Introduction

Psychedelic substances have long been associated with profound transformations in consciousness, self-perception, and worldview1,2,3, with significant focus on the substances’ promising therapeutic potential for a range of mental health disorders4,5. In recent years, researchers have begun to unravel the mechanisms through which psychedelics catalyze such changes6, highlighting the essential role of the subjective effects experienced during the psychedelic ‘trip’ 7,8,9.

Mystical-type experiences, often characterized by feelings of unity, transcendence of time and space, ineffability, and deep spiritual or existential significance, have been identified as central to psychedelics’ transformative effects10,11,12. Crucially, transformative outcomes are not limited to mystical states: non-mystical experiences involving an emotional breakthrough have also been shown to predict positive therapeutic change13. Integral to the transformative effects of psychedelics may be their capacity to evoke awe—a self-transcendent emotion that is increasingly recognized as a key psychological mechanism underlying long-term personal growth14,15.

Awe is considered an epistemic emotion (a state where evaluations of reality are altered) arising from two appraisals: a vastness in perception (stimulus too large to comprehend with existing mental structures) and a need for cognitive accommodation (re-organisation of structures as new learning)16. Ihm and colleagues17 propose that through this need for cognitive accommodation, awe facilitates meaning making in order to make sense out of ambiguity. They further argue that awe may have played a key role in the evolution of human societies and been foundational to the emergence of religion and societal structures, while for the individual, it may be a trigger for lasting changes in worldview and identity. A frequently cited example in awe studies is the “overview effect”, reported by astronauts when viewing Earth from space18. The overview effect is characterized by profound awe, a collapse of perceived boundaries, and a sense of unity with humanity and the planet, often accompanied by lasting shifts in values and worldview19.

Accordingly, events like psychedelic, mystical or otherwise extraordinary experiences that exceed one’s bounds of interpretative capacities for making meaning require reconfiguration of one’s life story and sense of self20. Several studies describe transpersonal changes involving shifts in psychedelic users’ metaphysical beliefs21,22,23, yet the processes that underlie these shifts are yet to be untangled.

Predictive coding theories posit that the brain functions as a hierarchical inference machine, using top-down priors to interpret bottom-up sensory inputs24. Psychedelics are thought to disrupt this process, reducing the influence of high-level priors and allowing for greater input from sensory and emotional data25. Studies of classic psychedelics suggest shifts in salience processing, effectively lowering the threshold for significance and meaning26,27,28. In Bayesian terms, 5-HT2A stimulation reduces the precision-weighting of top-down predictions, allowing a wider range of bottom-up signals to be appraised as noteworthy25.

This shift fosters openness to possibilities, unbound by habitual expectations, and lays the groundwork for intuitive reasoning—an embodied, rapid mode of understanding that synthesizes complex information in novel ways29. This freer state of cognition parallels the exploratory learning seen in children, described by Gopnik30 as a “high-temperature search” that prioritizes possibility over probability, exploration of the new over exploitation of the known. Psychedelics can temporarily recreate this cognitive flexibility, facilitating intuitive insights that feel revelatory and transformative31.

This disruption of prior frameworks for sense-making and overwhelming sense of new meaning has been termed ‘ontological shock’, a catalyst that elicits a feeling of ‘groundlessness’ within ontologically challenging psychedelic experiences and in turn necessitates changes in worldview that build new cognitive ground32. This process can also be understood through the lens of socio-cognitive research on Diversifying Experiences33. Diversifying Experiences (DEs) refer to unusual and unexpected events or situations that push individuals outside the realm of ‘normality’ and have been linked to increases in cognitive flexibility34. The process of reflecting on extraordinary experiences encourages a view of the world not previously considered and as such diversifies individuals’ framings of reality.

