Shame, Guilt and Psychedelic Experience: Results from a Prospective, Longitudinal Survey of Real-World Psilocybin Use
Amy Lehrner, Heather Jackson, David S. Mathai, Daniel E. Roberts, Sandeep M. Nayak, Nathan D. Sepeda, Matthew W. Johnson, Matthew X. Lowe, Albert Garcia‐romeu
Journal of Psychoactive Drugs February 7, 2025 DOI: 10.1080/02791072.2025.2461997 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective longitudinal study Peer reviewed |
|---|---|
| Sample size | 679 |
| Population | Adults planning to use psilocybin in naturalistic settings |
| Intervention | psilocybin |
| Duration | 2-4 week follow-up for well-being; 2-3 month follow-up for trait shame |
| Topics | Psilocybin |
| Keywords | Shame Hallucinogen Clinical psychology |
| Citations | 11 |
| Key findings | Acute shame or guilt during psilocybin experiences was common (68.2%), and the ability to work through these feelings predicted later wellbeing, while psilocybin on average produced a small decrease in trait shame maintained 2-3 months after use. |
Abstract
The classic psychedelic psilocybin has attracted special interest across clinical and non-clinical settings as a potential tool for mental health. Despite increasing attention to challenging psychedelic experiences, few studies have explored the relevance of shame-related processes with psychedelic use. This prospective, longitudinal study involved sequential, automated, web-based surveys that collected data from 679 adults planning to use psilocybin in naturalistic settings at timepoints before and after psilocybin use. State and trait shame and feelings of guilt were collected using validated measures and assessed alongside other measurements of psychological health. Acute feelings of shame or guilt during psilocybin experiences were commonly reported (68.2% of users) and difficult to predict. Ratings of participant ability to constructively work through these feelings predicted wellbeing 2-4 weeks after psilocybin use. Psilocybin on average produced a small but significant decrease in trait shame that was maintained 2-3 months after use (Cohen's dz = 0.37). Trait shame increased in a notable minority of participants (29.8%). The activation of self-conscious emotions with psychedelics deserves further attention as a challenging experience subcategory that may be relevant to psychological outcomes. Such experiences could pose a unique and context-dependent learning condition for both therapeutic and detrimental forms of shame-related memory reconsolidation.