Shedding the self : ego-death and positive psychological transformation in naturalistic psychedelic use.

A new 28-item scale, the Perceived Positive Outcomes of Psychedelic Use (PPOPU), was developed and validated in a diverse international sample of 599 adult psychedelic users. Ego-death experiences strongly predicted perceived positive outcomes. Among four mental health conditions examined—depression, anxiety, PTSD, and substance use disorder—only a history of PTSD significantly predicted greater perceived benefits. No significant interaction was found between ego-death and mental health history. The findings suggest ego-death is a powerful catalyst for positive psychological transformation in naturalistic settings and that psychedelic experiences may hold transdiagnostic therapeutic potential, especially for trauma-related psychopathology.

Study at a glance

Abstract

Emerging psychedelic research highlights the therapeutic potential and broader positive psychological transformation of psychedelic-assisted therapy. While naturalistic studies support these outcomes, gaps remain in understanding the specific nature of perceived benefits and in the availability of validated instruments to assess them. This study aimed to develop and validate the Perceived Positive Outcomes of Psychedelic Use (PPOPU) scale, and to investigate how ego-death and mental health history contribute to perceived positive outcomes in naturalistic contexts. It also examined the interaction between ego-death and mental illness history in shaping outcomes. Adult psychedelic users (n = 599) from an internationally diverse sample completed an online survey assessing ego-death experiences, mental illness history, and perceived benefits of psychedelic use. Exploratory and confirmatory factor analyses yielded a psychometrically robust 28-item, three-factor model aligned with theoretical understandings of psychedelic-related benefits. Ego-death significantly predicted positive outcomes. Of the four mental health conditions assessed, depression, anxiety, post-traumatic stress disorder (PTSD), and substance use disorder (SUD), only a history of PTSD significantly predicted greater perceived benefits. No significant interaction effects were found between ego-death and mental health history. These findings provide strong initial validation for the PPOPU Scale. They also suggest that ego death is a powerful catalyst for positive psychological transformation in naturalistic settings. Furthermore, psychedelic experiences may have transdiagnostic therapeutic potential, with particularly beneficial effects for individuals with trauma-related psychopathology.