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ANCIENT SHAMANISM AND MODERN PSYCHOTHERAPY: FROM ANTHROPOLOGY TO EVIDENCE-BASED PSYCHEDELIC MEDICINE.

INTRODUCTION

In the last years, the debate on the therapeutic use of psychoactive drugs and compounds has intensified and has attracted a progressively growing body of research as well as of conferences and training courses. Some researchers feel to live a true "psychedelic Renaissance" (Sessa, 2017), which is anticipated to revolutionize future mental health care, whereas other scholars perceive a still persisting medieval obscurantism limiting this "Renaissance bloom" (Miller, 2017).

Psychotropic or psychoactive substances, as the term itself says, are able to act on the ordinary state of the psyche and, as such, to enable humans to experience non-ordinary states of consciousness. In the ancient times, in the traditional cultures, this was achieved through the administration of plant derivatives and was considered as a highly respected, sacred practice to perform within a ritual context.

We do not want here to express a praise of the myth of the "good savage" or of the "good drug", but we would make a serious anthropological reflection on the use of "narcotic substances" that always accompany the life of human beings and even animals on the Planet Earth.

With this regard, we can remember how in Europe drugs use was already present in the times of the Greeks before, and of the Roman Empire, subsequently. The Dionysian rites and the mysteries of Eleusi are historical examples of the use of psychoactive plants.

Archaeological traces of the therapeutic, religious and ritual use of substances such as coca and psilocybin in South America are millennial and bring us to a reality that the Spanish conquest first and the prohibitionist policies then altered so much to lead the public to a distorted view of such substances as demonic plants or capable of leading to madness and death.

In the East, cannabis, similarly, had a comparable fate: the first ascertained evidence of using this plant for therapeutic purposes dates back to the third millennium before Christ (BC) as described in the Nei-Ching text, written between 2700 and 2600. The plant was prescribed to treat diarrhoea, bronchitis, migraine, insomnia, appetite and nerve disorders. In India it is witnessed the use of cannabis in the second millennium in the sacred texts of the Vedas, where the demon of the nostrils Vide-Vadat, is symbolized by hemp, which also has the function of favouring ecstasy. In India, hemp is called bhang and takes a significant religious meaning as it is the favourite plant of Shiva God; his followers use it as a source of mystical inspiration. In the Indian religious literature, vijaya is called "victory" and in some Sanskrit scripts it is called indracarana or "God food".

But "the food of the gods", including not only cannabis, but all psychoactive plants, are defined in the various traditions, are forbidden to humans.

In the history of the Western civilization, prohibition begins its work of destroying use of psychotropic substances, stating that everything that alters the ordinary state of consciousness is potentially damaging and therefore prohibited.

This decision taken by most, if not all of the Western states, has put a halt to psychotropic substances-related research that in the 1970s saw, for example, in the work of Richard Hoffman and of the chemist Richard Evans Schultes, a prestigious ethnobotanist working at Harvard University, discoverer of the so-much discussed lysergic acid diethylamide (Lysergsaurediethylamid or LSD), as well as of many other scientists, the opportunity to go through the "Doors of Perception" (just to quote the title of the 1954 Aldous Huxley's essay).

The doors of psychoactive substance research over the last 50 years have been closed and research has been relegated to some laboratories or practitioners who have continued experimenting and reporting their personal experiences, however, contributing to the scientific progress that calls up for designing investigation protocol, carrying out the experimentation and testing, following a strict, rigorous and statistically robust methodology.

Meanwhile, data on anti-prohibition policies have shown that prohibition itself has not led to the diminution of abusive perpetuation in less secure and controlled spaces, nor to the possibility of discovering the therapeutic potential of the substances and their possible limits.

Today, psychiatrists, neuroscientists, psychologists, anthropologists in Europe, the USA and South America, following the more or less rigid regulations of each state (Ardito et al., 2017; Firenzuoli et al., 2017; Gulluni et al., 2018; Re et al., 2015; Re et al., 2016; Re et al., 2017), are progressively collecting the legacy of the previous researchers (Table i) with the aim of strengthening research on psychedelics, negotiating a regulation for therapeutic and scientific uses and providing serious and legitimate information to the public.

