Investigating the relationship between changes in metaphysical beliefs and death anxiety following a significant psychedelic experience

Abstract

Research examining the potential of the psychedelic experience to alter attitudes toward death is steadily emerging. However, the specific mechanisms leading to this change are not well understood. The present study investigated the potential relationship between changes in metaphysical beliefs and changes in death anxiety following a single significant psychedelic experience. A total of 155 participants completed a retrospective questionnaire that included questions about their acute experience and changes in death anxiety and metaphysical beliefs following a significant psychedelic experience. Although some participants reported an increase in death anxiety, there was an overall significant reduction in death anxiety from before to after the experience. Improvements in death anxiety were positively correlated with changes in belief in panpsychism, but no other measured metaphysical beliefs. The findings from this exploratory study provide direction for future research looking at the relationship between changes in metaphysical beliefs and death anxiety in the context of psychedelic experiences.

A growing body of research has revealed the potential therapeutic utility of psychedelic drugs (Aday et al., 2020; Andersen et al., 2021). Although the use of these substances comes with a variety of risk factors that are still being unpacked (Tupper et al., 2015), psychedelic use in naturalistic or clinical settings can lead to both improvements in measures of well-being and decreases in symptoms of psychopathology (Carhart-Harris & Goodwin, 2017; Raison et al., 2022). One psychological improvement often reported following psychedelic use is a reduction in death anxiety (see Moreton et al., 2020). However, the specific mechanisms leading to this change are not well understood. The present study investigates the relationship between changed metaphysical beliefs following a psychedelic experience and changes in death anxiety.

Death attitudes and death anxiety

Individuals hold a range of attitudes toward death and the dying process (Lehto & Stein, 2009; Wong et al., 1994). These include attitudes about oneself dying, the process of dying, seeing loved ones die, and the state of being dead (Lehto & Stein, 2009). The attitudes one holds toward death can vary significantly and are influenced by factors, such as religion, culture, or personal experience (Pehlivanova et al., 2022). One aspect of thinking about death includes an individual’s anxieties and fear, whether it be anxiety toward their own death or the death of others (Lehto & Stein, 2009). Death anxiety is a specific theoretical construct referring to apprehension or anxiety generated by the knowledge of one’s own mortality and the inevitability of death (Lehto & Stein, 2009). Death anxiety can also be conceptualized as a “fear of death,” and forms part of a broader concept of “existential distress” that has been used in the literature on the use of psychedelics in the context of serious or life-limiting illness (Schimmel et al., 2022). Death anxiety has been posited as being a transdiagnostic factor that contributes to the emergence of a variety of psychiatric presentations (Iverach et al., 2014; Menzies & Menzies, 2023). From this perspective, death anxiety may be an over-determined manifestation of a range of more specific death-related fears (Menzies & Menzies, 2023), such as the annihilation of the self, potential negative consequences in a variety of afterlife situations, or concerns for how loved ones will respond to the loss.

Psychedelic use and changes in death attitudes and death anxiety

The use of psychedelics can change attitudes and anxieties toward death (Moreton et al., 2020). When compared to placebo (although see Muthukumaraswamy et al., 2021 for a discussion of the issues with existing placebo controls in psychedelic research), a single moderate dose of psilocybin has been shown to lead to a reduction in negative attitudes toward mortality and a greater acceptance of limited life expectancy in patients with advanced stage cancer (Grob et al., 2011; Ross et al., 2016; Schimmel et al., 2022). LSD-assisted psychotherapy has also demonstrated significant reductions in anxiety and fear of death in those with life-threatening diseases (Gasser et al., 2014). There is emerging evidence that psychedelic experiences can also significantly change attitudes toward death in healthy populations. For example, Griffiths et al. (2011) found participants were more likely to endorse accepting beliefs about death after a psychedelic experience, such as ‘death is a transition into something greater’, ‘death is not an ending’, and ‘death is part of a process’. Interestingly, the N,N-Dimethyltryptamine (DMT) experience has shown similar phenomenology to near-death experiences (Timmermann et al., 2018), and research comparing psychedelic experiences to near-death experiences has also shown that psychedelic use can lead to similar reductions in fears of death (Sweeney et al., 2022).

