Altered Sense of Self and Ego Dissolution

Plain-language meaning

"Ego dissolution" (also called "ego death" in popular writing) is a research term for a weakened sense of being a separate self. People describe feeling that the boundary between themselves and the world is blurred. The term is used to describe an experience that some people report. It is not a target, a sign of progress, or something this library suggests anyone seek.

Evidence labels used here: insufficient evidence (a point rests on one or two small or non-randomized studies) and mixed.

How it is measured

The Ego-Dissolution Inventory (EDI) is an 8-item self-report scale. In a validation study, 691 people filled in an internet questionnaire about 1,828 past experiences with psychedelics, cocaine or alcohol. EDI scores rose with the amount taken for psychedelics but not for cocaine or alcohol, and the scale correlated strongly with a measure of "unitive" experience from a mystical-experience questionnaire. [1] The authors described ego-dissolution as a key feature of the psychedelic experience. [1]

Limits: this was an online, after-the-fact survey, so it shows the scale behaves consistently, not how common ego dissolution is or how it affects health.

What controlled studies add

• LSD and amount. In 16 healthy people, the highest of the LSD amounts tested produced greater ego dissolution than the next one down, and significant anxiety. Good drug effects reached a ceiling at the lower amount. [2]
• LSD and psilocybin compared. In 28 healthy participants, the higher LSD amount produced more ego dissolution, impaired control and cognition, and anxiety than the lower LSD amount. [3]
• Dreamlike imagery. Loss of self-boundaries was linked with dreamlike mental imagery after LSD in 25 volunteers. [4]
• Brain imaging. In 15 healthy volunteers, psilocybin-related ego dissolution was associated with reduced connectivity between a memory-related brain region and higher cortical regions, and with weaker integrity of the "salience network". [5] This is a correlation in a small imaging study, not an explanation of how or why the experience happens.

Ego dissolution and clinical outcomes

Findings are mixed and mostly come from small studies.

• In a study of 20 people with treatment-resistant depression who had psilocybin, a questionnaire scale called "oceanic boundlessness" and another called "dread of ego dissolution" were both related to later changes in depression scores at 5 weeks. The authors read this as showing that the quality of the experience matters. It analyzed experience ratings from one session in a small group, and an association does not show that the experience caused the change. [6]
• A systematic review of 12 studies of psilocybin, ayahuasca or ketamine looked at "mystical experience", a bundle of features that includes ego dissolution. It found associations with symptom reduction in 10 of 12, but the studies had small samples, little diversity, and 6 of 12 were open-label (no blinding). [7]

A strong experience is not proof of benefit, and a frightening one is not proof of harm. See why experiences vary and mystical-type experience measures.

Other substances

NIDA says some people who take psilocybin describe feeling they have no personal boundaries and are one with the universe, an experience some researchers call "oceanic self-boundlessness". It can be blissful, but it can also be frightening and cause fear or panic. [8] For esketamine, the label lists depersonalization and derealization (feeling detached from yourself or surroundings) among dissociative effects. [9] See dissociation.

Safety note

Altered sense of self can be distressing and can make judgment unreliable. The FDA label for esketamine says patients with psychosis should be carefully assessed before treatment because of its dissociative effects. [9] Research guidelines advise excluding volunteers with a personal or family history of psychotic disorders. [10] See psychosis vulnerability. In the US, call 911 for immediate danger or 988 for a suicide or mental-health crisis.