Our states of consciousness change as we move from wakefulness to sleep. We also can alter our consciousness through other means. This final section will consider how we can alter our states of consciousness through the use of psychoactive drugs, hypnosis, trances, and meditation. In addition, we will briefly introduce some cross-cultural perspectives on states of altered consciousness.

Psychoactive Drugs

On April 16, 1943, Albert Hoffman—a Swiss chemist working in a pharmaceutical company— accidentally ingested a newly synthesized drug. The drug—lysergic acid diethylimide (LSD)— turned out to be a powerful hallucinogen. Hoffman went home and later reported the effects of the drug, describing them as seeing the world through a “warped mirror” and experiencing visions of “extraordinary shapes with intense, kaleidoscopic play of colors.” Hoffman had discovered what members of many traditional cultures around the world already knew, there are substances that, when ingested, can have a powerful effect on perception and consciousness. Drugs operate on human physiology in a variety of ways and researchers and medical doctors tend to classify drugs according to their effects (Biswas-Diener & Teeny, 2023). Here we will briefly cover three categories of drugs: hallucinogens, depressants, and stimulants.

Hallucinogens

It is possible that hallucinogens are the chemicals that have, historically, been used the most widely to alter consciousness. Traditional societies have used plant-based hallucinogens such as peyote, ebene, and psilocybin mushrooms in a wide range of religious ceremonies. Hallucinogens are substances that alter a person’s perceptions, often by creating visions or hallucinations (sensory experiences that are not based on physical realities in the environment). There are a wide range of hallucinogens and many are used as recreational substances in industrialized societies. Common examples include marijuana, LSD, and MDMA (also known as “ecstasy”). Marijuana is made from the dried flowers of the hemp plant and is often smoked to produce euphoria (a feeling of intense excitement and happiness). The active ingredient in marijuana is called THC and it can also produce distortions in the perception of time, and rambling, unrelated thoughts. THC is sometimes associated with increased hunger or excessive laughter. The use of marijuana has been legalized in many states and is increasingly used for medical purposes, such as for the management of nausea or treating glaucoma (Biswas-Diener & Teeny, 2023). Marijuana is also used throughout the word as an entheogen—a substance that alters consciousness for religious purposes (Ferrara, 2021).

Depressants

Depressants are substances that, as their name suggests, slow down the body’s physiology and mental processes. Alcohol is the most widely used depressant. Alcohol reduces inhibition, meaning that intoxicated people are more likely to act in ways they normally would not. Alcohol works by increasing the action of a common inhibitory neurotransmitter, GABA. Increased GABA also affects the visual and motor systems of the brain and so produces physical effects, such as loss of balance and coordination (Biswas-Diener & Teeny, 2023).

Other common depressants include opiates/opioids (also called “narcotics”), which are substances synthesized from the poppy flower. Opiates stimulate endorphin production in the brain and because of this they are often prescribed as pain killers by medical professionals. Unfortunately, because opiates such as Oxycontin, reliably produce euphoria, their use is often abused, which has contributed to huge numbers of opioid-related deaths in the United States every year (Biswas-Diener & Teeny, 2023).

Stimulants

Stimulants are substances that “speed up” the body’s physiological and mental processes. Two commonly used stimulants are caffeine —the chemical found in coffee and tea—and nicotine, the active chemical in cigarettes and other tobacco products, including e-cigarettes. These substances are both legal and relatively inexpensive, leading to their widespread use. Many people are attracted to stimulants because they feel more alert when under the influence of these drugs. As with any drug there are health risks associated with consumption. For example, excessive consumption of caffeine can result in anxiety, headaches, and insomnia. Also, smoking cigarettes— the most common means of ingesting nicotine—is associated with higher risks of cancer (Biswas-Diener & Teeny, 2023).  90% of lung cancer among heavy smokers is directly attributable to smoking (Stewart & Kleihues, 2003).

Illegal stimulants. such as cocaine and methamphetamine (also known as “crystal meth” or “ice”), are also commonly used. These substances act by blocking the “re-uptake” of dopamine in the brain. This means that the brain does not naturally clear out the dopamine and that it builds up in the synapses, creating euphoria and alertness. As the effects wear off, it stimulates strong cravings for more of the drug. Because of this these powerful effects, stimulants are highly addictive (Biswas-Diener & Teeny, 2023).

Hypnosis

Hypnosis is a state of extreme focus where people pay minimal attention to external stimuli. You may have experienced a similar sensation called “flow”, when you were fully immersed in a task, such as playing a video game. When you experience flow, you are concentrating entirely on what you were doing such that you lose track of time and became less aware of what is around you (Csikszentmihalyi & Nakamura, 2018). Flow is an altered state of consciousness, which most of us experience from time to time in our normal lives. Although both flow and hypnosis feel relaxing and pleasant, one important difference is that during hypnosis, people become very open to suggestion. However, this does not mean that you would do things that you wouldn’t normally do (Lynn et al., 1990). Also, contrary to many depictions of hypnosis in books and movies, you can’t be hypnotized against your will (Lynn & Kirsh, 2006).  In therapeutic settings, clinicians may use hypnosis to reduce anxiety and help patients relax. Some psychologists use hypnosis to draw out forgotten (repressed) memories, but as you will read in the upcoming chapter on Memory, this technique is highly controversial. Hypnosis can also provide pain relief and reduce the side effects of medications. In one study, burn patients were treated with either hypnotherapy, pseudo-hypnosis (i.e., a placebo condition), or no treatment at all. Afterward, even though people in the placebo condition experienced a 16% decrease in pain, those in the true hypnosis condition experienced a pain reduction of nearly 50% (Patterson et al., 1996). Hypnosis has also been used in the treatment of depression and anxiety, smoking cessation, and weight loss (Alladin, 2012; Elkins et al., 2012; Golden, 2012; Montgomery et al., 2012; Williamson, 2019).

