ReWilding Set and Setting for Psychedelic Therapy

Myself and my two other ReWild Medicine Founders, Karina Sergi LMFT and Dan Kelly MD, were honored to have one of our research papers published recently. The study was a pilot trial of integrating a nature-themed video, Visual Healing, into psilocybin-assisted therapy for alcohol use disorder. We had the pleasure of collaborating with Louie Schwartzberg, an award-winning filmmaker who made the film Fantastic Fungi. Nature has long been a preferred setting for psychedelic experiences, including indigenous healing ceremonies as well as modern day psychedelic users, and studies suggest that developing a stronger and deeper connection with nature is a common outcome of psychedelic experiences. When we designed this study, we were unable to figure out how to do a psilocybin study outdoors and in nature so the idea was to use Louie’s beautiful films to bring nature into the clinic and the psilocybin dosing rooms. 

Louie made three nature films that we then showed to patients in the study during the pre-psilocybin preparatory counseling session, at the start of the psilocybin session before the full psychedelic effects reached a peak, and at the end of the psilocybin session to welcome patients back at the end of their journey. The study enrolled twenty patients with alcohol problems who wanted to reduce or stop their alcohol use. Each patient underwent two psilocybin sessions accompanied by a physician and therapist team of psychedelic facilitators and completed preparatory, integration, and alcohol use counseling weekly for 10 weeks. For the first psilocybin session half of the patients were randomly assigned to watch the Visual Healing videos after which they wore eyeshades and listened to a music playlist as is typical during psychedelic sessions. The other half of the patients wore eyeshades and listened to a music playlist throughout the psilocybin session. Results of the study showed that incorporating Visual Healing videos into the psilocybin sessions was safe and feasible, there were no serious side effects, and the video did not interfere with the psychedelic or mystical experience. Patients who watched the video as well as those that did not watch the video reduced their alcohol use significantly which is similar to other studies of psychedelic therapies for alcohol use disorder and suggests that psilocybin is a promising treatment for alcohol problems. Patents reported that Visual Healing relaxed them and helped them to “ease into” the psychedelic experience and patients who were randomly assigned to watch the video had a significantly lower increase in blood pressure during the psilocybin session suggesting that the inclusion of Visual Healing or other nature-themed videos may improve the cardiovascular safety of psychedelic therapies.

With ReWild Medicine we have now been able to go beyond bringing nature into the clinic and the psychedelic dosing room and have brought psychedelic therapy out of the clinic and back into nature. Set and setting have long been recognized as having an important influence on the psychedelic experience. The Visual Healing study shows that altering set and setting in the clinic can improve psychedelic therapy (reduce anxiety and lower blood pressure). Our legal therapeutic ReWild Medicine psychedelic retreats immerse patients in nature due to the nature-retreat setting and nightly outdoor psychedelic ketamine sessions under the stars. By bringing psychedelic therapy out of the clinic and into these natural settings we hope that we are ReWilding psychedelic therapy to help our patients have the deepest and most transformative experience and achieve the best clinical outcomes.