Psychedelic experiences often alter perceived boundaries, loosening distinctions between self and other, mind and body, and individual and environment. In prior research, these alterations are typically described in terms of ego dissolution, a diminished sense of self35 and oceanic boundlessness, a unitive state of interconnectedness10,36. The two phenomena are closely related and can co-occur, though they are not identical: ego dissolution highlights the attenuation of self-representation, whereas oceanic boundlessness captures the positive, unifying aspects of self-transcendence. Both psychedelic-induced ego dissolution and the feeling of oceanic boundlessness can foster a sense of interconnectedness and unity that transcends conventional separations10,35. Research has also indicated that psychedelic-induced ego dissolution can result in identity fusion, enhancing social bonding and prosocial behaviours37,38,39. These shifts in boundary perception may underpin changes in metaphysical beliefs and identity associated with psychedelics.

Despite growing evidence on the transformative effects of psychedelics, little is known about the kinds of epistemic shifts that underlie lasting changes in worldview and how awe experienced during psychedelic trips contributes to such changes. This study aimed to explore:

1. 1.

The kinds of epistemic changes in intuition, perceptions of normality and boundaries individuals report following transformative psychedelic experiences, alongside other shifts in their intrapersonal, interpersonal, and transpersonal understanding.

1. 2.

What aspects of the awe spectrum during a psychedelic experience relate to post-experience perceived self-other boundaries?

Methods

Participants and Design

This study used a mixed qualitative and quantitative cross-sectional design. Ninety participants who self-identified as having experienced long-lasting and significant changes following the use of psychedelic substances completed the online questionnaire on the survey platform Qualtrics (age range 18–75 years old, age M = 37.2, SD = 15.1). The participants were recruited via advertisements on social media and various fora including Twitter, Reddit, Facebook and Instagram. The recruitment ad text stated: “The many faces of psychedelic transformations: Have you experienced significant and long-lasting changes from psychedelics? This may include positive and/or negative significant shifts in perspective; how you perceive and/or understand yourself, others, and the world, visual or other perceptual changes”.

Inclusion criteria were (1) to identify as having experienced significant and long-lasting changes from taking a psychedelic drug (this was subjectively defined by the participant and there was no exclusion based on social context or purpose of taking the psychedelic), (2) be aged 18 or over. Participants were recruited via a range of means: The online survey was distributed via multiple social media channels and poster advertisements. There were no financial incentives for participation in the survey.

The majority (68; 75.6%) of these participants indicated living in the UK, 11 (12.2%) in other English-speaking countries (U.S.A, Canada and Australia), and 11 participants were based in non-English speaking countries across Europe and Latin America (12.2%), (with fewer than 5 participants in each country). Twenty-one participants (23.3%) resided in a country where the majority of people do not speak their native language. Demographic characteristics are presented in Table 1.

Procedure

Six pilot interviews were conducted with individuals associated with a transdisciplinary psychedelic interest group, composed of a variety of people, including academics, practitioners, and others with lived experience of psychedelic states. Through these interviews, a set of long-lasting changes from psychedelic use was identified. These included changes in how individuals understood and related to themselves, others, and the world. Previous literature on psychedelic research, along with the pilot interviews, informed the design of the survey reported in this publication and the follow-up in-depth interview study schedule.

Data collection and ethical approval

Data were collected anonymously via an online survey created in the online survey platform Qualtrics, between December 2022 and August 2023. The questionnaire comprised a written consent form, followed by a series of open-ended and closed-ended questions. The project was approved by the University of Exeter research ethics committee.

Quantitative measures and analyses

The Awe Experience Scale (AWE-S40) is a 30-item measure of awe comprising six factors: altered time perception, e.g., ‘I noticed time slowing’, self-diminishment, e.g., ‘I experienced a reduced sense of self’, connectedness, e.g., ‘I had the sense of being connected to everything’, perceived vastness, e.g., ‘I experienced something greater than myself’, physical sensations e.g. ‘I felt my eyes widen’ and need for cognitive accommodation e.g. ‘I felt challenged to understand the experience’. Participants were asked to think back to the acute effects of their most transformative psychedelic experience, under the influence of the substance, and to rate that experience in terms of agreement with each AWE-S item, based on a 7-point Likert scale ranging from Strongly disagree to Strongly agree. All subscales together had good reliability, Cronbach’s α = 0.92. Separately, the subscales also had adequate reliability: altered time-perception, Cronbach’s α = 0.91, self-diminishment, Cronbach’s α = 0.91, connectedness, Cronbach’s α = 0.94, perceived vastness, Cronbach’s α = 0.90, physical sensations, Cronbach’s α = 0.74, need for accommodation, Cronbach’s α = 0.85.

