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Limitations to 'Psychedelics and the science of self experience'

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Abstract

We read Matthew Nour and Robin Carhart-Harris editorial with enthusiasm. The Section History Ethics & Philosophy of Psychiatry Queensland meets once a month in the Brisbane area. The writers of this eLetter met at the end of March 2017and discussed this editorial. We congratulate and we agree with Derek K Tracy in “highlights of this issue” that it is a mesmerising read. We found that the editorial is well composed, interesting in its logic and we notice the structure to the editorial. There are 6 separate headings: defining the self, self in neuroscience, self disturbance , psychedelics as a window into the self, therapeutic implications, and conclusions. We discussed that overall the paper only presents a reductionist, non-compatabilist, materialist theory of self, which becomes a fallacy of a circular argument. For the purpose of this editorial such a reduction of a complex philosophical area is indeed suitable, but ignores other models and we miss a paragraph on these limitations. We feel that it would have assisted if there had been frank comments on the reductionist approach and the diverse facets to self relevant to psychiatry.
The quantitative meta analysis locates self experience to default mode network in a cortical median and anterior cingulate brain anatomy. Other theories of the self in the light of memories and emotions for example, made us curious about FMRI findings in the amygdala and hippocampal areas. However acknowledging FMRI as “correlation”, the subtext is identity with the subject of the correlation.
We were reminded that after all the self is a very complex philosophical area that preoccupied many eminent thinkers in the past (Remes P& Sihvola) We believe that also a discussion of other pathologies of self, multiple selves associated with dissociation and multiple personality disorder would have been more inclusive. We were curious about the role of language especially in people who speak several languages as the narrative (McAdams) of the self is based on semantics.
We believe that a paragraph highlighting the limitations to the approach would have made this a more balanced editorial. Also referencing evidence on psychedelics and clinical experience of their use, references that highlight a number of the risks and side effects (Larsen JK and Johnson M et al) would have added . There are merits in to including that psychedelics are also a potential double edged sword.
Beckmann, K. M., Brennan, R., & Arnold, J. (2017). Limitations to’Psychedelics and the science of self experience’.
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Thijs Roes

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