Brain imaging studies have demonstrated that hypnotic states are associated with global changes in brain functioning (Del Casale et al., 2012; Guldenmund et al., 2012). Hypnosis generally causes reduced activation in the medial prefrontal cortex, an area associated with day dreaming and sense of self. Hypnosis frequently uses visual imagery and so not surprisingly, hypnosis reliably activates visual areas in the occipital cortex. Similarly, imagining pain relief  during hypnosis, reduces activity in pain-related areas of the brain, such as the somatosensory cortex, and the anterior cingulate cortex in the limbic system (Landry et al., 2017; Williamson, 2019).

Historically, hypnosis has been viewed with some suspicion because of its portrayal in popular media and entertainment. Therefore, it is important to make a distinction between hypnosis as an empirically based therapeutic approach versus as a form of entertainment. Contrary to popular belief, individuals undergoing hypnosis usually have clear memories of the hypnotic experience and are in control of their own behaviors. While hypnosis may be effective in enhancing memory or a skill, such enhancements are very modest in nature (Raz, 2011).

How exactly does a hypnotist bring a participant to a state of hypnosis? Although techniques vary, there are four consistent components associated with hypnosis (National Research Council, 1994). These include:

1. The participant is guided to focus on one thing, such as the hypnotist’s words or a ticking watch.
2. The participant is made comfortable and is directed to be relaxed and sleepy.
3. The participant is told to be open to the process of hypnosis, to trust the hypnotist and let go.
4. The participant is encouraged to use their imagination.

People vary in terms of their ability to be hypnotized, but research suggests that most people are at least moderately hypnotizable (Kihlstrom, 2013). People can also be trained to self-hypnotize, which is an effective way to alleviate pain and psychological distress (Eason & Parris, 2019).

Meditation

There are a number of different meditation techniques but a central feature of all of them is to regulate physical and emotional states to bring about feelings of inner peace (Chen et al., 2013; Lang et al., 2012). Some practices focus the person’s attention to help them quiet their mind. The focus might be a single sound, image, or sensation, such as in transcendental meditation, where a person silently repeats a sound called a mantra. Other focused attention practices include using breathing techniques, body scanning, or silently repeating phrases relating to love and kindness. Mind-body practices like yoga, qigong, and tai chi also serve to focus the mind. In contrast, other meditation practices involve open monitoring, where instead of blocking out thoughts and feelings, people are encouraged to be aware of their thoughts, feelings, and sensations, in a non-judgmental way (Lutz et al., 2008). Mindfulness meditation is a popular example of open monitoring (Zeidan et al., 2012).

Meditative techniques have their roots in religious practices (Figure 4.15), but their use has grown in popularity among practitioners of alternative medicine in the West. Research indicates that meditation may help reduce blood pressure, and the American Heart Association suggests that meditation might be used in conjunction with more traditional treatments as a way to manage hypertension, although there is not sufficient data for a recommendation to be made (Brook et al., 2013). Like hypnosis, meditation also shows promise in stress management, improving sleep quality (Caldwell et al., 2010), treating mood and anxiety disorders (Chen et al., 2013; Freeman et al., 2010; Vøllestad et al., 2012), and for pain management (Reiner et al., 2013).

Culture and altered states of consciousness

In many parts of the world, different cultures embrace experiencing altered states of consciousness as part of religious, wellness and/or healing practices, and other rituals related to problem solving. In tribal societies and Eastern cultures, practices in which people experience altered states of consciousness are important, mystical, and sacred. They may allow people to feel connected with God(s), ancestors, and/or themselves. These altered states include samadhi in yoga, moksha in Hinduism, satori in Zen Buddhism, fana in Sufism and Ruach Hakodesh in Kabbalah. Even in the West, people have reported experiencing altered states of consciousness during mystical or spiritual practices, such as religious ecstasy or speaking in tongues, which is common within the Pentecostal religion. Multiple different cultures in Asia, the Middle East, Africa, and the Americas have used psychoactive substances as entheogens (Ferrara, 2021).

Many world cultures use shamanic healers (magico-religious leaders) who typically enter into trance states during various rituals. During the trances, the shamans often “travel” to a supernatural location where they experience vivid imagery filled with symbolic meaning. Trance states increase the kinds of slow waves that we see in deep sleep (Winkelman, 2012) and can be induced in a number of ways, including rhythmic drumming, chanting, dancing, or through sensory deprivation, celibacy, fasting, and/or the use of plants that produce psychedelic effects. Many shamans used a combination of techniques to induce a trance state. Shamanistic rituals also bring communities together and help to promote bonding, which may also be an important part of the healing process (Winkelman, 2012).