Psychedelics and metaphysical beliefs

A range of acute and enduring effects of the psychedelic experience have been suggested as the underlying mechanisms underpinning the salutary effects of psychedelic use. The enduring effect that is of particular interest in the present study is changes in metaphysical beliefs. “Metaphysical” here refers to beliefs an individual holds regarding the nature and structure of reality, including core beliefs about the nature of consciousness in living and non-living entities (Timmermann et al., 2021). These may range from physicalist beliefs, which emphasize a material construction of reality and mind, to dualistic approaches which emphasize the separation between body and mind or spirit, to more modern solutions to the “hard problem” of consciousness, such as panpsychism, which posits that consciousness is a fundamental feature of all things (Timmermann et al., 2021).

An emerging body of research suggests that psychedelic use can often lead to changes in metaphysical beliefs (Griffiths et al., 2019; Nayak & Griffiths, 2022; Timmermann et al., 2021). For instance, Timmermann et al. (2021) found that psychedelic use led to a greater endorsement of non-physicalist beliefs when compared to physicalist beliefs. Additionally, Nayak and Griffiths (2022) found that the psychedelic experience led to greater attributions of consciousness in a range of living and non-living entities. These changes were shown to persist up to six months later, suggesting that psychedelic use can lead to both immediate and enduring changes in metaphysical beliefs.

As there has been limited research into psychedelic use and metaphysical beliefs, little is known about why or how psychedelics may change beliefs about the nature and structure of reality (Nayak & Griffiths, 2022; Timmermann et al., 2021). However, two studies have found that ratings of mystical experience predicted changes in metaphysical beliefs (Nayak & Griffiths, 2022; Timmermann et al., 2021). One component of the psychedelic-induced mystical experience is a unitive sense of connectedness between the self, others, and environment, which may lead people to attribute belief in an ultimate consciousness (Nayak & Griffiths, 2022). However, further research is needed to understand how the subjective effects of the psychedelic experience may be related to changes in metaphysical beliefs.

It has previously been suggested that changes in metaphysical beliefs might be one mechanism through which psychedelics might reduce death anxiety (Moreton et al., 2020). Belief changes that move away from physicalist beliefs may allow the opportunity for individuals to consider that consciousness in some form might survive death (Moreton et al., 2020). For example, holding the belief that consciousness is not wholly dependent on the physical processes of the human body may reduce anxiety about the death of one’s physical body. However, no published research to date has looked specifically at correlations between changes in death anxiety and changes in metaphysical beliefs in the context of psychedelic experiences.

The present study

Multiple studies suggest reductions in death anxiety as a relatively common outcome of the psychedelic experience (Schimmel et al., 2022). Despite this, there is limited research investigating the underlying mechanisms of reduced death anxiety following psychedelic experiences (Moreton et al., 2020). As we specifically recruited individuals who had had significant psychedelic experiences that led to a change in “death anxiety or death attitudes,” we hypothesized significant reductions in death anxiety from before to after a psychedelic experience. We also hypothesized significant changes in metaphysical beliefs, marked by a reduction in physicalist beliefs and an increase in non-physicalist beliefs. We hypothesized that these changes in metaphysical beliefs would significantly correlate with changes in death anxiety, with changes in physicalist beliefs showing a positive correlation with changes in death anxiety and changes in non-physicalist beliefs showing a negative correlation with changes in death anxiety. We also hypothesized that changes in death anxiety would be predicted by acute subjective effects of the psychedelic experience and an additional exploratory aim was to investigate which specific metaphysical beliefs would best predict changes in death anxiety.

Methods

Participant eligibility

To be eligible for the study, respondents had to be at least 18 years old, fluent in English, and have had at least one significant psychedelic experience that they felt altered their attitudes or anxieties about death. A psychedelic substance was classified as any of the classic psychedelics (LSD, DMT, psilocybin, ayahuasca, or mescaline; Nichols, 2016). A significant or personally meaningful psychedelic experience referred to any subjective experience in which individuals felt a marked difference in cognition, sensory perception, affect, or behavior as a result of a psychedelic substance (Griffiths et al., 2011; Hodge et al., 2023; Nichols, 2016).