The Inclusion of Other in the Self Scale (IOS41) scale was a 7-point measure of interconnectedness measured through a choice of increasingly overlapping circles. We adapted this scale for the present study to measure the currently perceived degree of interconnection felt with other humans, non-human beings, and the world, respectively. The pictures were accompanied by the following instructions (taking the ‘world’ target as an example*): ‘How much overlap do you see between yourself and the rest of the world? See each statement [self–other humans/self-non-human beings/self–world] for what ‘other’ represents in the diagram and choose what’s closer to your view.’* Scores ranged from no overlap (a score of ‘0’) to almost complete overlap (a score of ‘6’). The scores for the three targets together reached adequate levels of internal consistency (Cronbach’s α = 0.85).

Pearson correlation coefficients were computed to examine the relationships between Inclusion of Other in Self (IoS) non-acute measures and Awe Scale (AWE-S) components referring to the acute experience. Although some awe subscales showed a skewed distribution, it was within the accepted tolerance of the Pearson correlation, which is robust to deviations from normality42. To account for the risk of Type I errors due to multiple comparisons, we applied the False Discovery Rate (FDR) correction using the Benjamini-Hochberg (B-H) procedure43. This method adjusts p-values to maintain an acceptable proportion of false discoveries among significant results, making it appropriate for exploratory analyses. All statistical analyses were conducted using SPSS (Version 29.0.1.0; IBM Corp.)

Qualitative Method

Open-ended questions. Participants were presented with the following open-ended questions:

1. 1.

Nature of acute experience: Reflecting on the questions above, is there anything you want to add about the nature of your acute experience (under the effects of psychedelics)?

1. 2.

Changes in intrapersonal understanding: Has your way of understanding yourself changed as part of your transformation? If yes, how?

1. 3.

Changes in interpersonal understanding: Has your way of understanding others changed as part of your transformation? If yes, how?

1. 4.

Changes in transpersonal understanding: Has your way of understanding reality* changed as part of your transformation? If yes, how? *This would include any shifts in your worldview/religious/spiritual beliefs

1. 5.

Changes in perception of boundaries: Have the boundaries you see between yourself and the rest of the world changed as a result of your transformative psychedelic experience(s)? If yes, how?

1. 6.

Changes of intuition*: Has your intuition changed following your transformative psychedelic experience(s)? If yes, how?*

1. 7.

Changes in perception of normality: Has your understanding of what is ‘normal’ changed following your transformative psychedelic experience(s)? If yes, how?

1. 8.

Stability of understanding psychedelic experience: Did your understanding of your experience remain stable, or did it change over time?

1. 9.

Managing uncertainty: Are you struggling more with the unexpected since your experience or feeling better equipped to manage what comes your way?

1. 10.

Vulnerability during experience: Did you experience increased feelings of vulnerability during your transformative experience(s) (under the direct influence of the substances)?

1. 11.

Vulnerability after experience: Did you experience increased feelings of vulnerability following your transformative experience(s) (not under the direct influence of the substances)?

1. 12.

Perceived impact of sharing the experience with others: Have you talked to others about your transformative experience(s)? If yes, how did this affect you?

Qualitative analysis

Structured Tabular Thematic Analysis (ST-TA) was employed to analyse the open-text data44. ST-TA is a form of thematic analysis designed based on both reflexive45 and ecumenical46 thematic analysis, to analyse brief texts such as written responses to open-ended survey questions. Excel spreadsheet software is used to organize the data and thematizing in ST-TA. Frequencies of themes are calculated to demonstrate how common a theme is within the dataset.

The current study was conducted using an inductive-deductive hybrid ST-TA analysis. Hybrid ST-TA analysis follows the following phases: 1. A priori theme development; 2. Deep Immersion in the Data; 3. Generating Codes and Themes; 4. Tabulating Themes Against Data Segments; 5. Checking Inter-analyst Agreement; 6. Exploring Theme Frequencies, 7. Developing thematic maps and diagrams, and 8. Producing the report44.

