SILENCE IS GOLDEN: SPEECH PRODUCTION DURING PSILOCYBIN ADMINISTRATION SESSIONS FOR THE TREATMENT OF POST-TRAUMATIC STRESS DISORDER

Background

The contribution and nature of participant support in the context of psychedelic trials remains the topic of considerable debate.

Aims

To provide additional detail about the structure and format of the monitoring and support used in Compass Pathfinder Ltd (Compass) trials, focusing on the administration sessions.

Methods

Transcripts from audio recordings collected during a 12-week clinical trial assessing the efficacy of 25 mg COMP360 psilocybin in 22 individuals with posttraumatic stress disorder (PTSD) were examined to quantify speech rates (words per minute, WPM) for both participants and support providers. Additionally, a thematic analysis of postdosing participant interviews was conducted to provide deeper insight into participants’ experiences of monitoring and support during the study.

Results

Comparisons of words per minute (WPM) between support providers and participants clearly differentiated administration sessions from preparation and follow up sessions. During administration, speech from either party was infrequent; on average, silence accounted for 78% of the session time, compared with 25%–30% in non-administration sessions. Thematic analysis of postdosing interviews revealed three overarching themes: (1) support was minimally enacted, yet experientially salient, (2) autonomy was promoted through the introspective psychedelic state and non-directive support, and (3) primary modes of support during altered states of consciousness included reassurance and validation.

Conclusions

The minimal level of verbal interaction and participant reports indicate that the style of monitoring and support used in Compass administration sessions is distinct from approaches commonly employed in traditional psychotherapies, MDMA-assisted therapy trials, and psycholytic treatment models involving psychedelic substances.