictions"
Highlights
•We review the use of classic hallucinogens in the treatment of addiction.
•Controlled trials support the efficacy of high-dose LSD for alcoholism.
•Pilot studies of psilocybin for nicotine and alcohol dependence suggested benefit.
•Definitive studies of efficacy and therapeutic mechanisms remain to be done.

The realities of psychedelic research in today's political milieu

My interest in psychedelic research primarily involves the use of natural plants and fungus that have been used for millennia in a spiritual context.  However, the comments in the articles below are germane for anyone considering the use of psychedelic substances.

Dr Robin Carhart-Harris is the first scientist in over 40 years to test LSD on humans - and you're next
Laurence Phelan 
The Independent Sunday 17 August 2014

"Depression and addictions rest on reinforced patterns of brain activity, and a psychedelic will introduce a relative chaos. Patterns that have become reinforced disintegrate under the drug. I've used the metaphor of shaking a snowglobe. And there's some evidence that psychedelics induce plasticity, in terms of neural connections in the brain, such that there is a window of opportunity in which connections can either be broken or reinforced. New things can be learnt at the same time that old things can be unlearnt. It induces a kind of suppleness of mind."

"The dangers with psychedelics – and there are potential dangers," says the doctor, " arise when they are taken without the proper caution. The model for how the drugs are taken therapeutically is very different from how people might take them recreationally. People are in a particularly sensitive and vulnerable state on psychedelics, and I do think you need that professionalism and structure to have it done properly."

"It is absurd to treat LSD and psilocybin as more dangerous than heroin," he tells me. In a 2010 study published in The Lancet, following on from the work that led to his controversial sacking from the chair of the Government's Advisory Council on the Misuse of Drugs the year before, Professor Nutt ranked the 20 most commonly used drugs according to the evidence for the overall amount of harm they do to the users and to society. Psilocybin came last, with an overall harm score of six, and LSD came 18th with a score of seven, compared with alcohol's 72 and heroin's 55.

No wonder the Czech psychiatrist Stanislav Grof, in 1975, predicted that "psychedelics, used responsibly and with proper caution, would be for psychiatry what the microscope is for biology or the telescope is for astronomy". Unfortunately, the effective prohibition of LSD research meant it was not to be. Perhaps Professor Nutt has Grof in mind when he says: "I think it's the worst censorship of research since the Catholic Church banned the telescope." He continues: "There's a lot of evidence for LSD being an efficacious treatment for things such as addiction. But no one's done a study on it for 50 years. This is outrageous."

Is LSD about to return to polite society?
For 40 years, Amanda Feilding, Countess of Wemyss and March, has believed psychedelics are an effective treatment for depression and anxiety. Now a growing number of scientists agree.
Ed Cummings
The Guardian Sunday 26 April 2015

High Hopes - new article from Science Magazine

Science, also widely referred to as Science Magazine is the academic journal of the American Association for the Advancement of Science (AAAS) and is, along with the British journal Nature, one of the world's top scientific journals.  Having this article on the potential of psychedelic drugs to treat various illnesses in such a prestigious journal is very gratifying.

High Hopes (PDF)
Kai Kupferschmidt
Science 4 July 2014: 18-23.
Psychedelic drugs fell from grace in the 1960s. Now, scientists are rediscovering them as potential treatments for a range of illnesses.
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New article: the biological basis for magic mushroom 'mind expansion'

Enhanced repertoire of brain dynamical states during the psychedelic experience
(PDF)
Human Brain Mapping, 2014.
It has long been claimed that the psychedelic (translated “mind-revealing” [Huxley et al., 1977]) state is an expanded state of consciousness in which latent psychological material can emerge into consciousness [Cohen, 1967] and novel associations can form. Indeed, this was the original rationale for the use of LSD in psychotherapy [Busch and Johnson, 1950]. It has also been claimed that psychedelics may be able to assist the creative process, for example, by promoting divergent thinking and remote association [Fadiman, 2011]. Thus, the increased repertoire of metastable states observed here with psilocybin may be a mechanism by which these phenomena occur [see also Carhart-Harris et al., 2014].
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It is a spiritual endeavor. Neglecting this fact is why treatment of PTSD and other psychosocial disorders are often ineffective.

The use of psilocybin and mindfulness meditation both are in essence a spiritual quest which involves quieting the mind to decrease our sense of self in order to allow our larger sense of Self, which includes all of nature, to come to the forefront of our senses.  Below are are series of articles that point this out.