Participant recruitment

Participants were recruited through local and international online platforms and social media applications, in addition to snowball sampling (i.e., additional participants recruited through referrals from participants who completed the study). The advertisements were distributed amongst psychedelic-specific groups with a link to an anonymous questionnaire. A total of 226 responses were recorded, with a median completion time of 21 min. Seventy-one responses were excluded due to incomplete (N = 66) or illegitimate (N = 5) answers (i.e., Submitting 0 in all fields or completing the questionnaire within a few minutes). The final sample size included 155 participants (97 men, 53 women, four non-binary, and one “prefer not to say”; M_age = 29.5 (SD = 7.78). In the significant psychedelic experience, participants selected which of the psychedelic drugs they had taken, and the breakdown was as follows: 78 instances involved LSD, 38 included psilocybin, 39 involved ayahuasca, 29 included DMT, and 13 involved mescaline. A sensitivity analysis concluded sufficient power to detect correlations of r = .22 based on our sample size of 155, power = .80, and alpha = .05. Additional information on participant demographics including geographic distribution, lifetime psychedelic use; characteristics of the single chosen psychedelic experience and changes in variables broken down by drug type is presented in Supplementary Material.

Study procedure

Data was collected with the online survey platform Qualtrics. Participants were provided informed written consent before completing the questionnaire. The specific aims and hypotheses of the study were not revealed to avoid biased responses or demand characteristics. Demographic information, such as age, gender, ethnicity, religious beliefs, and country of residence was first collected. This was followed by information about an individual’s lifetime use of psychedelics (i.e., the types of substances and frequency of psychedelic experiences across their lifetime). Participants were then asked to answer questions relating to one specific instance of psychedelic use and their beliefs and attitudes in the three months before and up to three months after this single experience. Upon completion, participants were given debriefed information about the nature of the study, including specific aims of the study and links to confidential support services. As compensation, participants were offered the option to enter an anonymous raffle to win one of two $100 gift vouchers. All procedures were approved by the University of Wollongong Human Research Ethics Committee (protocol 2022/100).

Measures

Psychedelic experience measures

Lifetime use

Participants were asked to indicate which psychedelic substances they had previously used and how many times they had taken psychedelics in their lifetime, including when the last time of use was.

A single instance of psychedelic use

Participants were asked to indicate which psychedelic substances were used in a single significant or personally meaningful instance of psychedelic use. This included information about the subjective level of dose, route of administration, additional substances taken at the time, and how long ago the experience was. The subjective level of dosage was recorded due to the difficulties in assessing objective levels of dose in a retrospective study.

Acute effects measures

Mystical Experience Questionnaire-30 (MEQ30; Barrett et al., 2015)

The MEQ30 measures the key characteristics that make up the construct of a mystical experience: a sense of unity or interconnectedness with one’s surroundings, increases in positive affect, changes to a sense of time and space, and feelings of ineffability (Hood & Francis, 2013; MacLean et al., 2012). Each of the 30 items (e.g., “Feeling that you experienced eternity or infinity”) is measured using a six-point Likert-type scale (from ‘None’ to ‘Extreme’. The mean score was calculated for each participant. The MEQ30 is a widely used measure and has shown good internal consistency, predictive validity, and convergent validity (Barrett et al., 2015; Ching et al., 2023; Garcia-Romeu et al., 2019; Griffiths et al., 2008; MacLean et al., 2012), and there was excellent internal consistency in the current sample (α = .97).

Psychological Insights Questionnaire (PIQ; Davis et al., 2020, 2021)

The PIQ measures the degree to which individuals felt like they discovered or gained new insights about their behavior, beliefs, attitudes, or emotions as a result of a psychedelic experience (e.g., “[I] Realized ways my beliefs may be dysfunctional”). The PIQ is a 23-item questionnaire, with each item measured on a 6-point Likert-type Scale ranging from ‘No, not at all’ (0) to ‘Extremely, more than ever before in my life’ (5). The internal consistency in the current sample was excellent (α = .97). The average score in the present sample was 2.90 (SD = 1.07), which is similar to Davis et al. (2020) who reported a mean of 3.38 (SD = 0.91).

