Aaron Paul Orsini felt utterly alone in the world: emotionally numb and devoid of any sense of connection with anybody, including himself. Sunk deep in depression since his teens, he spent much of his time alone in his bedroom, as he puts it, “trying to figure out how the game of being human worked … I kept going to therapy. I kept reading books. I kept working at my desk job. I kept trying new medications. I kept failing, time and time again, with the simple act of identifying the emotional needs of myself and others.”
He spoke to his therapist about his struggles to maintain contact with friends and make new ones, “and how even one-on-one moments felt very confusing at times. I was physically close to people such as my girlfriend, but still very much emotionally distant, from her, myself, and really, everyone in my life.”
At 23 he was at last given a diagnosis that made sense of his tortured efforts to connect socially: autism spectrum disorder. But while the revelation was intellectually interesting, he says, it left him in precisely the same bind: unable to make sense of his own emotions or others’, “feeling irretrievably broken” and increasingly having thoughts about ending it all.
He even began to lose his few remaining close connections. People just weren’t prepared to put up with him any longer, he recalls. He quit his job and shortly afterwards matters came to a head when a loyal friend was knocked down and killed by a drunk driver. “This was hell. And there was no escaping it. That was really how I seemed to believe my life would go. And I was so, so exhausted by that belief.”
In a last-ditch attempt to break out of the psychological prison in which he found himself, Aaron sold all his belongings, packed a bag and took off. Somehow he wound up alone in a forest where he consumed around 200 micrograms of LSD.
What happened next proved to be a turning point in his life. As he describes it in his newly published book Autism on Acid, “so many realisations seemed to come crashing in all at once” as the cognitive processing centres of his brain began to mesh for the first time. “Connection. Such connection. I felt it, in so many ways. I felt it.”
As the LSD took hold, he connected, “with the trees and breeze and sunlight around me, I experienced a deep moment of engagement. Yes. A moment of connection, with nature, with thoughts of my parents, my family, friends, and the whole of the human family and the broader web of life.”
Not only did he not feel like killing himself any more, he felt very much like living. “And while yes, this dose exposed me to many of the commonly described hallmarks of the larger-dose LSD experience, it was what happened after the peak effect that really blew my mind, or should I say, heart, into a state of absolute wonderment.”
After a few joyous hours of communing with the natural world, he stood up and walked out of the forest and encountered a stranger. “A stranger, yes, that suddenly, somehow, didn’t seem strange at all. And I said “Hi.” And they said “Hi.” And it felt, natural?! I felt, compelled, to connect. And that might not seem like that big of a deal, but for me, it was everything!”
While they talked about nothing of any consequence, he found he was aware of the feelings and intentions of the other in a way that had been impossible just a few hours earlier. “I felt the weight of their words. I sensed their state of mind. I grasped the context of what was unfolding. And for the first time in my entire 27 years of existence, I felt fully connected to the person opposite me … I could be conscious of the impact of my words and actions, because I felt them, within myself, within the person across from me. Empathy. Arresting empathy. I felt it.”
What Aaron was experiencing was the dawning of “theory of mind” – an intuitive awareness of others’ thoughts, feelings and intentions, and how the particular words he chose, their intonation and delivery would impact how he or she would feel. This ability is lacking to a greater or lesser degree among people “on the spectrum” of autism, which ranges from the high functioning of Asperger’s at one end to profound disablement at the other, and it helps explain their vulnerability to social isolation, anxiety and depression.
Aaron is not the only autistic man to make claims publicly about the beneficial effects of psychedelic drugs on their condition. A quick internet search reveals three other compelling examples. There’s a young British man called Alyx who blogs about his journeys of discovery on magic mushrooms, which have apparently allowed him to ditch his unhealthy computer obsessions and make eye contact with his carer for the first time; a YouTube video of an American who remains remarkably coherent after a very large, enlightening dose of LSD; and an interview on the Voices in the Dark podcast with a man who claims LSD and MDMA “opened a door he didn’t know existed” into the social world of his fellow humans. Other positive accounts can be found on Reddit, such as this one.
