Imagining Better Futures in Psychedelic Assisted Therapy

Maria Fedorova is a PhD researcher in the project Philosophy as Conceptual Engagement at the University of Vienna. She mainly works at the intersection of philosophy of mind, philosophy of cognitive science and epistemology. Her current research focuses on imaginative engagement with possible futures and its epistemic value. You can find out more here

A post by Maria Fedorova

Classic psychedelics, such as LSD and psilocybin, are both mind-altering and mind-revealing agents. They sharpen one’s sensations, induce illusions and hallucinations, distort the perception of space and time, evoke intense emotions and cause changes to one’s sense of self. After a long hiatus, psychedelics are making a comeback. Part of the reason for this comeback is thanks to psychedelics’ potential to reduce symptoms of some mental health disorders, such as depression, anxiety and addiction. One plausible explanation for psychedelics’ therapeutic benefits is that they can facilitate a dramatic shift of perspective on one’s life. During a psychedelic experience, one can discover alternative ways of thinking about oneself, as well as one’s actions, values and relations to others (Letheby, 2021). But how do psychedelics help one achieve this shift in perspective? I argue below that experiential imagination plays a key role. 

Experiential imaginings are imaginings that represent possible experiences––what it would or could be like to go through something. For the purposes of this short piece, I take for granted that experiential imagination involves mental imagery. The kind of experiential imagination I have in mind is best described as “attitude” imagination (Langland-Hassan, 2020) or “immersive” imagination (Humbert-Droz & Vazard, 2023). Following Peter Langland-Hassan (2020), I define this kind of experiential imagination (just “imagination” henceforth) as rich, elaborate thought about possible experiences. Here, I focus on the use of imagination for deliberating about one’s possible better future. 

It’s commonly assumed that psychopathology is at least partly rooted in certain maladaptive beliefs, often acquired during one’s formative years following a specific event or series of events (Letheby, 2021; Grodniewicz, 2024). They are called maladaptive because they cause negative thought processes and behaviours. To illustrate this general phenomenon, consider Chris Letheby’s example of a patient with treatment resistant depression who was told “boys don’t cry” by his parents when, at eight years old, he was grieving the death of his grandfather (Letheby, 2021, p. 138). This resulted in the patient’s maladaptive belief that expressing emotions equates with weakness and therefore repressing his emotions ever since. 

Maladaptive beliefs are core beliefs in the sense that they represent some of “the deepest and most general convictions we hold about the world, other people, and ourselves” (Grodniewicz, 2024, p. 4). Core beliefs highly influence—that is, constrain—perception and cognition, making one notice some things and ignore others. That way, when core beliefs are adaptive, they help us navigate the world. When they are maladaptive, they do the opposite (Letheby, 2021). Take a person struggling with anxiety who believes that she is unlikeable. She will likely interpret her experiences in light of this belief. A facial expression of an interlocutor, for instance, will likely be taken to indicate that he is displeased with her behaviour even if he isn’t. 

One of the instances of the influence of maladaptive beliefs on cognition is distorted imagination. People who suffer from depression, for instance, either can’t vividly imagine positive future events, like getting a job promotion or finding a life partner, or fail to imagine them all together (Vazard, 2024). More generally, someone who has a mental health disorder, be it depression or anxiety, will have difficulty imagining other, better ways of being because her imagination is constrained by maladaptive beliefs (Letheby, 2021). To revisit the patient from Letheby’s example, given his belief that expressing emotions is a weakness, a possible future in which he expresses rather than represses his emotions won’t feature amongst the possibilities to which the patient has imaginative access

Naturally, one might suppose that in order to gain imaginative access to a possible better future, a person struggling with depression or anxiety will have to change her beliefs. Indeed, following J.P. Grodniewicz (2024), belief revision has been central to Cognitive Behavioural Psychotherapy. On this view, a depressed person who believes herself incompetent (Grodniewicz, 2024) will be able to imagine a possible future in which she feels confident about her knowledge and skill once she revises what she believes. 

One of the main difficulties facing belief revision in psychotherapy is that maladaptive beliefs tend to be immune to the methods we normally use for belief revision, such as presenting evidence to the contrary (Grodniewicz, 2024). That’s unsurprising considering the fact that maladaptive beliefs filter one’s experiences, be they actual or imaginative. The anxious person from the example above will likely dismiss her therapist’s observation that her interlocutor expressed an interest to meet again. So, first, the constraints of maladaptive beliefs must be lifted. Psychedelics do just that. 

In their seminal work, Robin Carhart-Harris and Karl Friston (2019) propose a model of psychedelic action, titled Relaxed Beliefs under Psychedelics (REBUS). According to REBUS, the main action of psychedelics is to decrease one’s confidence in one’s fundamental—that is, core—beliefs. Building on their work, Letheby (2021) claims that psychedelics’ therapeutic benefits stem from the decreased confidence in one’s beliefs about oneself. He identifies two central upshots of psychedelic therapy: (1) psychological flexibility and (2) psychological insight. Neurologically, psychological flexibility and psychological insight while on psychedelics result from the disturbance of the Salience Network and the Default Mode Network. Phenomenologically, they manifest in changes to one’s sense of self, such as “decentering” from one’s narrative self (e.g., ascribed character traits, goals and social responsibilities) or disruptions to one’s minimal self (e.g., disembodiment, loss of the sense of ownership over one’s thoughts and feelings), and the experience of powerful “existential” emotions (e.g., the emotions of openness, possibility, freedom and connectedness with the world). 