During Phase 4, the two analysts engaged in a process of establishing agreement to ensure transparency and consistency in theme formation corresponding to the data. Conclusions were reached through consensus to avoid idiosyncratic interpretations.

Reflexivity and research process

The study was designed within a transdisciplinary research centre for psychedelic studies. During the study design phase, we used a deductive process to develop a set of questions around participants epistemic changes, based on existing literature. These formed the meta-themes that provided organising categories for data into the kinds of change reported. Within these categories, the process of deriving themes was conducted inductively, based on collating data codes into semantic groupings and then into labelled conceptual themes.

EKA and CJAM designed the survey. EKA and FF conducted the analysis of the brief written texts. The interactive dialogical approach was taken to data analysis. A series of scheduled discussions between the analysts involved intrapersonal and interpersonal reflections to inform the development of the themes.

The cyclical, iterative and inter-subjective nature of ST-TA analysis aids towards consistency and transparency. The agreement reaching process involves two analysts independently analysing part of the dataset and reaching a minimum of 80% agreement44. The analyst pair met to discuss theme revisions to ensure clarity and cogency until 80% inter-analyst agreement was reached. The interanalyst agreement process helps to ensure a non-solipsistic, consensual approach to analysis.

Following the first layer of inductive analysis, Thematic Network Analysis was conducted as a method of visualising the relationships between the data. EKA and AF revisited the themes and organised the data using Gephi, conducting the analysis led by SS.

Inductively generated codes were extracted from the frequency table and transformed into a co-occurrence table, consisting of which codes were coded alongside other codes (Supplementary Materials Data file). The data were imported into a social network analysis program (Gephi 0.9.5) to create a visual representation of the relationships between thematic codes and their significance within the overall network, following prior examples of network representation of qualitative data47.

To minimize noise and exclude co-occurrences likely to have occurred randomly, the association rule “lift” was applied as a backboning filter. The lift value was calculated as the ratio of observed co-occurrence frequency to the expected co-occurrence frequency, based on the individual occurrences of the nodes. This allowed us to quantify how much more likely two codes were to co-occur compared to random chance. To manage extreme values in the network, we capped lift values at the mean of [6.22], which represents the average co-occurrence strength. This threshold was chosen to balance the preservation of typical relationships while minimizing the impact of outliers that could disproportionately influence the network structure47,48,49. Visual exploration, using the ForceAtlas 2 algorithm, was employed to examine interactions between codes, while modularity algorithms identified codes that frequently co-occurred50,51,52,53,54,55. These Thematic Network Analysis graphs illustrate code relationships by representing the total occurrences of a code as node size (weighted degree), the frequency with which particular codes are discussed together in a reference as the thickness of line between codes (edge weight), the overall references shared across codes (network centrality), and clusters of closely related codes (modularity clusters). A Thematic Data Extraction Table, showing selected references, with applied codes, interpretations and the clusters they relate to, can be found in supplementary materials.

Results

Quantitative descriptive results

Psychedelic Substance Use: Age at first use, substance and number of experiences

Participants were asked how old they were at the time they first used psychedelics (age range 15–68, age M 24.8, SD 10.15). Twenty-two (24.4%) were under the age of 18, 31 (34.4%) between 19–24, 13 (14.4%) between 25–29, 7 (7.8%) between 30–34, 3 (3.3%) between 35–39, 5 (5.6%) between 40–55 and 2 (2.2%) were over 55 years old when they had their first psychedelic experience. Seven participants (7.8%) did not respond.

When asked to report the number of transformative experiences they have had, 7 participants (7.8%) only had one transformative experience. 42 (46.7%) had between 2-5 transformative experiences. 15 (16.7%) had between 6 and 10 transformative experiences and 18 (20%) had had more than 10. Eight (8.9%) participants did not respond.

