Motivation and emotion/Book/2022/DMT and spirituality

Overview
In the pursuit of understanding the fundamental nature of the human experience, it is common to arrive at these persistent questions: What is the origin of life? What happens after death? What is the meaning of existence? Do I have a purpose in the world?

In the search for answers to these questions, there is often found, a direction towards an aspect of spirituality to provide some knowledge and comfort. Dimethyltryptamine (DMT) is a psychedelic substance that can offer a pathway to having a spiritual experience through an altered state of consciousness. DMT: The Spirit Molecule is a popular documentary that explores DMT and its associated spiritual experiences. This film was inspired by the book under the same title, written by Dr. Rick Strassman, and is often the inception for many people in their discovery of DMT facilitated spiritual experiences.

Empirical research relating to DMT is still relatively nascent, however there is a strong association of DMT with spirituality. There are multiple psychological theories that can provide an understanding of how DMT can facilitate spiritual experiences. Anecdotal reports and emerging clinical studies are suggestive of DMT inducing spiritual experiences and a vast spectrum of emotions, and various healing properties.

Focus questions:
 * What is DMT?
 * What is a spiritual experience?
 * What is the relationship between DMT and spiritual experiences?
 * How do DMT and spiritual experiences affect emotions?
 * Are there benefits in having a spiritual experience using DMT?

What is DMT?


Belonging to a class of serotonergic psychedelics, DMT (N,N-Dimethyltryptamine or N,N, DMT) is a psychoactive alkaloid that can be found in a variety of plant (as seen in figure 1) and animal species as well as humans. Whilst DMT is an endogenous monoamine, the physiological function of it remains undetermined. DMT is a hallucinogen that is used recreationally and as an entheogen, eliciting out-of-body encounters and profound dream states (St John, 2016).

Chemical composition
N, N-dimethyltryptamine (DMT or N,N-DMT) is structurally related to neurotransmitter serotonin (5-hydroxytryptamine) and melatonin (N-Acetyl-5-methoxytryptamine). Additionally, DMT is both structurally and functionally related to other psychedelic tryptamines such as psilocybin (4-PO-DMT) and O-methylbufotenin (5-MeO-DMT) (Davis et al., 2020).

DMT is typically smoked, ingested or injected; however, it requires a monoamine oxidase inhibitor (MAOI) to make it active when ingested (McKenna, 1996). Oral administration of DMT, in which it is commonly taken with other plant mixtures such as ayahuasca, extends the onset and timing of the related stages, as the total duration of the effects last up to several hours (Davis et al., 2020).

Different methods of intake require different dosages, influencing the duration and intensity of the effects of DMT. PsychonautWiki has gathered anecdotal data on the dosage and timeline of the expected stages of the DMT experience:

Table 1. Expected duration of DMT stages when taken as a separate substance

History




There is a history of cross-cultural use amongst indigenous communities for traditional healing practices. Pharaonic Egyptian depictions of the Eye of Horus and the third eye (ajna chakra) in Hindu spiritual tradition are often equated with the pineal gland. This notion has prompted speculative evidence of the use of endogenous DMT (Nichols, 2017). Early evidence includes the finding of a 1,000-year-old ritual bundle in the Andes which contained chemical residues of psychoactive plants including DMT (Miller et al., 2019).

Furthermore, evidence suggests indigenous cultures had advanced botanical knowledge, practicing shamanic rituals with psychoactive substances. For hundreds of years, native Amazonian people have been using DMT with ayahuasca for medicinal purposes with some tribes consuming it for storytelling, artistic inspiration and using it to solve interpersonal conflicts (George et al., 2020). It is important to recognise the historical roots of psychedelic plant medicines as modern concepts of DMT appropriate the traditional practices and medicinal use. Additionally, indigenous communities are often excluded from empirical studies (George et al., 2020).

DMT is still new to western world; first being synthesised in 1931 by chemist Richard Manske and subsequently learned as natural occurrence in plants in 1946 by microbiologist Oswaldo Gonçalves de Lima (Barker, 2018). In 1956 Stephen Szara, a Hungarian chemist and psychiatrist, bridged the link between the chemical and its use, after extracting DMT from the Mimosa hostilis plant and administering the extract to himself intramuscularly (Barker, 2018).

Like other classic psychedelics that substantially alter perception, cognition and emotion, it is currently used both recreationally and ritualistically.

The pineal gland
The pineal gland is often associated with discussions relating to DMT and spiritual experiences. The rationale behind this relationship is due to the ancient symbolism of the pineal gland combined with its endogenous presence in the human brain. DMT is ostensibly believed to be secreted from the pineal gland during birth, after death and through mindful activation. In a clinical experiment inducing cardiac arrest on rats, DMT levels were significantly increased in the cortex region of some of their brains regardless of whether pineal glands were removed (McKenna, 1995). This increase is possibly due to the near-death experience (NDE) of the rats, similar to those of humans given exogenous DMT. However, it is unclear whether this surge is endogenously replicated in humans who survive a NDE; Only 20% of cardiac arrest survivors report having a NDE (McKenna, 1995).

