실로시빈 보조 요법: 정신 건강을 위한 재연결

### 실로시빈 보조 요법: 연결과 치유를 위한 그룹 형식
* 😔 많은 정신 건강의 어려움은 우리 자신, 타인, 지역사회, 지구와의 깊은 관계 단절에서 비롯되며, **미국 외과의사 장관이 공중 보건의 위기**로 인식하고 있습니다.
* 🍄 마술 버섯의 활성 성분인 실로시빈은 재결합에 초점을 맞춘 새로운 치료법으로, **암으로 인한 우울증 환자와 코로나19 팬데믹 기간 동안 소진을 경험한 일선 의료진**을 대상으로 **실로시빈 보조 요법 임상시험**이 진행 중입니다.
* 🧠 실로시빈은 의식에 상당한 변화를 일으켜 **자신과 타인, 세상과의 깊은 연결감**을 특징으로 하는 경험을 유도하는 대표적인 환각제로 꼽힙니다.
* 💊 임상시험에서 실로시빈은 **준비 및 통합 세션과 함께 치료 프로토콜 내에서 투여**되며, 환자의 의도가 경험의 영향에 큰 영향을 미칩니다.
* 🧠 실로시빈을 복용하면 뇌는 일시적으로 **여러 신경망의 통합과 상호 연결이 강화**되는 상태에 들어가 우울증과 같은 질환과 관련된 경직된 연결 패턴이 완화됩니다.
* 👥 원주민 문화에서 환각제를 의식적으로 사용하는 데서 영감을 얻은 그룹 실로시빈 보조 치료는 공유된 경험과 연결의 치료적 측면을 활용하는 것을 목표로 하며, **파일럿 연구인 HOPE 시험에서 그룹 형식이 안전하고 효과적으로 투여**될 수 있음을 입증했으며, 참가자들은 **우울 증상이 6개월까지 지속되는 유의미한 개선**을 보였습니다.
* 🌱 실로시빈 보조 치료의 지속적인 개발에는 **환자가 경험하는 연결성의 종류**를 이해하고 활용하며, **치료가 어려운 질환을 가진 사람들을 위한 접근성 확대**가 포함됩니다.
* ❓ 연사는 사이키델릭 보조 치료를 정신과에 적용하는 것에서 **정신과가 어떻게 더 사이키델릭해질 수 있는지 탐구**하는 것으로 관점을 전환할 것을 제안합니다.

실로시빈 보조 치료는 재연결을 통해 정신 건강 문제를 해결하고, 깊은 상호 연결감을 키우며, 우울증 증상을 완화하는 것을 목표로 합니다.

Many of the mental health struggles
that we see in our world come from a loss of connection, the loss of connection to ourselves, to each other, to our communities, to the Earth. This loss of connection is so profound that the United States Surgeon General
has called it a public health crisis. Thich Nhat Hanh said,
we are all connected. When you touch one thing,
you are touching everything. Whatever we do has an effect on others. Therefore, we must learn
to live mindfully, to touch the peace inside each of us. Psilocybin, the active ingredient
in so-called magic mushrooms, is an emerging treatment
that is about reconnection. As a psychiatrist at the Huntsman
Mental Health Institute, I have been running clinical trials
with psilocybin-assisted therapy, working specifically with two groups: patients dealing
with symptoms of depression associated with a cancer diagnosis; and frontline health-care workers
experiencing burnout and depression.

related to the COVID-19 pandemic. These two groups appear
very different on the surface, but their suffering is related
to a loss of connection. Each person dealing
with a cancer diagnosis is unique. However, patients face
some common challenges: the uncertainty, the treatments, the impact
on family and friends. This can result in symptoms of loss,
grief, depression, anger, feelings of hopelessness, and isolation. The COVID-19 pandemic
has heightened burnout in frontline health care providers who feel disconnected from their work, disconnected from their patients,
and their suffering. They feel overwhelmed and inadequate. There are clear distinctions
between these two groups, but there is overlap
in this sense of disconnection. Psilocybin is considered
a classic psychedelic, one of a group of chemicals that acts
on the serotonin system in the brain. The term psychedelic
comes from the combination of the Greek words psyche, or mind, and delos, to reveal or make manifest.