Participants were asked whether they had only transformative experiences with psychedelics. Twenty-two (24.4%) responded yes. Fifty-nine (65.6%) responded no, and nine did not give a response. Of those that also had non-transformative psychedelic experiences, 39 (43.3%) had taken psychedelics more than 10 times, 15 (16.7%) had taken psychedelics between 6-10 times and 5 (5.6%) had taken them between 2-5 times.

Participants reported what substance they had taken during their most transformative psychedelic experiences. They could report more than one substance if appropriate. The two most commonly reported were psilocybin (47.8%, 43 participants) and LSD (41.1%, 37), followed by ayahuasca (25.6%, 23), cannabis (16.7%, 15), DMT (12.2%, 11), ketamine (10%, 9), MDMA (7.8%, 7). Other reported substances included mescaline (4.4%, 4), nitrous oxide (3.3%, 3) salvia divinorum (3.3%, 3), LSD analogues including 1P-LSD and LSA (3.3%, 3), 2 C family substances, including 2C-B and 2 Ci (3.3%, 3), 5-MEO-DMT (2.4%, 2), iboga (1.1%, 1) and amanita muscaria (1.1%, 1). Two participants (2.2%) reported using amphetamines in addition to a psychedelic.

Participants were asked how long ago they had their last transformative experience with psychedelics. Seventeen (18.9%) stated it was within the previous month, 11 (12.2%) within the previous 3 months, 6 (6.7%) within the last 6 months, 15 (16.7%) within the last year, 14 (15.6%) said it was sometime within the last 5 years, 4 (4.4%) within the last 10-20 years and 5 (5.6%) over 20 years ago.

Experiences following psychedelic substance use

Table 2 shows data frequencies and percentages of the sample from responses to a close-ended question on types of experiences they had following their psychedelic use. The list was informed by the types of outcomes often reported as outcomes of psychedelic experiences. Participants could select multiple responses if needed.

Overall evaluation of psychedelic transformation Participants were asked whether they would evaluate their psychedelic transformation as ‘positive’, ‘negative’, or ‘mixed’. Fifty-eight (64.4%) responded positive, 4 (4%) negative, and 22 (24%) mixed. Six participants (6.7%) did not answer.

Descriptive Statistics for Awe and Inclusion of Other in Self

Descriptive statistics for IoS measures and AWE-S components are represented in Fig. 1. Participants reported moderate to high levels of overlap between the self and other (IoS measures referring to non-acute state) and substantial awe experiences (referring to acute trip state), across all AWE-S subscales. The IoS Overall measure demonstrated a mean of 4.44 (SD = 1.26), reflecting significant overlap across categories.

Fig. 1: Descriptive statistics for awe and self - other measures.

Means (bars), Standard Deviations (lines) and Data Distributions (dots) for AWE-S (acute) and IOS (non-acute) measures.

Correlation analysis between awe and inclusion of others in the self

Pearson correlation analyses revealed significant relationships between IOS (non-acute) measures and AWE-S (acute) components. To account for multiple comparisons, we applied the False Discovery Rate (FDR) correction using the Benjamini-Hochberg procedure.

The IOS Overall (non-acute) measure was significantly positively correlated with AWE-S (acute) Connectedness (r = 0.329, padjusted = 0.002), Vastness (r = 0.377, padjusted = 0.003) and with Overall Awe (r = 0.267, padjusted = 0.047) (Fig. 2). These results indicate that higher perceptions of self-other overlap are associated with stronger awe experiences, particularly in terms of connectedness and vastness.

Fig. 2: Correlation matrix for awe and self - other overlap.

Pearson correlations between IoS non-acute measures and acute AWE-S components with FDR correction. Note. * = p ≤ .05, ** = p ≤ .01, FDR-corrected.

Qualitative analysis of the written narratives of lasting changes

90 participants provided written accounts of the changes they experienced following their psychedelic trip.

Meta-theme 1: nature of acute experience

Following completion of the AWE-S scale retrospectively referring to their trip, participants were asked to share additional reflections on their acute psychedelic experience. Sixty-seven provided responses, with ten themes emerging. The most common, Emergence of Insights and Purpose (23%), involved increased clarity and direction. Sense of Oneness and Connectedness (20%) described a profound unity with everything, while Suffering, Death, and Challenging Experiences (16%) captured distressing or overwhelming effects.

