Sub-Acute Effects of Psilocybin on Empathy, Creative Thinking, and Subjective Well-Being

Creativity and empathy are important for everyday social functioning and subjective well-being, and previous work shows both are reduced in stress-related psychopathologies such as depression, anxiety disorders and PTSD. Creativity is framed as having convergent (CT) and divergent (DT) components: CT denotes generating a single optimal solution, whereas DT denotes generating many varied ideas. Emotional empathy (EE) refers to sharing others' feelings, while cognitive empathy (CE) denotes recognising and understanding others' emotions. Earlier research indicates that these processes are plastic and can be enhanced by interventions, and anecdotal and quasi-experimental studies suggest that a single administration of psychedelics such as ayahuasca, LSD or psilocybin can enhance creative thinking and emotional empathy; clinical studies have also reported sustained improvements in well-being after psilocybin administration. However, it remained unclear whether such effects persist beyond the acute intoxication period and how changes in creativity and empathy relate to subjective well-being. Mason and colleagues designed the present naturalistic study to assess sub-acute effects of a single psilocybin administration on convergent and divergent thinking, cognitive and emotional empathy, and life satisfaction. The authors hypothesised that DT, CT, EE and satisfaction with life would be enhanced sub-acutely while CE would remain unchanged, and that improvements in creativity and empathy would correlate with increased life satisfaction. They also hypothesised that participants with prior psilocybin experience would report higher baseline life satisfaction than psilocybin-naïve participants.

Participants were volunteers attending psilocybin retreats in the Netherlands organised by the Psychedelic Society UK. Fifty-five participants (26 female; mean age 34.8, SD 8.9) consented to take part. Most were European (80%); education levels were predominantly undergraduate or graduate. About 52.7% had used psilocybin previously and 49.1% had used other psychedelics. Facilitators screened attendees and excluded individuals with psychiatric disorders, psychiatric medication use or relevant medical conditions. Participation was voluntary and approved by an institutional ethics committee. The intervention was a single-day administration of psilocybin-containing truffles provided in tea form during the retreat. Truffles were crushed and infused in ginger tea; participants could re-infuse and later consume residual truffle. A truffle sample (15 g, Psilocybe Hollandia) was analysed and contained 1.9 mg psilocybin and 10.5 mg psilocin; participants ingested an average 34.2 g (SD 8.9) of truffles, corresponding to a reported average psilocin consumption of 27.1 mg after applying a metabolic conversion factor. Assessments were conducted at three time points: baseline (the evening before ingestion), the morning after ingestion (in person at the retreat) and seven days after ingestion (online). Cognitive and affective outcomes were measured using the Picture Concept Task (PCT) for convergent and divergent thinking, the Multifaceted Empathy Test (MET) for cognitive and emotional empathy (implicit and explicit EE, and CE), and the Satisfaction With Life Scale (SWLS) for global life satisfaction. Acute subjective effects were retrospectively rated the morning after using ten visual analogue scales (VASs). A sample of truffles was analysed by HPLC to determine psilocybin/psilocin content. For statistical analysis the investigators used linear repeated measures models with Session (baseline, morning after, seven days) as the within-subject factor. Because of the small sample at seven days, separate repeated measures models were fitted for each outcome variable and covariance structures chosen by best fit (examples given include compound symmetry heterogeneous and AR1). When Session effects were found on the MET, additional analyses separated responses by valence (positive/negative). Post-hoc contrasts compared baseline with follow-ups using Bonferroni correction. For outcomes with a Session effect, the authors ran mixed models including previous psilocybin experience (yes/no) as a between-subject factor to examine moderation by experience. Correlational analyses of change scores were planned (the Methods section states Pearson correlations), but reported correlations in the Results are Spearman rank correlations. Acute VAS ratings were analysed with one-sample t-tests against zero.