What is spirituality in relationship to our Western culture? This article in The Guardian puts that comparison in perspective. The articles highlights the views of Davi Kopenawa Yanomami, who has been dubbed the Dalai Lama of the Rainforest and is considered one of the most influential tribal leaders in Brazil.

#14Days: Psilocybin, where science meets spirituality (CBS News)
Psilocybin is a naturally occurring psychedelic compound found in some species of mushrooms that has been used in indigenous cultures as a spiritual sacrament for hundreds of years. Dr. Stephen Ross, director of the NYU Addiction Psychiatry Fellowship, believes this compound, administered in the proper dosage and in a controlled setting, may help resolve the symptoms of spiritual distress involved in a person with alcoholism.

Ceremonial PTSD therapies favored by Native American veterans
Eurekalert! 27 June 2014
The majority of survey takers felt that "most people who suffer from PTSD do not receive adequate treatment," said Urquhart. For Native veterans who did seek standard treatment, the results were often disappointing. Sixty percent of survey respondents who had attempted PTSD therapy reported "no improvement" or "very unsatisfied" (See also DOD and VA Can't Prove Their PTSD Care is Working, IOM Study Claims). Individual counseling reportedly had no impact on their PTSD or made the symptoms worse for 49 percent of participants. On the other hand, spiritual or religious guidance was seen as successful or highly successful by 72 percent of Native respondents. Animal assisted therapy – equine, canine, or other animals – was also highly endorsed.

The neuroscientific study of spiritual practices
Newberg AB. 
Front Psychol. 2014 Mar 18;5:215. 
PMID: 24672504
In considering the neuroscientific approach to religious and spiritual phenomena, one can ponder whether theological and epistemological issues can actually be addressed, sometimes referred to as “neurotheology” (Newberg, 2010). For example, brain correlates may help explain certain elements of spiritual practices. However, a biological correlate does not necessarily negate an actual spiritual component. Even situations in which religious states are induced by pharmacological agents does not necessarily detract from the spiritual nature of these states for the individual. For example, Shamanic practices in which various substances are ingested to aid in the spiritual journey are not viewed as less real or less spiritual by the participants because of the use of these exogenous substances.
PDF
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Below is a write-up in AL.com that features lead author Peter Hendricks, a professor of Clinical Psychology at the University of Alabama Birmingham regarding his article "Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population.":

Magic Mushrooms, LSD and other psychedelics might protect against depression and suicide

• Researchers culled the data from almost 200,000 responses to the National Survey on Drug Use and Health.
• People who said they used psychedelic drugs at least once in their life reported better mental health and fewer suicide attempts. 
• The results set psychedelics apart from other drugs. Lifetime users of substances such as cocaine, marijuana and heroin reported poorer mental health and a higher frequency of suicidal thoughts.
• After controlling for other variables, the research showed a strong correlation between use of psychedelics and better mental health.
• Hendricks said he thinks the improvement in mental health could come from the spiritual nature of the psychedelic experience.
• "Despite advances in mental health treatment, suicide rates have not declined," Hendricks said. "We have a problem with suicide and we don't seem to be getting better at preventing self-harm. It's exciting to think that this could be one of the interventions that could make a difference."
• Psychedelics could prove to be a one-time treatment with the possibility to change the lives of those suffering from mental illness.

Psilocybin-occasioned mystical experiences in the treatment of tobacco addiction

Garcia-Romeu A, Griffiths RR, Johnson MW.

Curr Drug Abuse Rev. 2014;7(3):157-64.

PMID: 25563443

Psilocybin-occasioned mystical experiences have been linked to persisting effects in healthy volunteers including positive changes in behavior, attitudes, and values, and increases in the personality domain of openness. In an open-label pilot-study of psilocybin-facilitated smoking addiction treatment, 15 smokers received 2 or 3 doses of psilocybin in the context of cognitive behavioral therapy (CBT) for smoking cessation. Twelve of 15 participants (80%) demonstrated biologically verified smoking abstinence at 6-month follow-up. Participants who were abstinent at 6 months (n=12) were compared to participants still smoking at 6 months (n=3) on measures of subjective effects of psilocybin. Abstainers scored significantly higher on a measure of psilocybin-occasioned mystical experience. No significant differences in general intensity of drug effects were found between groups, suggesting that mystical-type subjective effects, rather than overall intensity of drug effects, were responsible for smoking cessation. Nine of 15 participants (60%) met criteria for "complete" mystical experience. Smoking cessation outcomes were significantly correlated with measures of mystical experience on session days, as well as retrospective ratings of personal meaning and spiritual significance of psilocybin sessions. These results suggest a mediating role of mystical experience in psychedelic-facilitated addiction treatment.