Other themes reflected encounters with something beyond the ordinary. Experience of Something Greater Than Oneself (13%) described perceived guidance from an external wisdom, while Positive Emotions (12%) included feelings of love, bliss, and awe. Sense of Profundity or Higher Reality (10%) involved the perception of hidden aspects of reality, and Religious or Spiritual Experience (8%) reflected newfound spiritual awareness. Additional themes included Themes of Nature (7%), Expansion and Wholeness of Self (7%), and Questioning the Nature of Reality (7%), reflecting altered perceptions of self, nature, and existence. Example quotes are presented in Supplementary Table 1.

Post-experience epistemic changes

Meta-theme 2; Intrapersonal changes: changes to understanding of self

Seventy-nine participants (88%) reported changes in their understanding of the self, reflecting shifts in self-awareness, values, and relational perspectives. Thematic analysis identified eight interrelated themes; These include Greater Self-Insight (42%), characterized by increased self-awareness and recognition of personal patterns; Increased Compassion (24%), marked by greater kindness toward oneself and others; and a Shift in Purpose and Values (23%), reflecting re-evaluations of priorities and moral orientations. Some described an Increased Awareness of Wholeness and Complexity (17%), seeing themselves as multifaceted and shaped by conditioning, while others reported Increased Authenticity (11%), feeling more aligned with their true desires. Some reported general improvements in Wellbeing (8%), whereas Increased Awareness of Oneness (8%) reflected a dissolution of self-boundaries. A minority (3%) reported significant Negative Repercussions of Change, struggling with distressing insights. Example quotes are presented in Supplementary Table 2.

Meta-Theme 3: interpersonal changes: Changes to understanding of others

Seventy-three participants (81%) reported changes in their understanding of others, reflecting shifts in empathy, perspective-taking, and relational awareness. Thematic analysis identified six interrelated themes. The most common, Increased Empathy (28%), involved a heightened ability to understand and forgive others, often accompanied by Increased Acceptance of Difference (24%), where participants recognized that individuals construct and interpret the world in unique ways. Awareness of Commonality in Human Experience (23%) emerged as participants acknowledged shared struggles and emotions, while Interrelatedness (21%) reflected a broader recognition of interconnectedness and the relations between parts, shifting from an “us vs. them” mentality to a more unified perspective. Increased Compassion (18%) was reported as a deepened sense of kindness and consideration for others, while Sense of Sonder (10%) captured the realization that others are complex, whole individuals with their own inner worlds. Example quotes are presented in Supplementary Table 3.

Meta-Theme 4: transpersonal changes: changes to understanding of reality

Seventy-four participants (82%) reported changes in their understanding of reality, reflecting shifts in metaphysical, existential, and epistemological perspectives. Thematic analysis identified ten interrelated themes. The most common, Increased Sense of Animism (29%), involved perceiving nature as more alive and communicative. Increased Awareness of the Subjectivity of Reality (18%) followed, with participants recognizing reality as perspectival rather than absolute. Some experienced a Shift in Life Purpose and Values (11%), while others described a heightened sense of Interrelatedness (9%), perceiving deeper connections across systems and existence. Several themes reflected changes in belief frameworks. Reductionism Reduction (9%) marked a move away from strictly physicalist perspectives, while Increased Religiosity (9%) indicated shifts toward faith or spiritual conviction. Some reported an Increase in Philosophical Inquiry (9%), engaging more deeply with existential and metaphysical questions, or Increased Openness and Curiosity (8%), returning to a more exploratory, childlike perspective. Perception of Mortality (7%) often shifted toward reduced fear of death, while Increased Agnosticism (6%) reflected greater uncertainty about prior beliefs. A small minority (2%) reported significant Negative Change, describing distressing and destabilizing shifts in worldview. Example quotes are presented in Supplementary Table 4.

