How Altered Consciousness Is Changing Psychiatry
From self-induced trance to psychedelics, altered states of consciousness are experiencing a renewed interest in the scientific community for their therapeutic value.
GENEVA — Swiss psychiatrist Valérie Picard describes her weekly trance practice as being plunged into a feeling of intense happiness: “I often find myself parachuted into magnificent natural landscapes. With a feeling of weightlessness all my perceptions are amplified, in a kind of ecstasy of the senses”
Working at the Belmont Clinic in Geneva, she does not, however, have the sort of profile of someone traditionally interested in these techniques. These explorations of states of consciousness are still considered by many to be controversial.
Far from being a shaman, Picard learned to induce trance during a training session organized at her hospital. "In Switzerland, we are much more open to alternative approaches to care," she says. This did not prevent her from being shaken during her first attempt.
“For a rational doctor trained in neuroscience and psycho-pharmacology, experiencing this type of hallucinatory state of depersonalization, which one might think are psychotic episodes, is disturbing to say the least," she admits. “What reassured me and convinced me to continue was that I could come out of it at any time and that I was in control.”
Drawn to the shamanic drum
The very rigorous approach of Corine Sombrun, the facilitator of this training, also played an important role in making this technique credible in her eyes. Sombrun was trained by a shaman from the Tsaatan ethnic group, in the north of Mongolia, on the borders of Siberia. But while many Westerners are quick to appropriate the “shaman” title, Sombrun does not. The story of her initiation was also told by director Fabienne Berthaud in the film A Bigger World, released in 2019, with Sombrun played by famed French actress Cécile de France.
It all began in 2001 during a report for the BBC, where Sombrun had to film a trance rite, during which she herself was going to be caught, against her will, by the sound of the drumbeat by the shaman. This was a sign for the local officiant that she was part of the inner circle — there are only 30 shamans in Mongolia for three million inhabitants. The officiant strongly encouraged her to come back to learn to master her potential. Otherwise, he explained, it would go from bad to worse.
Hallucinogenics are not science fiction
For eight years, Sombrun spent two to three months each year in the middle of nowhere, without any comfort, near the one who was chosen to train her and who, confronted by her whining, gave her the nickname of "little asshole."
"Contrary to what one may think, shamans do not take themselves seriously,” she says. “What many in the West see as a power, they view rather as a burden.”
At the same time, Sombrun was also going to try to understand and explain, in the so-called "civilized" world, what happened to her. Obviously, at the beginning, her doctor sent her to a shrink. But with perseverance, she found more attentive ears, in particular with the neuropsychiatrist Pierre Flor-Henry, from the Alberta Hospital in Edmonton, Canada. In 2006, Flor-Henry was the first to have her undergo electroencephalograms (EEG) to study the activity of her brain in a trance state.
In this state, we are more resistant to pain and feel a bigger physical force.
It took him 10 years to publish an article in a scientific journal attesting that the shamanic trance was not "a psychopathological condition." He found that there was a very clear modification of the cerebral activity with a change of control from the left hemisphere, master of logic and analysis, to the right hemisphere, source of imagination, intuition and dreams. In short, it was not science fiction.
In the meantime, Sombrun continued her fight, the story of which she tells in La Diagonale de la Joie (Albin Michel) (“The Joy Diagonal”).
"The skepticism I was confronted with gave me the drive," she says, especially since the practice of trance allows her to discover the unsuspected capacities for self-healing in her body.
"I could note that, in this state, we are at the same time more resistant to pain and feel a bigger physical force,” she says. “So we can potentially revisit some of our traumas and integrate them better."
But for Sombrun, it’s not enough to show that the state of trance is not a matter of theatricalization, as many ethnologists have long believed, or, worse, of psychiatry. She also wants to prove that, far from being reserved for a few shamans, this capacity is in each of us. And that we don't necessarily need to go to Siberia or ingest hallucinogenic plants to access it.