Link to PDF
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Psilocybin and spirituality: treatment for suicidal behavior, PTSD and moral injury
An October 2015 post motivated by a Veterans Affairs researcher advocating a spiritual approach to Veterans mental health issues such as PTSD, suicide, and moral injury.

The posterior cingulate cortex as a plausible mechanistic target of meditation: findings from neuroimaging.

The posterior cingulate cortex as a plausible mechanistic target of meditation: findings from neuroimaging
Brewer JA, Garrison KA. 
Ann N Y Acad Sci. 2014 Jan;1307:19-27. 
PMID: 24033438
There has been an increased interest in mindfulness and meditation training over the past decade. As evidenced by exponential growth in the number of publications since the beginning of the 21st century, progressively more is becoming known about both the clinical efficacy and underlying neurobiological mechanisms of mindfulness training. This paper briefly highlights psychological models of stress that converge between ancient and modern day (e.g., operant conditioning); identifies key brain regions that, with these models, are biologically plausible targets for mindfulness (e.g., posterior cingulate cortex); and discusses recent and emerging findings from neuroimaging studies of meditation therein, including new advances using real-time functional magnetic resonance imaging neurofeedback in neurophenomenological studies.
PDF
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Mindfulness increases psychological flexibility, decreases PTSD symptoms in women

Examining Mechanisms of Change in a Yoga Intervention for Women: The Influence of Mindfulness, Psychological Flexibility, and Emotion Regulation on PTSD Symptoms
Conclusion: Preliminary findings suggest that yoga may reduce expressive suppression and may improve PTSD symptoms by increasing psychological flexibility. More research is needed to replicate and extend these findings.
Dick AM, Niles BL, Street AE, DiMartino DM, Mitchell KS. 
J Clin Psychol. 2014 May 28. [Epub ahead of print] PMID: 24888209

Psilocybin use results in an increase in positive mood by decreasing activation of the amygdala

Psilocybin-Induced Decrease in Amygdala Reactivity Correlates with Enhanced Positive Mood in Healthy Volunteers 
Conclusion:  These results demonstrate that acute treatment with psilocybin decreased amygdala reactivity during emotion processing, and that this was associated with an increase of positive mood in healthy volunteers. These findings may be relevant to the normalization of amygdala hyperactivity and negative mood states in patients with major depression.
Kraehenmann R, Preller KH, Scheidegger M, Pokorny T, Bosch OG, Seifritz E, Vollenweider FX. 
Biol Psychiatry. 2014 Apr 26. pii: S0006-3223(14)00275-3. 
PMID: 24882567 
(PDF)
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This research was conducted by the Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.  Among the well know academics associated with this institution is Carl Jung.

Do individuals with PTSD experience depression or negative thoughts?  Might psilocybin, given therapeutically with the proper mindset and in a supportive environment, assist in their recovery? Research in this area needs to be furthered by those who have a responsibility for treatment of individuals with PTSD.

The amygdala is hyperactive in those with PTSD.  "The amygdalocentric model of PTSD proposes that it is associated with hyperarousal of the amygdala and insufficient top-down control by the medial prefrontal cortex and the hippocampus in particular during extinction. This is consistent with an interpretation of PTSD as a syndrome of deficient extinction ability." (Wikipedia: PTSD)

So how does the amygdala relate to mindfulness?  The passage below may shed some light on this matter.

"Mindfulness mediation is designed to alter peoples’ perception of the world by making them disengage from ruminations and attention to negative thoughts and become aware of and accept thoughts non-judgmentally without trying to change them. An 8-week course of mindfulness meditation increased grey matter in brain regions involved in learning and memory, emotion regulation, self-referential processing and perspective taking in healthy people. In stressed individuals, the decrease in perceived stress after an 8-week course of mindfulness meditation was associated with a decrease in the right basolateral amygdala grey matter density. If the changed perception of the world brought about by mindfulness meditation over a period of 8 weeks can cause changes in the brain, this raises the possibility that the change in perception due to psilocybin may result in changes in the brain over a matter of weeks. How such brain changes may interact with the changes in psychology is not known. There is need for more work on the long-term psychological changes associated with psilocybin, as well as research on the long-term brain changes and their possible association with the psychological changes." (From: Young SN. J Psychiatry Neurosci. 2013 Mar;38(2):78-83. Review.)

Psilocybin appears to be uniquely structured (structure determines function) to calm those areas of the brain that are overactive in those suffering from PTSD, plus its effects are long lasting.  If there is another substance or therapy that has similar or better potential, I'd sure like to read about it.