On the cognitive level, psychological flexibility leads to what Letheby refers to as “unconstrained cognition” (Letheby, 2021, p. 107). Once the influence of maladaptive beliefs on one’s experience subsides, one becomes aware of this influence and can therefore gain insight on one’s beliefs and how they came about. The patient from Letheby’s example which I considered earlier reported that during his psilocybin experience, he relived the event from his childhood that had caused him to form the belief that expressing emotions is a weakness. The experience made him realise that this belief had been the source of his inability to express emotions (Letheby, 2021, p. 139). Psychological flexibility also prompts a shift in perspective on one’s life––one reaches further insight on alternative ways of thinking, seeing, experiencing and being. Ultimately, psychedelics can help one to revise one’s beliefs. What remains an open question, however, is how such belief revision is achieved. 

"Alternative Perspectives", 2024, courtesy of Maria Fedorova

Throughout his book, Letheby describes belief revision as “discovering other ways of thinking, [...] feeling and attending” (2021, p. 148), “reaching [a] new perspective on” one’s life (ibid), “zooming out” (p. 149) and gaining an “experiential insight into other ways of being” (p. 151). These are, arguably, epistemic achievements as they allow one to gain access to certain truths[i] about experiential possibilities. That is, one discovers what one’s life could be like. What isn’t fully clear from Letheby’s account of psychedelic therapy is the kind of process behind belief revision. I propose imagination as the means with which to construe the process through which one discovers alternative ways of being in a psychedelic state. 

One of the key philosophically recognised roles of imagination is to reveal truths about what’s possible. Following Magdalena Balcerak Jackson (2018), imaginings directed at possible experiences inform us of what things could be or look like. Balcerak Jackson also observes that when one uses one’s imagination to deliberate about possible futures, for instance, when thinking about becoming a parent, one “actively creates a representation of what it will be like to live a certain future” (2020). What imagination thus reveals in such cases are alternative perspectives on one’s life––what it could be like if something was different. 

Letheby (2015) recognises the possibility that imagination might play a role in the shift in perspective on one’s life that can occur whilst on psychedelics when he claims that psychological flexibility leads to imaginative flexibility. He explicitly states that imagination unconstrained by maladaptive beliefs provides access to alternative ways of being. Interestingly, Letheby (2021) regards imaginative flexibility as an implication of belief revision. Yet, as I’ve shown, his original idea that imaginative engagement paves the way toward belief revision has strong intuitive appeal as well. During a psychedelic experience, one attempts to “imaginatively scaffold” (Kind, 2020, 2021): to subtract and modify one’s old beliefs in order to discover, or rather “design” (Balcerak Jackson, 2020) a better future that could lie ahead. 

That imagination may be behind belief revision in psychedelic therapy has possible implications for both the philosophical understanding of psychotherapy and the epistemic value of imagination. In the case of the former, it emphasises the significance of imaginative engagement for recovery (see Vazard, 2024 for a similar suggestion). In the case of the latter, it seems to undermine L.A. Paul’s (2014) scepticism about the possibility of learning from imagination what it would be like to have a transformative experience, such as becoming a parent or moving house. Paul contends that one can only learn what a transformative experience is like by having this experience. A transformative experience changes a person—what she believes and feels. So, she can’t imagine it because what she imagines is a projection of her present self, not the self she would become post-transformation. Psychedelic experiences can be transformative in that they can change one’s outlook on life. Imaginative engagement with alternative ways of being, as I’ve argued, however, precedes this transformation––it’s required for the transformation to take place. The process of transformation, to use Clavel Vázquez & Clavel Vázquez’s (2024) words, is a “creative enterprise”. 

* * * 

Thanks to Matt Dougherty, Max Kölbel and Emily Kay Williamson for their helpful comments on an earlier draft of this post and to Juliette Vazard and Ohan Hominis for insightful discussions on the topic. 


Notes:

[i] Letheby (2021) considers kinds of knowledge other than factual knowledge as plausible candidates for epistemic achievements acquired through psychedelic experience, such as knowledge-how and knowledge by acquaintance. I’m sympathetic to this idea but don’t have the space to discuss it here.


References 

Balcerak Jackson, M. (2018). Justification by Imagination. In F. Macpherson & F. Dorsch (Eds.), Perceptual Imagination and Perceptual Memory. Oxford University Press.

Balcerak Jackson, M. (2020). “Designing our Futures”. In The Junkyard, September 16, 2020.

Carhart-Harris, R. L., & Friston, K. J. (2019). REBUS and the Anarchic Brain: Toward a Unified Model of the Brain Action of Psychedelics. Pharmacological Reviews, 71(3), 316–344.

Clavel Vázquez, A. & Clavel Vázquez, J. (2024). “On Bearing Witness, Listening, and Imagination”. In The Junkyard, October 9, 2024. 

Grodniewicz, J. P. (2024). Belief revision in psychotherapy. Synthese, 203(4), 124.

Humbert-Droz, S., & Vazard, J. (2023). Imagining Out of Hope. Philosophical Quarterly, 1-22.

Kind, A. (2020). What Imagination Teaches. In J. Schwenkler & E. Lambert (Eds.), Becoming Someone New: Essays on Transformative Experience, Choice, and Change. Oxford University Press.

Kind, A. (2021). Bridging the Divide: Imagining Across Experiential Perspectives. In A. Kind & C. Badura (Eds.), Epistemic Uses of Imagination. Routledge.

Langland-Hassan, P. (2020). Explaining Imagination. Oxford University Press.

Letheby, C. (2015). The Philosophy of Psychedelic Transformation. Journal of Consciousness Studies, 22(9-10), 170-193.

Letheby, C. (2021). Philosophy of Psychedelics (1st ed.). Oxford University Press.

Paul, L. (2014). Transformative Experience. Oxford University Press.

Vazard, J. (2024). Losing the Light at the End of the Tunnel: Depression, future thinking, and hope. Mind and Language, 39(1), 39–51.