The substances currently undergoing clinical trials are cannabis, psilocybin, N,N-dimethyltryptamine (DMT), ayahuasca, ecstasy (MDMA) and LSD.

These are experimented against most common mental health pathologies, such as Post Traumatic Stress Disorder (PTSD), cancer-related anxiety, depression, cachexia, pharyngeal pain, multiple sclerosis and other organic disorders.

The research developed in the United States, Switzerland, England and Spain follows rigorous research protocols in which the mindset or set (the clinical and biographical history of the patient) plays a key role, the setting (the environment in which the experience is perceived) and the substance (typology, dosage, quality and quantity) play a major role.

The treatment setting provides a cozy room with a sofa that is used during the session, a mask to cover visual stimuli, headphones linked to a piece of music chosen by the patient and two therapists, usually a physician and a psychotherapist who monitor the biological parameters of the person and are available for any need. The target involves inclusion or exclusion criteria/choices for research participation, pre- and post-session evaluations by administering tests and psychotherapy sessions to prepare before and, then, integrate the experiences lived during the session.

Some patients report dissolution experiences of the Ego that, thanks to advanced and sophisticated neuro-imaging techniques, are associated with a marked decrease in activity in a brain area called "Default Mode Network" (DMN); this area seems to be overactive during episodes of rumination and rebirth, typical in depressive states, and plays an important role also in the ability of introspection and the development of mind theory, or the ability to "read" and interpret the emotions of others.

Additionally, substances such as MDMA or Ayahuasca have empathic properties and are able to develop a state of trust and compassion, also allowing the emergence of ancient or removed memories, facilitating the processing of traumas and the possible treatment of addictions whose etiological cause/trigger is given by a traumatic event/component.

However, because of regulatory concerns, sample sizes are small, given the difficulties involved in experimenting with substances. Like any other pharmakon, psychoactive substances may too lead, during or after administration, to the insurgence of adverse effects that, as in any experimentation, may and must be reported. However, the presence of suitably trained staff and a safe and secure context can be the ingredients to be able to proceed to an experimental process that freedom of research in science should provide to researchers.

As such, the research field of psychoactive drugs, despite its promises, is characterized by a number of challenges which, in the future, should be properly addressed, concerning, for instance, their potential therapeutic use. There is a concrete possibility to revitalize the use of these substances by bridging past and present, combining ancient knowledge and modern science to serve new therapeutic paradigms.

REFERENCES

[1.] Ardito, Rita, Pirro, Piero Stanley, Re, Tania Simona, Bonapace, Isabella, Menardo, Valentino, Bruno, Emanuela, and Gianotti, Laura, 'Mindfulness-Based Stress Reduction Program on Chronic Low-Back Pain: A Study Investigating the Impact on Endocrine, Physical, and Psychologic Functioning', The Journal of Alternative and Complementary Medicine, vol. 23, no. 8, 2017, pp. 615-623.

[2.] Firenzuoli, Fabio, Re, Tania Simona, Epifani, Francesco, and Loiacono, Idalba, 'The challenges of global health in a system', in Bistagnino, Luigi (ed.), microMACRO_EN, iBooks, 2017.

[3.] Gulluni, Nadija, Re, Tania Simona, Loiacono, Idalba, Lanzo, Giovanni, Gori, Luigi, Macchi, Claudio, Epifani, Francesco, Bragazzi, Nicola, and Firenzuoli, Fabio, 'Cannabis Essential Oil: a preliminary study for the evaluation of the brain effects', Evidence-Based Complementary and Alternative Medicine, 2018, in press.

[4.] Miller, Richard Louis, Psychedelic Medicine: The Healing Powers of LSD, MDMA, Psilocybin, and Ayahuasca, Park Street Press, 2017.

[5.] Re, Tania Simona, Palma, Jose, Martins, Jorge, and Simoes, Mario, "Transcultural perspective on consciousness: traditional use of ayahuasca in psychotherapy in the 21st century in western world" Cosmos and History: The Journal of Natural and Social Philosophy, vol. 12, no. 2, 2016, pp. 245-253.

[6.] Re, Tania Simona, Ventura, Carlo, Vitiello, Giuseppe, Simoes, Mario, and Martins Jorge, Transcultural perspective on Consciousness: a bridge between anthropology, Medicine and physics. Cosmos and History: The Journal of Natural and Social Philosophy, 2015, vol. 11, no. 2, 228-241.