Enduring effects measures

Metaphysical Beliefs Questionnaire (MBQ; Timmermann et al., 2021)

The MBQ is a novel measure capturing changes in an individual’s metaphysical beliefs. This measure was chosen as it is the only existing measure capturing changes to metaphysical beliefs as a result of the psychedelic experience at the time of the study planning stage. The MBQ was presented twice, and the language presented asked participants to rate how they felt in the three months before and up to three months after a single significant psychedelic experience, based on similar retrospective psychedelic studies (e.g., Raison et al., 2022). The MBQ contains 13 items scored on a scale from 1 (strongly disagree) to 7 (strongly agree). Supporting the convergent validity of the measure, Timmermann et al. (2021) showed that scores on non-physicalist beliefs positively correlated with an existing measure of “belief in a unifying spiritual principle.” In the current sample, good internal consistency was observed for both subscales: PB (pre α = .79, post α = .83) and NPB (pre α = .90, post α = .90).

Death Attitude Profile-Revised—Fear of Death Subscale (DAP-R; Wong et al., 1994)

The DAP-R Fear of Death subscale was used to measure death anxiety. Each of the seven items (e.g., “The prospect of my own death arouses anxiety in me”) was rated on a scale from 1 (strongly disagree) to 7 (strongly agree). As with the MBQ, this measure was presented twice in the same fashion. Prior studies support good internal consistency and construct validity of the DAP-R (Zuccala et al., 2022). In the current sample, there was excellent internal consistency for both pre (a = .90) and post (a = 93).

Statistical analyses

Paired sample t-tests were conducted to assess within-subject changes in metaphysical beliefs and fear of death. Following Timmermann et al. (2021), we looked at both subscales (physicalist and non-physicalist beliefs), as well as the individual items. This was because there are significant differences in the content domain of each item and evidence suggests that psychedelics might not affect all metaphysical beliefs (e.g., Nayak & Griffiths, 2022). One aim of the present study was to provide more clarity about which specific metaphysical beliefs might be most affected by psychedelic experiences and how these specific beliefs might relate to changes in death anxiety.

To test correlations between acute subjective effects and changes in metaphysical beliefs and death anxiety, we first computed residualized change scores for metaphysical beliefs and fear of death by regressing post-scores on pre-scores and computing a residual change score for each individual. This approach has the advantage over using raw change scores in that it controls for potential relationships between pre-scores and change scores (e.g., participants with higher initial death anxiety might on average have a greater reduction in death anxiety) and thus account for potential regression to the mean (Castro-Schilo & Grimm, 2018). The Benjamini-Hochberg False Discovery Rate procedure was employed to control for multiple comparisons and all hypothesis tests were included in the adjustment (i.e. all before-after comparisons and correlations).

Results

Paired samples t-tests

A summary of the paired samples t-tests can be seen in Table 1. Averaged over participants, there was a significant overall increase in non-physicalist beliefs. However, only two individual statements had significant changes: MPQ1 (Ontological Transcendentalism) and MPQ7 (Non-Naturalism). There was a significant average reduction in Fear of Death before and after the psychedelic experience. Interestingly, participants had varied responses to the experience. A total of 81 participants reported a decrease in their fear of death, as indicated by a negative change score. On the other hand, 57 participants reported an increase, as indicated by a positive change score. Additionally, 17 participants reported no change, with identical pre- and post-experience scores for fear of death.

Table 1. Paired-samples t-tests for death attitudes and metaphysical beliefs, and correlations between change scores (N = 155).