Subjective experiences
DMT elicits an intense psychedelic experience that is characterised by a rapid onset of vivid visual imagery and somatic effects (Strassman, 1996). The effects of DMT are reported to include the feeling of (Davis et al., 2020):


 * Hallucinations
 * Transcending from one’s body
 * Meaningful, insightful or spiritual experiences
 * Pleasurable feelings
 * Affective distortions
 * Distortions of space-time and self
 * A sense of familiarity

Additionally, a deep and profound immersion into what is recognised as a "breakthrough" will occur where it is described as the sense of entering an alternative world or dimension. As opposed to ayahuasca, the intensity of DMT prohibits individuals from resisting and pushes one to "let go" and have a breakthrough. At this stage, there are reflections on death, dying and the after-life as well as perceived communication with ‘entities’ or ‘presences’ (Timmermann et al., 2019). The states experienced are explained as feeling particularly real to existence and of having a NDE (Timmermann et al., 2019).

Ego-death or ego-dissolution is a common effect of DMT. It refers to the state of transcendence in which a person loses a sense of their subjective identity and is associated with having a NDE (Kazmarek, 2020). The transcendent hallucinations and NDEs alter perceptions of space, time and consciousness. The mental, emotional and spiritual liberation that is associated with an ego-death lasts long after the use of DMT (Kazmarek, 2020). Notably, DMT induced ego-dissolution is comparable to the Buddhist philosophy and attribute of effective meditation (Carhart-Harris & Friston, 2019). Strassman described similarities between the psychedelic experience and what Buddhists call "bodhicitta" (Nelson, 2016). Concurrently, there is often religious iconography (Carhart-Harris, 2014) and cross-cultural visuals of ancient architecture and symbols associated with the visual experience of DMT trips.



Common emotional responses during a DMT comprise of joy, trust, surprise, love, fear and sadness (Davis et al., 2018). A study reported DMT as being highly personally meaningful, spiritually significant and psychologically insightful as well as having a substantial positive change to the purpose of life and life’s meaning, social relationships and attitudes about life and the self (Davis et al., 2018).

Physiological effects
DMT is a partial serotonin agonist for the 5-HT2A G protein-couple receptors (von Elk & Yaden, 2022). The 5-HT2A receptors are involved with learning and memory, pain perception and the sleep/wake cycle (von Elk & Yaden, 2022; Barker, 2018). Concentration areas of these receptors within the brain which may offer reasoning as to why DMT affect cognitive, perceptual and emotional functions (von Elk & Yaden, 2022). Concurrently, effects with other serotonergic, glutaminergic receptors as well as interactions with dopamine and acetylcholine functioning may have a confounding role (Davis et al., 2020; von Elk & Yaden, 2022). Frontocortical glutamate receptors and glutamate release facilitated by 5-HT2A receptors are postulated to be the regulatory mechanism of serotonergic hallucinations (Davis et al., 2020). Additionally, observational increases in synaptic growth and density of neurons is suggestive of DMT being a psychoplastogen, promoting structural and functional neural plasticity (von Elk & Yaden, 2022).

Brain activity on DMT
Timmermann et al. (2019) conducted a placebo-controlled investigation using an electroencephalogram (EEG) to record DMT induced changes in brain activity. The participants were intravenously administered with varying dosages of DMT and provided their subjective ratings of the intensity minute-by-minute for a total of 20 minutes (Timmermann et al. 2019). The study by Timmermann et al. (2019) provides insight into the neurobiology of consciousness with key findings including:


 * Decreases in total spectral power in alpha and beta bands when immersed into the DMT state.
 * Increases in spontaneous signal diversity and emergence of theta and delta oscillations particularly in the temporal lobe when DMT effects were at the peak.
 * A correlation between the decrease in alpha power and the chronological changes in the subjective intensity of DMT.

Comparative analysis of the brain waves and the subjective experiences described by the participants leads Timmermann et al. (2019) to postulate that the DMT breakthrough experience is associated with perception changing from a top-down process to a bottom-up process, such as what happens during REM-sleep dreaming.

Spirituality
Understanding of what classifies as spirituality has shifted throughout history, expanding its meaning beyond traditional reductive interpretations of religion and believing in a 'God' or 'Creator'. Spirituality in the contemporary context, no ties to a singular religion, culture or deity/deities (Greyson & Khanna, 2014). It is a broad term that encompasses one's beliefs and refers to the relationship to the sacred, reliant on a range of experiences and states of awareness that involve transcendent values (Greyson & Khanna, 2014).

