Philosophy of Psychedelics and the Comforting Delusion Objection

I'm reading an interesting book by Chris Letheby, "Philosophy of Psychedelics", International perspectives in philosophy and psychiatry.

It's a review of much of the recent and very exciting mental health research going on in the use of psychedelic drugs as part of treatment for some otherwise very difficult to treat conditions. It seems that the classic psychedelic drugs psilocybin (found in magic mushrooms), LSD, DMT (the active ingredient in ayahuasca) and mescaline (found in peyote cactus) are very effective in treating a number of conditions like obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), addiction, and treatment-resistant depression when used as the basis of a therapeutic intervention. They also appear to be extremely safe when used under supervision and in a controlled and safe environment. There is considerable uncertainty about how these drugs work, but one leading theory is that they all induce an experience that allows for a changed sense of the self in relation to others, past events, or the world. Unhelpful concepts of self are common to many of these mental disorders.

The so-called psychedelic drugs are currently illegal in most of the world except with special authorisation for research, although this is starting to change. For example, as of 1 July 2023 psilocybin can be prescribed in Australia as therapy for treatment-resistant depression. One of the modern psychedelic-type drugs, MDMA (ecstasy) is very close to authorisation in the US, Canada and Australia for the treatment of PTSD.

Letheby's book is an exploration of the philosophical implications of the use psychedelics. It suffers a  bit from unnecessarily academic language which makes it harder to read than it needs to be, so I'm going to summarise what I see as the main ideas over a few posts, and my own responses to those ideas. Mainly as my own notes on this but if the reader also finds it useful, then fine :-)

The Comforting Delusion Objection

This is one of the main philosophical objections to using or allowing the use of psychedelics. There's a philosophical idea called naturalism (which I don't see as different from physicalism) that is basically this: there is nothing existing outside of, or separate from, the physical world - no spirit world, no other dimension, no god(s), ghosts, afterlife, heaven or hell. Just the everyday world around us. Although not scientific, in the sense that the idea not scientifically testable, this is one of the working assumptions that science makes when it goes about its daily work. Religions generally make the opposite assumption.

Now psychedelic use, including in therapy, fairly commonly gives users a sense of contact and communication with precisely such a non-physical reality: god, a spirit world, or the sense that there is indeed something more than the everyday, that underlies or stands behind or within the physical world. This can create a profound sense of awe, greatly enhanced emotion and meaningfulness - a mystical experience.

The Comforting Delusion Objection argues that this is a problem because:

1. Naturalism is true.
2. If the mystical psychedelic experiences cause people to believe things that aren't true then we shouldn't use them as therapy.
3. If naturalism is true then the beliefs caused by psychedelic mystical experiences are false.
4. Therefore we shouldn't use psychedelic therapy.

Letheby argues that point 3 of the Comforting Delusion Objection doesn't matter because:

• it doesn't seem to be the beliefs per se that cause the therapeutic benefit (they are more of a side-effect in some patients),
• even if it causes patients to believe things which are false, it does also help them realise things which are true (and we don't have any other way of achieving that), 
• the experience is also compatible with a purely naturalistic spirituality that doesn't require supernatural belief.

Others have argued (and Letheby acknowledges) that the assumption about naturalism could be wrong. I agree. But I think Letheby overlooks a far more important argument.

I think the Comforting Delusion Objection is overly concerned with the question of truth or falsity, ie, I disagree with assertion 2. Whether beliefs are helpful is much more important than whether they are "true".

If there is a "real" or "true" reality (and my working assumption is that there is one and therefore it's possible for beliefs to be wrong), then to the extent that beliefs are inconsistent, people believe all kinds of crazy shit. Many of the beliefs of world's religions are incompatible with each other, and almost all of them are incompatible with naturalism. (Which is not a claim that naturalism is true, though it is believed by many).

Should we counsel people against their religious beliefs because they are probably false? The Comforting Delusion Objection suggests that that would be appropriate, because truth is more important than helpfulness.

Even more seriously, the Comforting Delusion Objection supposes the everyday world we experience without psychedelic drugs is somehow "true" or "real" in a way that the drug-induced mystical experience is not. This is particularly amusing because it's the very naturalist disciplines of science that have shown us that the world we experience bears very little resemblance to the "real world" revealed by careful experimentation. 

Our experience of time isn't "real": we know from Einstein's general relativity (which is "true" as far as we can tell) that time flows at different rates depending on velocity and gravitational field strength. Quantum mechanics (the physics of very small subatomic particles) is generally acknowledged to be weird AF, describing behaviours that are nothing like our subjective experience of reality. Physicists still can't agree on what the mathematics of quantum physics means, as a representation of the truth.

My favourite is the mundane example of colour vision. Colour is an hallucination. Light in the real world only has different wavelengths - a difference of quantity, not quality. The "truth" is that there is no qualitative difference between red light and blue. Our experience of those things isn't "real". Does it matter?

From an evolutionary perspective, the way we experience the world has been selected to:

1. Maximise our survival, and
2. Maximise our reproductive success

That's all.

It doesn't have to be "true". 

It also doesn't have to make us happy, or serve our mental health needs. 

So, in terms of the Comforting Delusion Objection, I argue that the normal, non-psychedelic human state is also characterised by beliefs that we either can't defend or know to be false (not an accurate representation of reality). The normal state of mind is not philosophically privileged, and is no "truer" than the psychedelic one. The only difference is a practical one, in terms of survival (safety).

I think the main concerns here are practical, not philosophical.