[7.] Sessa, Ben, The Psychedelic Renaissance: Reassessing the Role of Psychedelic Drugs in 21st Century Psychiatry and Society, State University of New York Press, 2017.

[8.] Re, Tania Simona, Manca, Fabrizio, Siri, Anna, and Spulber, Diana, 'Communities as agents of change; toward an ecological perspective', in Bistagnino, Luigi (ed.), microMACRO_EN, iBooks, 2017.

(1) Editor's note: Foundations of Mind, the independent research group that has provided the papers for this special edition, has never taken either corporate or state money and is financed entirely by donations. Authors keep copyright without paying. The typical fee for this charged by open-access journals such as those published by PLOS, is around $2k. If you value this project, and wish to see further such proceedings from this group, we ask you to consider donating to Foundations of Mind--as little as $5 per download, through their website: http://www.foundationsofmind.org/donate. This will ensure there will be further published proceedings on the foundations of mind like this one for you and others to enjoy free.

Nicola Luigi Bragazzi (1,2,3,4), Hicham Khabbache (4), Ignazio Vecchio (5), Mariano Martini (2,3), Marco Perduca (6), Riccardo Zerbetto (7), Tania Simona Re (3), *

(1) Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy

(2) Section of History of Medicine and Ethics, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy

(3) UNESCO Chair "Health Anthropology, Biosphere and Healing Systems", Genoa, Italy

(4) Faculty of Literature and Humanistic Studies, Sidi Mohamed Ben Abdellah University, Fez, Morocco

(5) Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

(6) Associazione Luca Coscioni, Rome, Italy

(7) Gestalt Research Center--CSTG, Milan, Italy

* Corresponding Author

tania.re77@gmail.com
Table 1. List of pioneers in the field of experimentation of
psychoactive drugs and compounds.

Pioneer in the field of   Birth and    Notable work(s)
psychoactive drugs        death

Augustin Pyrame de        1778-1841    A prominent Swiss botanist,
  Candolle                             author of books like "Historia
                                       Plantarum Succulentarum" and
                                       "Astragalogia"
Ernst von Bibra           1806-1878    A German naturalist,
                                       author of "Plant Intoxicants:
                                       A Classic Text on the Use of
                                       Mind-Altering Plants"
Richard Spruce            1817-1893    A British botanist
                                       specialized in bryology and
                                       explorer
Mordecai Cubitt Cooke     1825-1914    A prominent British scholar
                                       of botany and mycology
Paolo Montegazza          1831-1910    An Italian neurologist,
                                       physiologist, and
                                       anthropologist, he
                                       investigated the effects of
                                       coca leaves
Alphonse Tremeau de       1836-1912    A French botanist,
  Rochebrune                           malacologist and a zoologist
Angelo Mariani            1838-1914    Italian, inventor of the first
                                       cocawine, Vin Mariani
Stephen Powers            1840-1904    An American ethnographer
William James             1842-1910    A prominent American
                                       philosopher and
                                       psychologist
Louis Lewin               1850-1929    A German pharmacologist,
                                       he attempted the first
                                       systematic classification of
                                       psychoactive drugs with his
                                       book "Phantastica" (1924)
Carl Hartwich             1851-1917    Author of "Die menschlichen
                                       Genussmittel'
Karl Koller               1857-1944    An Austrian
                                       ophthalmologist, he
                                       introduced cocaine as a
                                       local anaesthetic for eye
                                       surgery
Henry Havelock Ellis      1859-1939    A British psychologist,
                                       physician and writer, he
                                       experienced on himself the
                                       effect of mescaline
John William              1869-1929    An American botanist
  Harshberger                          specialized in plant
                                       geography, ecology
Aleister Crowley          1875-1947    A well-known recreational
                                       drug experimenter