Spirituality embodies feelings, thoughts, experiences and behaviours developing from a search for the divine, higher values, inner freedom, well-being and things that give life a meaning (Nelson, 2016; Greyson & Khanna, 2014). The effect of spirituality is transformative within individuals lives and relationships, taking it beyond the mundane daily experience (Nelson, 2016).

What is a spiritual experience?
There are varying interpretations of what is constituted as a spiritual experience. Traditionally, it has been associated with organised religion but as understanding of belief systems has expanded so has what constitutes as a spiritual experience.

William James believed that spiritual experiences are dependent on the subconscious thoughts becoming part of the conscious (Carhart-Harris, 2014). An extension of this notion is made by Carl Jung who believed religion to be a manifestation of the collective unconscious articulated through symbolism and rituals (Carhart-Harris, 2014).

A systematic exposition of seven universal components that encompasses a spiritual experience was comprised by Walter Stace (as cited in Carhart-Harris, 2014):


 * 1) Diminished spatial and temporal awareness
 * 2) Diminished subjectivity (increased objectivity)
 * 3) Feelings of profound joy and peace
 * 4) A sense of divinity
 * 5) Paradoxicality
 * 6) Ineffability
 * 7) Sense of oneness with the world

There is emphasis on the sense of oneness with the world or the unitive experience. The duality of the ‘self vs. other’ is a relatively consistent observation spiritual experiences. The ‘other’ is not bound to referring to any specific object, being or concept.

Across cultures and throughout history, traumatic experiences such as a NDE are associated with spiritual growth (Greyson & Khanna, 2014). Altered states of consciousness associated in the stages of near-death include (Greyson & Khanna, 2014):


 * Resistance to death
 * Surrender and life-review
 * Transcendence

Those who have a NDE frequently have a sense of great understanding, harmony or unity, joy and revelation.

Psychological theories and framework
In a DMT trial, 36% of participants prior to taking the substance reported to align with an aspect of spirituality, yet after the experience 58% reported having a belief system (Davis et al., 2018). Psychological theories can provide an understanding of how DMT facilitates a spiritual experience.

Social sharing of emotion
Social sharing of emotion is an important part of the subjective emotion. It involves an individual processing an event and its implications on their feelings and emotional reactions to the circumstance by having an open conversation with another person (Singh-Manoux & Finkenauer, 2001). This practice is believed to support individuals in interpreting and accepting possibly distressing aspects of the event and in rebuilding their belief system (Singh-Manoux & Finkenauer, 2001).

Emotional sharing of emotions may serve to directly communicate an individual’s needs to others, allowing the possibility to cope with the emotional event and its consequences. The emotional response to the experience induced by DMT may elicit the need for social sharing of emotion. The interpretation of the event afforded by the social sharing of emotion may provide individuals with a perception of the event as a spiritual experience.

Complex appraisal
Lazarus and Folkman (1984) proposed that cognitive appraisal has a significant role in mediating an individual’s environmental conditions and coping. There is a focus on evaluating whether a situation or event has personal relevance to an individual’s wellbeing using complex appraisals such as potential benefit, harm or threat. Appraisals can be impacted on the basis of personal relevance, goal congruence and ego involvement.

Projected coping influences the way a situation is appraised; the initial stage is the primary appraisal to the event which then leads to the secondary appraisal of their coping potential relevant to the event. A modified appraisal elicits a change in emotion. The secondary appraisal occurs after reflection, as an assessment is made on coping with the possible benefits, harms or threats of the event. In which an individual’s cognitive, emotional and behavioural efforts are made to manage coping with the appraisals. Emotion according to the understanding afforded by Lazarus and Folkman (1984) is based on one’s motives such as goals and wellbeing, being at stake. Emotional changes are relevant to the changes in a person’s appraisals and motives.

DMT experiences lead to heightened perception and emotion of internal condition; as psychological well-being and spirituality are at stake, a person’s potential to cope will influence their experience. Individuals with the belief that DMT will facilitate a spiritual experience for which they perceive they can cope, can elicit positive emotions relating to this experience.

Broaden and build theory
Broaden and build theory depicts the form and function of positive emotions. Proposing that positive emotions broaden the individuals momentary thought-action repertoire; furthermore, they promote discovery of novel and creative actions, ideas and social bonds which then form an individual’s personal resources (Fredrickson, 2004). Conversely, a narrowed mind-set is generated by negative emotions which leads to action tendencies such as fleeing or attacking (Fredrickson, 2004).

A positive DMT experience may begin with emotions such as happiness or interest intensifying to optimism, euphoria or awe; these emotions result in the desire to further explore the ideas, or spiritual experience. By doing so, the individuals sense of self and resources further develop.