Trained as a musicologist, she recorded and reworked in the studio the most effective drum sequences to induce this state. After a lot of trial and error, she managed, thanks in particular to the help of the mathematician Cédric Villani, to model a sound loop lasting a few minutes. Tested with some students of the Ecole des Beaux-Arts, this recording had an unexpected result: 16 out of 20 entered into a trance.
Better still, she was able to attest that after much practice, the students were able to do without the sound loop. In fact, in order to dissociate this technique from any cultural reference to shamanism, she called it "self-induced cognitive trance". This was a big step forward that allowed her to enlarge the community of expert "trancers” and to submit her postulates to scientific studies on a wider basis. This was essential to giving credibility to the results.
A pioneer in the study of altered states of consciousness such as comas, the University Hospital of Liège soon followed suit. First, it performed "high-density" EEGs, then enlarged the sample to 27 subjects in a trance state.
Audrey Vanhaudenhuyse, a neuropsychologist devoted to the treatment of pain, says that “to deepen the study, we associated the MRI images and the EEG tracings of the 'experimenters' with the account of their experience that we also processed using a speech analysis software.”
The results corroborate those of Edmonton and explain an undeniable change in brain organization. However, showing that something is happening does not prove anything about a supposed therapeutic interest. To objectify its studies, the University Hospital of Liège has just launched a four-year research program with the goal of evaluating the impact of cognitive trance to relieve the emotional distress and pain of oncology patients. The study also aims to compare it with meditation and hypnosis, which are already established and used widely.
The history of hypnosis
Although it has rekindled interest in the trance of shamanic traditions, Sombrun's technique is not the first practice inducing a modified state of consciousness to have been studied and used for its therapeutic potential. The history is even very old. The term "trance" itself was first used in Great Britain by the followers of spiritualism. It was also taken up by the Austrian doctor Franz-Anton Mesmer, father of "animal magnetism." And above all, it was used by the French neurologist Jean-Martin Charcot, the great theorist of hypnotic trance to treat hysteria.
"Psychotherapies were in fact born from the study and use of hypnosis," says psychologist and hypnotherapist Antoine Bioy. Bioy is co-head for the training of a new and unique university diploma that has just been launched by the University of Paris-VIII Vincennes-Saint-Denis on the study of trances and modified states of consciousness.
"In the course of the 20th century, psychologists gradually dissociated themselves from this field, no doubt for fear of being dispossessed of a form of power over their patients,” Bioy says. “Only psychoanalysis continued to base its practice on hypnotic states."
It was not until the 1960s that trance became an object of study again. It was partially via anthropology, which was interested in possession trances practiced in traditional African and Amazonian societies. The resurgence was also through psychology, which revived investigations into the subject but by preferring to refer to it as modified states of consciousness.
Psycho-anthropologist David Dupuis explains that "the term 'trance' is in fact a catch-all term which designates very diverse states whose only common point is to vary with regard to the ordinary state of consciousness.”
Dupuis adds that this “normal state” has never been really defined and can differ according to individuals and their unique cultures.
In Indonesia, dancers in trance after shaman recited incantations are performing the mystical dance Zapin Api, where the dance toward a fire, accompanied by gambus and kompang musical instruments.
Meditation to mescaline
In fact, starting in the 1990s, people began to take an interest in the potential of another technique: meditation. Long before Corine Sombrun, the Buddhist monk Mathieu Ricard had exposed his meditating brain to EEG equipment at the University Hospital of Liège.
"While they may all provoke a different experience and perception of reality, all these methods are not interchangeable,” Antoine Bioy says. “In hypnosis, one can direct the feeling by suggestion. Meditation is more self-centered. As for cognitive trance, it plunges you into a very direct, abrupt feeling of reality. One leaves one's reflexive thought to be only perception with the impression of no longer belonging.”
During Bioy’s first experience, the psychologist saw himself metamorphosed into a kind of maggot hiding under the leaves, perceiving with great acuity the humidity all around him.