So mind-manifesting or expressing this idea that these chemicals can reveal
aspects of the mind that we otherwise don't have access to. These chemicals cause significant
changes to consciousness, including experiences that are referred to
as mystical or spiritual in nature. Experiences characterized by a deep sense
of connection to oneself, to others, and to the world. And in recent years,
there has been a renewed interest in the study of these compounds
for therapeutic purposes. Using psilocybin in the context
of a clinical trial looks quite different
than it does in other settings, such as recreational use. For one thing, while classic psychedelics
are remarkably safe from a medical standpoint and don't have the same potential
for abuse as other substances, they nonetheless cause
powerful changes to consciousness that can present risk. In particular, for people
with a risk of psychosis or mania. This is not a treatment for everyone. Our studies employ a rigorous screening
process to ensure that this is safe.

both medically and psychiatrically. We also embed the dosing session
within a therapeutic protocol, with preparation, and what we call integration
sessions following. There are two qualities
to this form of therapy that I'd like to emphasize that distinguish this intervention
from anything else in psychiatry. The first is the importance
of the experience itself. A reliable finding across multiple
studies with psilocybin is that specific kinds
of changes to consciousness, often with a single session, appear to be important
for therapeutic changes. Patients report a sense of connection,
or the interconnectedness of all things; a sense of preciousness
or sacredness to the experience; and a deep sense that this reveals
something true or fundamental about the nature of reality. The second quality is the combination of a drug administration
with a therapeutic protocol. This is not simply about taking
a pill and expecting a result. This is a form of assisted psychotherapy
with specific preparation, support through the session itself.

and integration following. One's intentions matter. A patient's mental preparation
going into a session can profoundly shape
the impact of the experience. How these tools are employed
is central to their effect. One current model for understanding
brain changes with psychedelic drugs examines changes in connectivity
between different brain regions. With administration of psilocybin, the brain temporarily enters a state
of global increase in integration and interconnection across different neural networks
that are normally compartmentalized. Simply put, brain regions that normally
don't talk to each other are now conversing. Of course, this doesn't last, but as the brain cools
from this experience, previously rigid patterns
of neural connectivity related to the beliefs
characteristic of, say, depression, are softened, given some wiggle room, some flexibility is introduced
into the system. Current models of psilocybin-assisted
therapy in clinical trials involve two therapists per person through a process that is
generally 20 or more hours.

Our research group at the University of Utah has naturally asked the question, can we do this in groups to expand the scale on which these promising treatments can be delivered? Now, in a way, this is nothing new. Psychedelics have been used in group context for millennia by Indigenous groups. This includes ceremonial use of psilocybe mushrooms, San Pedro cactus and ayahuasca, the dimethyltryptamine containing South and Central American brew. But when we look at modern studies, these have focused on individuals and individual sessions. But going deeper, group process is about connection and shared experience. If these forms of suffering we're looking at in our studies, depression associated with cancer, health care provider burnout, are characterized in part by a loss of connection, exploring these tools in supported shared experiences makes sense, potentially enhancing therapeutic aspects of group process that are already there. Last year, our research group completed the HOPE trial.

This was a pilot study of group psilocybin-assisted therapy for 12 patients dealing with symptoms of depression associated with a cancer diagnosis. We ran groups of four participants at a time. Patients with cancer are a well-studied population with psilocybin in individual formats. These previous studies have shown significant and enduring therapeutic effects that have been sustained for years following even a single dosing session. Our study is the first modern trial to employ a full group format. All three of our preparatory sessions, our single eight-hour dosing session, and our three integration sessions were run as groups. This was a small study designed to look at safety and feasibility, but we found a clear signal that the group format may amplify the sense of connection that we know is important in treating depressive symptoms. The group format requires thoughtful preparation. The neighbor on your right may be giggling uncontrollably while the neighbor on your left is sobbing.