Rebus model
RElaxed Beliefs Under pSychedelics (REBUS) model is, proposed by Dr. Robin Carhart-Harris. The REBUS and the anarchic brain model is based on the concept that in humans, the cortical hierarchical typically functions from a top-down process using brain regions associated with the Default Mode Network (DMN) but that the DMN decreases in activity and the brain is more entropic in its activity when under the influence of psychedelics (Carhart-Harris & Friston, 2019).

The increase in bottom-up processing and entropic brain activity influences the proposed intermediate levels of the brain that are relevant to cognition, perception and emotion subsequently result in a reduction in the stability and rigidity of a person’s beliefs, models and assumptions (Carhart-Harris & Friston, 2019). DMT prompts insight and openness to re-evaluate the past, present and prospective future, particularly relating to personal experiences, beliefs and behaviours stimulate a variety of strong emotions. The influx of transcendent information and meditative states are often attributed to spiritual experiences.

Emotional and spiritual benefits of DMT
The positive enduring effects of DMT include affirmative changes in subjective well-being, life satisfaction, life purpose and life meaning. During DMT encounters with entities, most participants in a study stated that they felt positive emotional responses such as love, kindness and friendship (Davis et al., 2020). Ego-death elicited by a DMT experience often provides individuals with a sense of catharsis as the experience is conceived as unitive (Millière et al., 2018). A unitive perspective is associated with high pro-social behaviours and elicit increased traits of altruism, kindness, empathy, openness and compassion (Millière et al., 2018). Furthermore, individuals who have spiritual experiences report an improved sense of general wellbeing and have a lower probability of developing depression and addiction (Millière et al., 2018).

Most studies on the potential therapeutic uses of DMT have been in combination with Ayahuasca (Barker, 2018). Long-term users of Ayahuasca have shown reduced ratings of hopelessness and an improvement in depressive symptoms (Barker, 2018). Individuals who have self-reported using psychedelic substances outside of clinical trials demonstrate a statistical likelihood to indicate psychological distress and suicidality, showing a lower occurrence of overall mental health problems (Swanson, 2018).

DMT may also be useful in treating substance abuse, inflammation and possibly cancer (Barker, 2018). However, more research particularly on DMT as a lone substance will provide further substantiation on these promising treatments. Considering it is known that DMT acts on the serotonergic system as well as other neurotransmitter systems, further research should be done as hypothetically it may lead to discoveries explaining conditions such as delirium, symptoms of psychoses, sleep disorders, autism and other perceptual anomalies (Barker, 2018).

Risks
Whilst there are limitations on empirical data regarding the safety of DMT, it is not reported as lethal even at a high dosage (Gable, 2007). Regardless, consideration should be taken. Hallucinogen-persisting perceptual disorder (HPPD) is a disorder listen in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. HPPD occurs when an individual has enduring visual perceptual abnormalities that surpass the duration of the psychedelic drug experience (Carhart-Harris & Friston, 2019). Its prevalence is rare; however, the symptoms often cause distress to an individual (Carhart-Harris & Friston, 2019). Although the duration of DMT effects are short, the hallucinatory experience is highly intense and may cause distress to some individuals. Having a safe and supportive environment can help mitigate any negative emotions after the experience (von Elk & Yaden, 2022).

Spiritual experiences elicited by DMT may lead individuals to associate their psychological problems with entities they perceive within their experience; for example, narrowing down the causation of negative events within their lives to the doings of demons or evil spirits (von Elk & Yaden, 2022). However, one may also interpret their experience as a form of narcissism as they perceive their revelations to give them social status and a significance (von Elk & Yaden, 2022).

Conclusion
DMT is an endogenous psychoactive alkaloid with an extensive cultural history, rooted in spiritual rituals and medicinal practices. The neuropharmacological mechanisms for which DMT influences cognitive, perceptual and emotional states are complex, however a principal element is the substance's interaction with serotonergic and glutaminergic receptors. The intense subjective effects associated with DMT, particularly the hallucinations and ego-dissolution elicit a transformative, emotional experience.

DMT often provides users with a semblance of understanding the origins of life, meaning of existence, an idea of what happens after death and an innate purpose within the world. Furthermore, it can elicit emotions such as love, joy, unity, friendship and fear.

Social sharing of emotions, complex appraisal, the broaden and build theory, as well as the REBUS model contribute an understanding of how DMT can facilitate a spiritual experience. The DMT induced spiritual experience can be highly beneficial for individuals who have a low sense of hope and well-being; additionally, it can enhance long-term positive emotions and prosocial behaviours. Future studies should focus on the medicinal and healing properties of DMT whilst taking into account the historical traditions and understandings of the substance.