The Therapeutic Potential of Psychedelics on Reducing Rumination: A Mini-Review

Rumination is a well-established risk factor for the onset and maintenance of depression and anxiety and is associated with various other forms of psychopathology (e.g., eating pathology, obsessive-compulsive disorder, posttraumatic stress disorder). Evidence suggests that rumination is a transdiagnostic process that may play a key role in the comorbidity of such disorders. However, rumination and related disorders are often difficult to treat and frequently resistant to change, often rendering conventional modes of treatment (e.g., psychotherapy and pharmacology) unsuccessful. A recent renaissance of psychedelic research shows promise in treating psychopathology with potential for acting on ruminative processes. Though theoretical explanations for the therapeutic effects of psychedelics implicate the reduction of rumination via changes in the default mode network, a limited number of studies have tested this link directly. This mini-review examined the existing empirical research linking psychedelic use and rumination. The results from six studies demonstrate a significant association between psychedelic use and lower levels of rumination, providing evidence that rumination may serve as a key cognitive factor in psychedelic treatment. Further research should explore whether identifying ruminative tendencies and encouraging the practice of disengaging from rumination before the psychedelic treatment session, particularly for those who report high levels of rumination, may result in better adherence to "letting go" during the session. Moreover, due to a possible diminishing effect of therapeutic outcomes after a single psychedelic dosing session, "booster" sessions may provide psychological relief once more; however, financial treatment costs are expectedly high. As such, understanding the role of rumination in psychedelic treatment can be critical for maintenance strategies (e.g., rumination-focused cognitive behavior therapy, mindfulness techniques) in postdosing integration sessions and long-term treatment plans.