“To Have the Encounter with Our Own Finiteness in that Existential Way”: Descriptions of Existential Experience in Patients with Cancer and Major Depression Participating in Psilocybin-Assisted Group Therapy

Background: Cancer poses an existential threat for patients and caregivers. Psilocybin-assisted therapy (PAT) has emerged as a potential tool to meet these existential needs, yet little is known about how patients describe this element of their cancer journey, and how it might be affected by PAT, especially in the group therapy context.

Purpose: To explore how patients with cancer and depression describe their existential journey through the experience of cancer and group PAT.

Methods: Grounded in the Conceptual Model of Existential Experience in Adults with Advanced Cancer, this study is a qualitative analysis of existing data from semi-structured exit interviews with participants ( n = 28) of the psilocybin trial, “The Safety and Efficacy of Psilocybin in Cancer Patients with Major Depressive Disorder” (NCT04593563). This study uses a qualitative descriptive approach paired with template analysis to analyze interview transcripts.

Results: Our analysis revealed three overarching themes: (1) Participants described cancer prompting a deepened lived understanding of their mortality, as well as a re-prioritization of their attention, relationships, and efforts; (2) Therapeutic intentions for participating in the PAT trial went beyond relief of depression and extended to gaining a new perspective toward existential worries and building spiritual resources; (3) Participants described the lasting effects of PAT as a healing, unfolding transformation, noting an enhanced sense of meaning, agency, aliveness, and connectedness.

Discussion: Our findings provide important insights into the existential experiences of people with cancer and depression, as well as the potential role of PAT, in a novel group therapy context, in addressing existential suffering and fostering personal growth.