The Default Mode Network In Therapeutics
Although the DMN plays a significant role while active, its suppression could be just as important for therapeutics — and perhaps our ancestors were more aware of this in some ways than we are right now. For centuries, psychedelic drugs have intrigued and mystified people — used by shaman in spiritual ceremonies to induce hallucinations, and sometimes demonized as evil and dangerous, but it’s only been over the last two decades that the medical potential of these substances has really been understood in detail.
In fact, a growing body of evidence demonstrates that drugs like psilocybin, the chemical agent in magic mushrooms and other substances can bring relief to patients suffering with depression, anxiety, and addiction disorders if given in a supervised environment. How does it work?
Psilocybin is a chemical that primarily targets your brain’s serotonin system, where its molecules bind with chemical receptors that we recognize as the brain’s default mode network, particularly the 5-HT2A receptors. When this fusion takes place, the DMN is suppressed, creating an experience where the individual is lifted from their own ego — the need to protect their own image, and they can revisit aspects of their lives from a different viewpoint.
Dr. Ekaterina Malievskaia, the co-founder of a mental health company called Compass Pathways that has researched psychedelic treatments, explains how such a therapy might happen: “With skillful support, and in carefully controlled, supported environments, they’re able to process traumatic events, memories, and generate more insights. With subsequent skillful integration, they’re able to embody those insights, and that could lead, potentially, to changes in unhelpful behavioral patterns.”
Decades of neuroimaging have demonstrated that our DMN is routinely active for most of the time when we’re awake. Its signal is strongest during some of our more repetitive tasks that we do without a lot of thought, but it also comes into play when we worry about the next day, when we find ourselves lost in daydreams, or when we retrieve memories. Neuroscientists think of it as an autopilot mode from the brain, that allows us to conserve energy, but the network can make it difficult for people with depression or anxiety to function.
In such a situation, psychedelic agents could potentially serve as a type of “reset mode.” When activity in the DMN tones down, the brain is able to break loose from its routine patterns, and other regions of the brain are forced to interact with each other and make new connections.
Studies conducted by researchers like Malievskaia have found that these beneficial effects can potentially outlast the psychedelic agents — with some cases showing the effect for months after the drugs leave a patient’s system.
Given the high skepticism of these agents, and their high potency, Malievskaia and her colleagues are being cautious in their public outreach, knowing that it was an arduous process to gain enough acceptance for these compounds to be studied. “What we’re not talking about is this idea of self-medicating, or going on these wild trips,” she says. “This really is a practice with deep scientific rigor, with high-efficacy outcomes.”
What A Session Might Be Like
According to Kelsey Ramsden, the president and CEO of Mind Cure Health, a psychedelic therapy session in the near future won’t seem much different from a current music therapy session. The patient would enter an inviting living room area with licensed therapists who supervise their doses of psilocybin. You would be invited to either sit or lie down with a blindfold and listen to music until the effects die down.
Afterward, there would be an “integration period,” of days and weeks following your experience with psilocybin — to make sense of everything felt and seen during that short period, a chance for the patient to relate the experience to themselves and their own community. A ballot initiative recently passed that approved psychedelic agents for medicinal use and the first clinical trials are expected to take place as early as 2023.
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