Variable	Before		After		t	p	B-H Adjusted p	Cohens d	Change correlated with MEQ	Change correlated with PIQ	Change correlated with change in Fear of Death
	M	SD	M	SD
DAPR: Fear of death	4.53	1.39	4.13	1.54	3.90	<.001	.006	0.31	−.251*	.077
MBQ: Physicalist beliefs	4.32	1.14	4.37	1.34	−0.54	.589	.687	−0.04	.155	.245*	.169
MBQ: Non-physicalist beliefs	4.29	1.27	4.54	1.31	−2.50	.014	.038	−0.20	.462*	.196*	−.078
There exists another separate realm or dimension beyond this physical world that can be experienced or visited. (Ontological transcendentalism)	4.17	1.64	4.59	1.67	−2.86	.005	.019	−0.23	.475*	.195*	−.183
Visiting such immersive “realms” or “worlds” can sometimes depend on a supernatural/magical transition process or event. (Supernatural transcendentalism)	4.28	1.76	4.43	1.83	−1.06	.291	.374	−0.09	.343*	.124	−.064
There are two separate realms of existence, the physical (body, brain and external world) and the mind, the latter being non-physical/non-material. (Dualism)	4.23	1.76	4.53	1.73	−2.06	.041	.089	−0.17	.285*	.094	−.036
There is just one primary reality: the mind and/or consciousness and all material things derive from it. (Idealism)	4.19	1.66	4.23	1.83	−0.30	.761	.786	−0.02	.227*	.199*	.112
There is just one primary reality: the physical; the mind (and/or consciousness) is just physical/functional properties of the brain and has an entirely material explanation. (Materialism)	4.07	1.68	4.02	1.82	0.34	.737	.774	−0.03	.108	.273*	.127
There are other realms of existence which are more important than everyday reality. (Primacy of other realms)	4.35	1.65	4.69	1.65	−2.17	.032	.075	−0.17	.360*	.103	−.039
The universe obeys a unifying principle which is beyond any possible material or scientific explanation. (Non-naturalism)	4.35	1.64	4.77	1.69	−2.70	.008	.027	−0.22	.361*	.149	−.045
The universe obeys a unifying principle which is (in theory) completely addressed by a material or scientific explanation. (Naturalism)	4.15	1.63	4.22	1.84	−0.47	.643	.709	−0.04	.130	.211*	.154
The physical world is an illusion generated by consciousness or the mind. (Solipsism/Idealism)	4.32	1.64	4.39	1.66	−0.47	.640	.709	−0.04	.283*	.284*	.129
Mind, consciousness, or soul is a fundamental quality of all things in the universe, either animate or inanimate. (Panpsychism)	4.45	1.64	4.70	1.65	−1.69	.094	.162	−0.14	.427*	.232*	−.240*
My conscious experience is entirely a construction of reality performed by my brain. (Internalism about consciousness)	4.39	1.50	4.44	1.68	−0.36	.719	.768	−0.03	.135	.187	.077
My ‘self’ is entirely a construction of my brain. (Virtual self theory)	4.46	1.45	4.42	1.72	0.28	.783	.796	0.02	.115	.220*	.156
My experience and my ‘self’ are deeply rooted in my body and its interactions with the world and not the sole construction of my brain. (Enactivist approach to consciousness)	4.54	1.53	4.76	1.64	−1.60	.112	.177	−0.13	.136	.094	.101

Note. * Indicates adjusted B-H p-value <.05.

Correlations

As seen in Table 1, MEQ scores were significantly correlated with residualized change scores for fear of death, non-physicalist beliefs subscale of the MBQ, and eight out of the 13 individual metaphysical belief statements. PIQ scores were significantly correlated with residualized changed scores for both physicalist and non-physicalist subscales of the MBQ and seven out of the 13 individual belief statements. PIQ scores were not significantly correlated with changes in fear of death. Interestingly, changes in fear of death were largely unrelated to metaphysical beliefs with the only significant correlation after being with the item measuring panpsychism.

Discussion

The present study investigated changes in death anxiety following a psychedelic experience and correlations with acute subjective effects and changes in metaphysical beliefs. Although a substantial proportion of participants reported increases in death anxiety, there was a significant average reduction in death anxiety. There was an average overall increase in non-physicalist beliefs, but only two belief statements had significant increases: ontological transcendentalism and non-naturalism. The only metaphysical belief change that significantly correlated with changes in death anxiety was the belief in panpsychism. Mystical experience and psychological insight predicted change in more than half of the metaphysical belief statements. However, only mystical experiences and not psychological insights predicted changes in death anxiety.

The overall reported reduction in death anxiety is not surprising for two reasons. Firstly, psychedelic-induced reductions in death anxiety have been widely reported in prior research (e.g., Blomstrom et al., 2020; Griffiths et al., 2016; Moreton, Arena, et al., 2023; Moreton, Burden-Hill, et al., 2023; Sweeney et al., 2022). Secondly, the study specifically sampled participants who had a self-reported change in death anxiety or death attitudes. However, the reduction in death anxiety was not a foregone conclusion as the study wording also included recruitment of individuals who had had a worsening of death anxiety. Nevertheless, considering that recruitment that includes online psychedelic forums likely leads to a positive bias in sampling as people who have had predominantly bad experiences with psychedelics are perhaps less likely to actively participate in online psychedelic communities, it is informative that a substantial proportion of this survey of naturalistic psychedelic experiences reported an increase in death anxiety. These findings dovetail with the findings of other recent research by Moreton, Arena, et al. (2023), which also found a significant number of participants reporting increases in death anxiety. As there have been recent suggestions that harms from psychedelic use may be underrepresented in psychedelic research (van Elk & Fried, 2023), potential increases in death anxiety represent an important investigation for future research.

