The way of O: phenomenology of psychedelic use and the path to ultimate reality

Abstract

There has been a renewed interest in the clinical applications of psychedelics, with increasing use for a variety of psychiatric conditions. Individuals often describe psychedelic sessions as among the most significant experiences in their lives, emphasising the sense of awe, connectedness, and spiritual transformation they undergo. They can also feel they are experiencing truth and becoming aware of reality in deeper ways than ever before. As elusive as it is inescapable, Wilfred Bion’s ‘O’ denotes contact with absolute truth, approachable through an intuitive awareness of reality that goes beyond cognitive strategies seeking to ‘know’. The state of mind cultivated to enter into such realms, to reach O, and indeed to achieve mystical experiences under psychedelics, is one of surrender and transcendence of a cognitively weighted, sensorially bound interfacing with reality. This paper outlines the neurophenomenology of psychedelic use, the concept of O, and their clinical significance vis-à-vis contemporary psychodynamic thinking. As our understanding deepens regarding the changes associated with use of psychedelics, we can draw parallels between acquisition of insight and subsequent reshaping of one’s templates and perspectives taking place through use of these drugs, and the process that occurs over the course of a psychoanalysis or psychodynamic therapy.

Keywords:

• Neuroscience
• psychedelics
• Bion
• neuropsychoanalysis

Disclosure statement

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

Additional information

Notes on contributors

Christopher W. T. Miller

Christopher W. T. Miller, M.D., is a psychiatrist and psychoanalyst practicing at the University of Maryland Medical Center and an associate professor at the University of Maryland School of Medicine.