Mystical-Type Experience Measures: What the Questionnaires Measure

What is being measured

In psychedelic research, a "mystical-type experience" is a label for a set of self-reported feelings that people sometimes describe during a session. NIDA gives one example: a dreamlike, euphoric state in which a person feels they have no personal boundaries and are one with the universe. [1] The word "mystical" is a research category used by questionnaires. It does not say anything about whether the experience reveals spiritual truth, and it is not a judgment about anyone's beliefs.

The best-known tool is the Mystical Experience Questionnaire. The 30-item revised version (MEQ30) was first built from an online survey of experiences with psilocybin-containing mushrooms that people rated on average eight years after the event. It was later checked against data pooled from five laboratory experiments (184 participants). The check supported its reliability and showed that MEQ30 scores predicted lasting change in attitudes, behavior and well-being that participants attributed to the session, even after accounting for how intense they rated the drug effects. [2]

What that means in plain terms: the MEQ30 is a self-report rating of the experience, and the "outcome" it predicted was also self-report of change that people credited to the session. That is useful information. It is not a clinical rating of depression or anxiety.

Evidence labels used here: promising but limited, mixed and insufficient evidence. They are explained where used.

Where the idea came from

In a double-blind study of 30 volunteers who regularly took part in religious or spiritual activities, psilocybin increased measures of mystical experience, and at 2 months people rated the experience as having substantial personal meaning and spiritual significance. They also reported sustained positive changes in attitudes and behavior, and community observers rated changes that were consistent with this. [3] Those volunteers were hallucinogen-naive and chosen for their religious or spiritual practice, so the results do not stand for everyone.

Scores and clinical outcomes in trials

• Cancer-related distress. In a randomized double-blind crossover trial of 51 people with life-threatening cancer and symptoms of depression or anxiety, the mystical-type experience on session day mediated (statistically accounted for) the effect of psilocybin dose on therapeutic outcomes. [4]
• Treatment-resistant depression. In 20 patients, ratings of "oceanic boundlessness" (a mystical-type scale) and "dread of ego dissolution" (an anxiety-type scale) were related to depression score changes at 5 weeks. [5]
• A systematic review. Twelve studies using psilocybin, ayahuasca or ketamine were reviewed. Ten of twelve found a significant association, mediation or prediction between mystical experience and symptom reduction. But the studies were mostly small, lacked diversity, and 6 of 12 were open-label, which makes them prone to bias. [6] Label: promising but limited.
• Survey of planned experiences. In an online prospective survey, higher mystical-type ratings had a positive effect on the change in well-being, while "challenging experience" and "visual effects" ratings did not. Baseline personality and trait variables had the strongest effect on well-being change. [7] This was not a trial, so no causal claim can be made.
• A proposal, not a result. One paper argues that the subjective effects of psychedelics are necessary for their enduring benefits and account for most of them. The authors present this as a proposal, based on studies in which certain subjective effects predicted outcomes after intensity was controlled for. [8]

Measures versus clinical outcomes

A clinical trial for depression usually has a main outcome such as change in a clinician-rated depression scale (for example the MADRS) at a set time. In one phase 2 trial in treatment-resistant depression, the main outcome was MADRS change at week 3, and adverse events occurred in 77% of participants. [9] Mystical-type scores are a different kind of measure. They describe the session. They do not replace clinical outcomes, and a high score does not prove that a person improved. Also, mediation or correlation does not prove that the experience is what produces the benefit. See proposed mechanisms vs proven clinical outcomes and how to read a psychedelic clinical trial.

Cautions

• The MEQ30 was built and validated with psilocybin data, so these sources do not show it works the same way for other substances.
• NIDA lists expectations, mood and surroundings among the many factors that shape effects, so ratings reflect more than the drug. [10] See context and expectancy.
• A frightening session can occur alongside meaning-making. See acute anxiety and distress.

This page is education only. It does not recommend seeking a particular kind of experience.