Interestingly, changes in death anxiety on the whole did not show large correlations with changes in metaphysical beliefs. This was surprising for several reasons. Firstly, many outcomes of psychedelic use may correlate through virtue of being related to the strength of the experience. Secondly, changed metaphysical beliefs have previously been suggested to play a causal role in reducing death anxiety following a psychedelic experience (Moreton et al., 2020). As such, it was somewhat surprising to see none of the MBQ items pertaining to “other realms” beyond the physical significantly correlating with changes in death anxiety, as the existence of other realms opens up the possibility of life after physical death. However, there was a significant correlation with changes in Panpsychism, which posits that consciousness, or some form of mind or experience, is a fundamental attribute inherent to everything in the universe, extending beyond just humans and animals.

To our knowledge, there is no published research specifically looking at panpsychism and death anxiety. However, there are several speculative mechanisms through which panpsychist beliefs might reduce death anxiety. Firstly, the belief that consciousness is a fundamental aspect of the universe may offer comfort in the idea that some form of consciousness continues to exist after physical death, thereby reducing the fear of “nothingness” or nonexistence. Secondly, panpsychist beliefs may strengthen notions of universal interconnectedness, which could make the idea of death less isolating and more a part of a natural, universal process. Previous research in existential psychology has found connectedness to be a predictor of reduced death anxiety, with a connection with nature being suggested to help people deal with existential concerns (Passmore & Howell, 2014). Relevantly, Nayak and Griffiths (2022) recently reported psychedelically induced changes in the endorsement of allocation of consciousness to non-human primates (63–83%), quadrupeds (59–79%), insects (33–57%), fungi (21–56%), and plants (26–61%), which may be in part due to increased panpsychist views, since adopting panpsychist beliefs could logically broaden the spectrum of entities perceived as conscious. The increased sense of connectedness with nature that might come from such belief changes could be a potential mediator of the relationship between increased panpsychism and lower death anxiety. Replicating the correlation found in the present study and unpacking potential mechanisms is a topic for future research.

Although we observed a correlation between changes in panpsychism and death anxiety, our study did not detect significant changes in panpsychism beliefs pre- and post-psychedelic experience, diverging from Timmermann et al. (2021), who reported increased endorsement of panpsychism following psychedelic experiences. Two main factors might explain this discrepancy: gender differences and the set and setting of the experience. Timmermann et al. highlighted ‘emotional synchrony’—the shared emotional connection among group members—as crucial in moving away from physicalist beliefs. This effect was particularly pronounced in younger women, suggesting that gender and age play significant roles in these belief shifts. In our study, the predominance of male participants could explain the lesser shift in metaphysical beliefs observed. Additionally, the concept of ‘pre-state identity fusion’—the sense of unity with the group before the psychedelic experience—underscores the importance of the ceremonial context, which our study’s more varied settings might not have fully captured. Our inclusion of reports from non-ceremonial, non-retreat, and unguided experiences suggests that the setting significantly influences the extent and nature of belief changes. This points to a broader question: to what degree are changes in metaphysical beliefs induced by psychedelics mediated by contextual factors that shape the subjective and enduring effects of the experience?

Limitations

The present study has limitations that must be considered. The retrospective nature of this study introduces forms of response bias, such as social desirability, effort justification, hindsight bias, and availability heuristics, which tend to be more salient in retrospective pre/post-tests compared to standard pre/post-tests (Lam & Bengo, 2003; Moore & Tananis, 2009; Pratt et al., 2000). One limitation of the present study was that participants’ perceptions of recall accuracy were not measured, which future studies could use to control for. Nevertheless, the benefits of using a retrospective pre-post design in certain contexts—such as when assessing interventions that change subjective interpretations—can outweigh the limitations. For instance, the retrospective pre-post design can provide more accurate measures of change than traditional pre-post measures under conditions where internal states or definitions of constructs are likely to change as a result of the intervention (otherwise known as “response shift bias”; Howard & Dailey, 1979; Sprangers & Schwartz, 1999). Nevertheless, to help address bias, we incorporated several methodological safeguards, such as the maintenance of anonymity and anchoring participant responses to a specific time-period before the experience. Future research in psychedelics could employ comparative studies to systematically evaluate how different methodological approaches, such as prospective vs. retrospective assessments, influence the risk of bias, thereby elucidating the most accurate and reliable ways to measure the effects of psychedelic experiences.