70 years ago, psychedelic therapies were widespread in the United States.
The development of neuroscience and medical imaging techniques since the turn of the millennium has finally allowed us to start quantifying these very diverse states of modified consciousness. This includes those induced by hallucinogenic substances. LSD, ecstasy, mescaline, iboga, psilocybin, ayahuasca, bufo alvarius (extracted from the glands of the toad of the same name)... Like cognitive trance or hypnosis, these psychedelics are also the object of renewed interest in the scientific and medical community.
"In the 1950s and 1960s, psychedelic therapies were widespread in the United States and considered safe," says psychiatrist Christian Sueur, president of the Group for Research and Clinical Studies on Cannabinoids. Then the excesses of LSD-based recreational practices led to the UN Single Convention on Narcotic Drugs that prohibited the use, even medical, of hallucinogenic substances. This did not prevent institutions like Imperial College London or John Hopkins University in Baltimore from resuming their research on the subject a little later. Nor the most motivated consumers, who went to traditional tribes to experience their effects a bit “on the fly."
Therapeutic effects of psychedelics
Among the most popular destinations in the last 30 years is Peru, where thousands of Westerners have gone to take ayahuasca under the control of local healers. This is often done for personal development or even to heal traumas. Nicknamed the "purga" or the "maestra," this hallucinogenic plant is ingested in a mixture that causes vomiting and has the power to make you do a kind of express psychotherapy.
It brings up buried things and reconnects you with who you are.
"Many mention a real emotional catharsis," says David Dupuis, who between 2008 and 2013 interviewed and followed a hundred practitioners for his doctoral thesis.
“There is no magic wand," says Coralie, who has made many trips to Peru. “Ayahuasca brings up buried things and reconnects you with who you are. But afterwards, it is up to you to transform your life.”
Pierre, another user, shares a similar sentiment: "This plant helps you remove the filters with which you perceive your reality, but it's up to you to embody what it teaches you." Hence the interest of being accompanied by a therapist.
"Since November 2020, the UN has changed its doctrine regarding psychedelics,” says Christian Sueur. “It still considers them dangerous narcotics, but now it admits that they have a therapeutic interest." Several American states are in the process of decriminalizing them.
New mapping of consciousness
In France, we’re still far from legalization. However, some renowned voices in the field no longer hesitate to argue their potential. "While traditional psychiatric therapies have broken down, the psychedelic renaissance could revolutionize both psychiatry and addictology," writes professor Amine Benyamina in an editorial in the November 2020 issue of the Addiction Prevention Network (Respadd). The research still needs to be continued. The opportunity is there to build a bridge to traditional societies that have real knowledge on the subject, but also there’s a need to invent a legal and ethical framework for safe use.
The advantage of the self-induced cognitive trance promoted by Corine Sombrun, who founded the TranceScience Research Institute with a team of international researchers, is that, as its name indicates, it does not need any substance to be triggered. "It's an ability that we all have within us but we don't use it very much," she says.
The objective of the degree at Paris-VIII — which welcomes for its first class 35 medical, psychology and research students — is to understand the motives and to evaluate the potential therapeutic indications by comparing them with other induction methods.
“We notice that many individuals undergoing psychotherapy remain stuck in self-accusatory ruminations," Antoine Bioy says. “The trance experience could break this mechanism by opening them up to another reality of themselves.”
For Bioy, experimentation with these modified states of consciousness also has a more ecological, even humanistic dimension. It could put us back on the road to a more respectful relationship with our environment. "It's a way to commune with all living things and to touch our total interdependence," says the explorer-filmmaker Priscilla Telmon, who has practised a lot during her reports on sacred rites in traditional societies.
If, for some, all this is a return to magical thinking, others see the beginning of a new mapping of consciousness. In fact, for Bioy, it’s time to consider that "our rational consciousness is partial." And that we are also made up of a whole variety of other states. We have an enlarged consciousness to which the trance can give us access — and we should stop being afraid of it.
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