One mantra we use through this process is, all is welcome. All is welcome. We learned this mantra from Mary Cosimano, a mentor of ours at Johns Hopkins. This mantra is about saying, Yes! It is about opening up to whatever is coming up for you personally, but also what is coming up in the whole room. All is welcome. The processes of others around you are not a distraction. They are there for you, and you for them. In this spirit, our study used a communal music playlist played over speakers rather than individual headphones, to emphasize and add to this collective experience. I wonder what this would be like for all of you right now to fully welcome everything coming up in this space. Excitement for this event, social dynamics of a large crowd, your private joys and sorrows, your connection with a person on this stage. Maybe even your anxiety, They might screw it up. (Laughter)

All is welcome. Our study showed that this treatment can be safely and effectively administered in a group format. Our participants demonstrated significant improvement in depressive symptoms that was sustained to our final endpoint at six months. Furthermore, participants felt strongly that the group format was a critical component of their process. We are still in the early stages of understanding how to use psilocybin-assisted therapy as a tool in mental health care. The HOPE trial is a small step in the ongoing development of this field towards understanding how to harness and sustain the kinds of connectedness that patients experience, and towards expanding access for people suffering with difficult-to-treat conditions. What if, instead of trying to fit psychedelic-assisted therapy into psychiatry, we asked, how can we make psychiatry more psychedelic? Thank you very much. (Applause)

Could Psychedelics Help Patients in Therapy? | Benjamin Lewis | TED

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연결 상실과 실로시빈 보조 치료의 영향

연결 상실은 전 세계적으로 정신 건강에 영향을 미치는 주요 공중 보건 위기로 미국 외과의사 장관이 규정한 바 있습니다.

실로시빈 보조 요법은 암 환자의 우울증과 코로나19 최전선 근무자의 번아웃을 치료하는 데 사용되어 연결 상실이라는 공통의 근본 문제를 해결하고 있습니다.

고전적인 환각제로 알려진 실로시빈은 뇌의 세로토닌 시스템에 작용하여 마음의 재연결 가능성을 드러내고 발현하는 치료법으로 떠오르고 있습니다.

치료 치료에서 실로시빈의 역할

실로시빈은 임상 시험에서 치료 잠재력에 대해 연구되고 있습니다.

이 화합물은 의식에 강력한 변화를 일으키는 것으로 알려져 있어 정신병이나 조증 소인이 있는 사람에게는 위험할 수 있습니다.

실로시빈을 이용한 치료는 엄격한 선별 과정을 거치며, 치료 경험의 중요성에 초점을 맞춘 치료 프로토콜 내에서 약물 투여와 심리치료를 병행하여 치료적 변화를 이끌어내는 방식으로 진행됩니다.

정신적 준비가 사이키델릭 치료에 미치는 영향

정신적 준비는 사이키델릭 치료 경험에 큰 영향을 미칩니다.

실로시빈과 같은 환각제는 일시적으로 뇌의 통합과 상호 연결을 증가시켜 우울증과 같은 질환과 관련된 신경 연결의 경직된 패턴을 잠재적으로 완화할 수 있습니다.

현재 그룹 치료에서 환각제를 사용하여 공유 경험의 치료적 측면 특히 연결성 상실을 특징으로 하는 질환의 치료적 측면을 강화하려는 연구가 진행 중입니다.

그룹 실로시빈 치료가 암 관련 우울증에 미치는 영향

그룹 실로시빈 요법을 사용하는 12명의 암 환자를 대상으로 한 파일럿 연구에서 그룹 형식이 우울 증상을 치료할 때 연결감을 향상시킬 수 있다는 분명한 징후를 보여주었습니다.

이 연구는 현대 임상시험에서 최초로 시행된 것으로, 그룹 형식은 신중한 준비가 필요하지만 치료 효과를 증폭시킬 수 있다는 사실을 밝혀냈습니다.

치료 세션에는 공동의 음악 재생 목록과 "모두 환영합니다"라는 진언이 포함되어 참가자들이 집단적이고 개방적인 경험을 할 수 있도록 장려했습니다.

HOPE 임상시험: 그룹 형식 실로시빈 보조 요법

실로시빈 보조 요법은 우울증 증상을 치료하는 그룹 형식에서 안전하고 효과적인 결과를 보여주며 최대 6개월까지 지속적인 개선 효과를 보입니다.

참가자들은 치료 과정에서 그룹 형식의 중요성을 강력하게 강조합니다.

HOPE 임상시험은 환각 보조 요법을 정신 건강 치료에 통합하는 작은 단계로, 치료가 어려운 질환에 대한 연결성을 강화하고 접근성을 확대하는 것을 목표로 합니다.