New research highlights the importance of emotional breakthroughs on subsequent psychological outcomes after a psychedelic experience. The study, which was published in the Journal of Psychopharmacology, sheds new light on the psychological mechanisms behind psychedelic-assisted therapy.

“Most of the papers that discuss current psychedelic therapy mention the mystical-type or peak experience as a mediator of the long term clinical changes,” explained Leor Roseman, the corresponding author of the study and a postdoctoral researcher at the Centre for Psychedelic Research at Imperial College London.

“However, in practice, and based on qualitative research, it is known that there are other important mediators. One of them are moments of emotional catharsis within a psychedelic session.”

“I wanted to quantify these moments in order to increase our knowledge on the psychological mechanism that leads to long term changes and to broaden the narrative from mystical-type experiences to other experiences as well,” Roseman said.

The researchers recruited 379 participants via internet advertisements, who agreed to complete online surveys before and after a planned psychedelic experience.

Prior to taking the psychedelic drug, the participants completed questionnaires to assess demographic information, their intentions for the psychedelic experience, and general mental wellbeing. After the experience, the participants completed the new Emotional Breakthrough Inventory, along with the Mystical Experience Questionnaire and Challenging Experience Questionnaire.

The Emotional Breakthrough Inventory assesses the psychedelic experience with questions such as “I faced emotionally difficult feelings that I usually push aside” and “I was able to get a sense of closure on an emotional problem.”

In contrast, the Mystical Experience Questionnaire assesses experiences of oneness and loss of time/space, while the Challenging Experience Questionnaire assesses feelings of isolation, physical distress, anxiousness, paranoid, and similar experiences.

Long-term outcomes were then measured two weeks after the experience.

The researchers found that emotional breakthrough was positively associated with post-psychedelic increases in mental well-being. In other words, people who scored higher on the Emotional Breakthrough Inventory tended to have greater increases in well-being two weeks later.

Mystical Experience Questionnaire scores also predicted increases in well-being, while those who reported more challenging experiences tended to see smaller increases.

But the three scales did not appear to be redundant. Rather, “a multi-factorial predictor model that combines all three measures performs better than any alternative that neglects any one of them,” the researchers wrote in their study.

“The average person should take from this study the idea that the quality of the psychedelic experience is related to long term changes,” Roseman told PsyPost.

“That is to say, that the therapeutic potential of psychedelics is not solely pharmacological like other medications, but it supports the emergences of psychological transformative processes, that can lead to long term changes if integrated well. The focus here on emotional breakthrough suggests that confronting difficult emotions and allowing their expression within the session is a healthy process.”

“Besides mystical-type experiences and emotional breakthrough, there are other experiences that mediate long term changes, such as cognitive insights, the connection with the therapists, and so on,” Roseman added.

“These are not quantified yet, and it is good to know that psychedelic therapy is not just about peak or cathartic experiences (the ones that are quantified), but it is much broader than this and can be quite unexpected sometimes.”

The study, “Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory“, was authored by Leor Roseman, Eline Haijen, Kelvin Idialu-Ikato, Mendel Kaelen, Rosalind Watts, and Robin Carhart-Harris.