Alexandre Rouhier         1875-i968    Author of "Le peyotl la plante
                                       qui fait les yeux emerveilles"
Kurt Beringer             1893-1949    A German psychiatrist and
                                       neurologist
Aldous Huxley             1894-1963    A prominent English writer,
                                       novelist, and philosopher
Max Rinkel                1894-1966    The first doctor in North
                                       America to work with LSD,
                                       he has been President of the
                                       Society of Biological
                                       Psychiatry
Heinrich Kluver           1897-1979    A German psychologist
Robert Gordon Wasson      1898-1986    Ethnomycologist
Harold A. Abramson        1899-1980    An early advocate of
                                       therapeutic LSD
Albert Hofmann            1906-2008    He synthesized and
                                       experienced on himself the
                                       effect of LSD
Weston La Barre           1911-1996    American anthropologist
                                       and scholar in the field of
                                       ethnobotany
Leo Zeff                  1912-1988    An American psychologist
                                       and psychotherapist, he
                                       pioneered the use of LSD,
                                       ecstasy/MDMA, and other
                                       psychoactive drugs in
                                       psychotherapy
Julius Axelrod            1912-2004    Prominent biochemist, he
                                       was awarded the Nobel
                                       Prize

John Cunningham Lilly     1915-2001    American physician,
                                       psychoanalyst, psychonaut,
                                       neuroscientist and
                                       philosopher
Richard Evans Schultes    1915-2001    American biologist, he is
                                       considered the father of
                                       modern ethnobotany
Ronald Arthur Sandison    1916-2010    A British psychiatrist and
                                       psychotherapist, he
                                       pioneered the use of LSD in
                                       psychiatry and clinical
                                       psychology
Humphry Fortescue         1917-2004    He invented the word
  Osmond                               psychedelic
Abram Hoffer              1917-2009    A Canadian psychiatrist
Oscar Janiger             1918-2001    Experimental psychiatrist
                                       and psychotherapist, he is
                                       known for his LSD research
Athanasios Kafkalides     1919-i989    A Greek neuropsychiatrist
Timothy Francis Leary     1920-1996    Author of "The Psychedelic
                                       Experience"
Murray Elias Jarvik       1923-2008    He invented the nicotine
                                       patch
Alexander Theodore        1925-2014    He resynthesized MDMA,
  "Sasha" Shulgin                      and, after recognizing its
                                       potential for therapeutic
                                       use, gave it to a therapist
                                       friend, Leo Zeff
Walter Norman Pahnke      1931-1971    A minister, physician, and
                                       psychiatrist, he is most
                                       famous for the "Good

                                       Friday Experiment"
Stanislav Grof            1931-today   A Czech psychiatrist, one of
                                       the founders of the field of
                                       transpersonal psychology
                                       and a researcher into the
                                       use of non-ordinary states of
                                       consciousness
Claudio Benjamin          1932-today   A principal developer of
  Naranjo Cohen                        Enneagram of Personality
                                       theories and a founder of
                                       the Seekers After Truth
                                       Institute
Barbara Myerhoff          1935-1985    An American anthropologist
Jack Sarfatti             1939-today   An American theoretical
                                       physicist, specialized in the
                                       study of quantum physics
                                       and consciousness
Andrew Weil               1942-today   Founder and director of the
                                       Arizona Center for
                                       Integrative Medicine
Terence Kemp              1946-2000    An American ethnobotanist,
  McKenna                              mystic, psychonaut,
                                       lecturer, author, and an
                                       advocate for the responsible
                                       use of naturally occurring
                                       psychedelic plants
Jonathan Ott              1949-today   He has coined the term
                                       "entheogen"
Dennis Jon McKenna        1950-today   An American
                                       ethnopharmacologist, and
                                       research pharmacognosist

Giorgio Samorini          1957-today   A free, independent scholar
                                       in the field of psychoactive
                                       drugs and compounds
Julie Holland             1965-today   An American
                                       psychopharmacologist,
                                       psychiatrist
Patrick Lundborg          1967-2014    A writer on psychedelic
                                       culture and author of books
                                       like "Psychedelia" and "The
                                       Acid Archives"
Patrick Karel Kroupa      1969-today   A heroin addict from age 14
                                       to 30, he got clean through
                                       the use of the hallucinogenic
                                       drug ibogaine
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Author:Bragazzi, Nicola Luigi; Khabbache, Hicham; Vecchio, Ignazio; Martini, Mariano; Perduca, Marco; Zerbe
Publication:Cosmos and History: The Journal of Natural and Social Philosophy
Date:Jan 1, 2018
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