The study’s cross-sectional nature limits the ability to establish causal relationships between variables. Also, on the topic of causation, the current study worked within a paradigm where psychological explanations provide explanations for the underlying mechanisms of change from psychedelic use, which is not necessarily the case. Additionally, the current study compared various serotonergic psychedelics and it is likely that the effects of psychedelics on metaphysical beliefs and death anxiety differ to some extent across these substances. However, the present study was not sufficiently powered for meaningful comparisons across these substances. Lastly, although single-item measures allow for concise data collection, the present single items used to measure metaphysical beliefs may not comprehensively capture these beliefs. Rennie et al. (2023) recently introduced a new measure aimed at providing a more comprehensive and accessible measure of metaphysical beliefs that will provide a useful tool for assessing psychedelic-induced changes in metaphysical beliefs.

Implications and future directions

The main implication of the present results is that reductions in death anxiety following psychedelic experience may be most closely related to panpsychism, as compared with other metaphysical beliefs. Nevertheless, future research is needed with larger sample sizes to provide further evidence of this relationship that may be split by type of drug and provide stronger evidence of a unique role of belief in panpsychism. Although changes from pre- to post-experience may not have been driven by the drug, the present study also provides evidence suggesting that psychedelic experiences may cause increases in death anxiety in some instances. More research is needed into factors that might drive the direction of the effect of psychedelics on death anxiety.

The transdiagnostic nature of death anxiety (Menzies & Menzies, 2023) highlights the importance of further research into the effects of psychedelics on death anxiety. Negative attitudes toward death, including death anxiety, are distressing for individuals and can involve significant spiritual suffering (Iverach et al., 2014; Menzies et al., 2019). Current interventions are limited and often only produce modest results (Menzies et al., 2018; Pehlivanova et al., 2022). Treatments often lack long-term improvements and changes to patients’ core existential fears (Menzies et al., 2019). By further understanding the mechanisms of the psychedelic experience that lead to changes in death attitudes and anxiety, we may gather crucial information to inform types of treatment and treatment outcomes.

The present study reported that mystical experiences, rather than psychological insights, were significantly correlated with changes in death anxiety. This finding aligns well with previous research that has emphasized the role of mystical experiences in altering attitudes toward death (e.g. Moreton, Arena, et al., 2023; Moreton, Burden-Hill, et al., 2023). Mystical experiences often involve a sense of unity and transcendence of time and space, which could potentially alleviate fears associated with death. On the other hand, psychological insights, though valuable for personal growth and understanding, did not show the same relationship with death anxiety in the present study. This suggests that the transformative power of mystical experiences may be a key factor in understanding how psychedelics can influence attitudes toward death, reinforcing the need for further research in this specific area.

In this study, both mystical experiences and psychological insights were found to be significant predictors of changes in metaphysical beliefs. This highlights the complex interplay between different types of experiences during psychedelic sessions and shifts in philosophical or spiritual viewpoints. Future research could delve into the specific aspects of the acute experience that contribute to these belief changes: Are there particular qualities or intensities of mystical experiences that are more likely to lead to shifts in metaphysical perspectives? What kinds of insights are most influential, and do they interact with mystical experiences in shaping new beliefs? What other components might play a role? As the study of the effects of psychedelics on metaphysical beliefs is still in its infancy, little is presently known about why and how psychedelics might change metaphysical beliefs.

Conclusion

Before the current study, examination of the psychological mechanisms underpinning changes in anxieties and attitudes toward death was limited. The current study investigated whether changes in metaphysical belief may be implicated in changes to death attitudes and death anxiety. Averaged over participants, there was a significant reduction in death anxiety, and this was predicted by the strength of the mystical experience. Additionally, changes in death anxiety significantly correlated with changes in belief in panpsychism, and no other measured metaphysical belief. This study lays the groundwork for future research aimed at understanding the complex interplay between metaphysical beliefs and death anxiety, particularly in the context of psychedelic experiences.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.