Attrition occurred across assessments: 55 participants completed parts of the test battery at baseline, 50 completed parts the morning after, and 22 completed parts at seven days. The truffle analysis yielded 1.9 mg psilocybin and 10.5 mg psilocin in a 15 g sample; mean truffle ingestion was 34.2 g (SD 8.9), with an average estimated psilocin consumption reported as 27.1 mg. Convergent thinking (PCT correct associations) showed a significant Session effect (F 2,37.48 = 5.94, p = .01). Participants made more correct associations at seven days compared to baseline (p = .01; Cohen's d = .46). There was no significant change in convergent thinking the morning after psilocybin. Divergent thinking showed Session effects on Fluency (F 2,38.22 = 5.27, p = .01) and Originality (F 2,45.09 = 7.23, p = .002). Compared to baseline, Fluency (number of associations) increased the morning after (p = .01; d = .47) and Originality increased the morning after (p = .001; d = .55). The Ratio (originality/fluency) did not show a significant Session effect (p = .12). By seven days, Fluency and Originality were not significantly different from baseline. Cognitive empathy (MET performance) did not show a significant Session effect (F 2,23.26 = 3.18, p = .06); participants recognised on average 22 emotions across sessions. Emotional empathy showed a significant Session effect for explicit EE (F 2,48.31 = 4.29, p = .02): explicit concern for pictured people increased the morning after ingestion (p = .02; d = .45). Valence-specific analyses indicated increased concern for negative emotions the morning after (F 2,38.04 = 5.87, p = .01; p = .01; d = .49) with no effect at day 7. Implicit EE (arousal ratings) also showed a Session effect (F 2,23.71 = 10.64, p = .001): implicit arousal to emotional stimuli was higher the morning after, and implicit arousal to negative stimuli remained increased at seven days (p = .05; d = .41). Explicit EE for positive stimuli did not show a significant Session effect (p = .09). Satisfaction with life (SWLS) demonstrated a significant Session effect. Contrasts showed SWLS increased both the morning after (p < .001; d = .77) and at seven days (p = .001; d = .50) relative to baseline. The extracted text reports baseline and morning-after SWLS means (baseline mean 22.3, SE .96; morning-after mean 26.5, SE 1.03) but the seven-day mean is not clearly reported in the supplied extraction. Regarding previous psilocybin experience, 29 participants reported prior use, 21 reported being naïve and five did not disclose. Mixed-model analysis of SWLS showed main effects of Session (F 2,52.44 = 16.768, p < .000) and Psilocybin experience (F 1,46.93 = 5.39, p = .025); those with prior psilocybin exposure reported higher baseline life satisfaction than naïve participants (p = .012; d = .39). No other outcome showed differential sub-acute effects by prior experience. Correlational analyses (reported as Spearman r_s) found medium-to-strong positive associations between increases in EE and increases in SWLS. Specifically, changes in implicit arousal to positive stimuli correlated with changes in SWLS from baseline to the morning after (r_s = .43, p = .05) and baseline to seven days (r_s = .61, p = .02). Changes in explicit concern from baseline to the morning after correlated with SWLS changes from baseline to seven days (r_s = .57, p = .03). Changes in concern for people in positive states correlated with SWLS changes from baseline to seven days (r_s = .58, p = .03). No significant correlations were found between PCT (creativity) outcomes and SWLS, or between PCT and MET variables. Acute psilocybin experience ratings on the VASs showed significant increases on all items (one-sample t-tests, t(49) = 14.56–23.73, p ≤ .000; d = 2.05–3.35).

Mason and colleagues interpret their findings as evidence that a single psilocybin administration in a naturalistic retreat setting is associated with sub-acute enhancements in aspects of creative thinking, emotional empathy and subjective well-being. They emphasise a temporal and construct-specific pattern: divergent thinking and emotional empathy were increased the morning after ingestion, while convergent thinking improvements emerged at seven days. Cognitive empathy remained largely unchanged. The authors note that implicit arousal to negative emotional stimuli persisted to day seven, whereas some other DT and EE effects returned to baseline by that point. The discussion places these results alongside prior work showing that serotonergic psychedelics can acutely increase divergent thinking and EE; comparisons are drawn with studies of ayahuasca and LSD that reported similar acute DT enhancements and mixed CT effects. The authors suggest a therapeutic rationale in which increased DT shortly after ingestion could promote psychological flexibility and the generation of new coping strategies, and subsequent longer-term improvements in CT might be harnessed during integration sessions. Limitations are acknowledged: small sample size and substantial attrition reduced power at the seven-day follow-up; selection bias and the non-random, self-selected retreat sample limit generalisability; and the naturalistic, uncontrolled setting and lack of placebo control mean set, setting and expectation effects cannot be ruled out. The authors note that prior literature has observed similar effects across clinical, experimental and naturalistic contexts, which they interpret as supporting a drug-related contribution to the observed changes, but they recommend future placebo-controlled experimental and longitudinal clinical research to more rigorously test causal mechanisms and to assess whether changes in creativity and empathy mediate therapeutic outcomes. In sum, the investigators conclude that psilocybin taken in a social retreat context was associated with sub-acute increases in certain components of creativity and emotional empathy and with higher life satisfaction, and that these effects outlasted the acute state, potentially providing a ‘‘window of opportunity’’ in which therapeutic interventions could be more effective.