Meta-theme 5: Changes to understanding of ‘normal’

Seventy-one participants (79%) reported changes in their understanding of ‘normal,’ reflecting shifts in its boundaries, origins, and significance. Thematic analysis identified nine interrelated themes. The most common, Greater Acceptance of Difference and Other Perspectives (22%), involved recognizing that what is considered normal varies across individuals and contexts. Seeing Normality as a Social Construct (21%) emphasized that norms are shaped by cultural and societal conditioning rather than inherent truths. Some described an Expanded Concept of Normality (20%), broadening their sense of what is possible and acceptable.

Other themes reflected deeper ontological and epistemic shifts. Complexity Awareness (17%) involved a recognition of the fluid and multifaceted nature of human perception, while Metaphysical Resonance (11%) captured an increased sense of sacredness or divine reality. Some participants described Rejecting Normal (8%), rejecting the concept entirely as a limiting construct, while others reported a strengthened Nature Connection (7%) and Interrelatedness (4%), seeing normality in terms of interconnected systems rather than fixed societal expectations. A small minority (2%) reported Negative Changes, describing paranoia and heightened fear responses. Example quotes are presented in Supplementary Table 5.

Meta-theme 6: Changes in intuition

Sixty-eight participants (76%) reported changes in their intuition, reflecting shifts in how they experience, trust, and apply it. Thematic analysis identified seven interrelated themes. The most common, Greater Guidance and Attunement to Intuition (21%), involved participants relying more on intuition to navigate decisions and feeling a stronger connection to their inner sense of truth. Greater Trust and Faith in Intuition (18%) reflected an increased willingness to trust intuition as part of a broader sense of surrender to life’s unfolding. Shift in Purpose and Values (17%) captured how intuitive insights led participants to reassess priorities, often letting go of material concerns or control over external circumstances. Other themes suggested a widening of intuitive perception. Interrelatedness (14%) appeared in changes to relationships, particularly in family dynamics, where intuition fostered a sense of gratitude and reciprocity. Metaphysical Resonance (13%) reflected an intuitive openness to spirituality, sacredness, or the presence of a divine force. Openness (10%) described feeling more receptive and mindful, while Greater Alignment with Self (9%) involved deeper bodily and emotional awareness. Additional themes included Complexity Awareness (8%), Nature Connection (7%), and Empathy (6%), while a small minority (4%) reported Negative Change, describing distressing or disorienting shifts. Example quotes are presented in Supplementary Table 6.

Meta-theme 7: Changes of boundaries between self and world

Seventy-two participants (80%) reported changes in their perception of boundaries between their self and the world following their transformative psychedelic experiences. Thematic analysis identified six themes. The most common, Interrelatedness (30%), reflected a heightened sense of interconnection, with participants describing understanding everything plays a role and has a place in a greater whole. Malleability (12%) captured perceptions of self-world boundaries as fluid and changeable. Some participants dismissed Boundaries as Illusory (11%), expressing the view that self-world divisions are temporary perceptions rather than inherent realities. Boundlessness (10%) described the removal of borders and boundaries in their perception, while Oneness (10%) reflected a more nuanced sense of unity, where participants expressed awareness that they are metaphysically indistinct from their surroundings. A minority (2%) reported Increased Disconnection, describing a shift in the opposite direction where their experiences led to feelings of isolation or detachment. Example quotes are presented in Supplementary Table 7.

Meta-theme 8: Vulnerability during the experience

Sixty-four (71%) participants experienced increased feelings of vulnerability during their transformative psychedelic experience. Sixteen (18%) experienced no increase and 10 did not respond. Seventeen (19%) participants did not specify the valence of this increase, 8 (9%) reported a positive experience of vulnerability, 9 (10%) reported both positive and negative experience of vulnerability, while 17 (19%) reported a negative experience of vulnerability during their transformative trip (e.g. Yes, I was very confused and scared at times. Had a difficult time grasping what was going on and felt that the world was a scary place).

Meta-theme 9: Post-experience vulnerability

Forty (44%) participants experienced increased feelings of vulnerability following their transformative psychedelic experience. Eight (9%) reported positive outcomes of vulnerability, 9 (10%) reported a mix of positive and negative outcomes, while 11 (12%) reported significant negative effects of their increased vulnerability (e.g