There have been no formal scientific investigations into the effects of classic psychedelics on autism for almost 50 years, but between 1959 and 1974 LSD was tried as an experimental therapy for children with severe autism aged between six and ten who hadn’t responded to any other treatment. The experiments were not only ethically questionable, however, they were also poorly designed by today’s standards, making any firm conclusions impossible. Nonetheless, the researchers who conducted them consistently reported that the drug led to improved speech, greater emotional responsiveness, more positive mood, including frequent smiling and laughter, and decreases in obsessive behaviour.
Interestingly, in a recent survey of a mixed group of people who take regular microdoses of psychedelic drugs in the belief they improve their cognitive and emotional functioning, respondents on the autistic spectrum reported no significant improvements in their symptoms. This makes sense in the light of a study published in the American Journal of Psychiatry in 2006 which found that people with Asperger’s have a lower density of the receptors to which psychedelic molecules bind (known as serotonin 2A receptors) in key brain regions.
If true, this would not only explain why microdoses have little apparent effect on autism symptoms but also the unusually high tolerance that people on the spectrum appear to have for much larger doses of psychedelics.
The same study also found that the density of serotonin 2A receptors in the brains of people with Asperger’s was inversely proportional to impairments in their ability to communicate socially. In other words, those subjects with the lowest receptor density performed worst in social situations.
There is known to be weaker connectivity between key regions in the brains of people with autism compared with “neurotypicals” while they perform tasks involving theory of mind: a skill vital for connecting with other people socially and emotionally. In particular, impaired connectivity between nodes of the “default mode network” – the network responsible for theory of mind and self-referential processing – has been linked to their difficulties intuiting the thoughts and feelings of others.
LSD and psilocybin acutely increase connectivity between brain regions. So in theory, by boosting connectivity, at least temporarily, they could provide people on the spectrum with flashes of insight into a world of social communication from which they’ve been excluded.
People on the spectrum are often excellent at focusing on fine details but this “superpower” seems to come at the expense of aspects of the bigger picture, notably social awareness and communication: they can’t see the wood for the trees. Another downside of this intense, narrow focus are overwhelming, distressing feelings of sensory overload in chaotic, unpredictable situations.
According to a leading theory of how the central nervous system works, the brain functions as a multilayered information-processing hierarchy, with predictions about the world being sent downwards from higher cognitive regions, while “prediction errors” – the discrepancies between these predictions and sensory data – pass upwards from the senses to update the brain’s models of reality.
Crucially, brain chemicals such as serotonin, dopamine and noradrenaline fine-tune the flow of information through this processing hierarchy. They control the volume or “gain” of the signals, adjusting the relative influence of top-down predictions and bottom-up sensory prediction errors.
Psychedelic molecules bind to serotonin receptors in brain regions near the top of the hierarchy, which is why they are proving such promising tools for breaking the dominance of unhelpful emotional and cognitive models in people suffering from a wide range of mental illnesses, from anxiety and depression to obsessive compulsive disorder (OCD) and post traumatic stress disorder. They shake things up, promoting cross-talk between brain regions that don’t usually communicate, opening a window of opportunity for relearning.
Autism can also be characterised as an imbalance between bottom-up and top-down signalling leading to entrenched, maladaptive cognitive models. So it makes sense that psychedelics might rebalance or “re-tune” the autistic mind to help people on the spectrum see the bigger social, emotional picture.
“LSD was the turnkey for my life,” Aaron writes in his book. “It simultaneously saved my life while at the same time imbuing it with a sense of meaning, connection, and accessibility.”
It goes almost without saying that psychedelic researchers are anxious not to repeat the mistakes of the Sixties, so it may be several years before they turn their attention to the most controversial potential therapeutic uses for drugs such as LSD and psilocybin, and the psychedelic tea ayahuasca, not least autism and bipolar disorder (which I’ve written about in a previous post).
Aaron doesn’t recommend anyone else on the spectrum takes the same path he did. “LSD is still an unregulated and illegal drug. So anyone who hears of my story, please, please, please, for the sake of your own safety and the safety of others, please do not consider this story to be an invitation to try this at home … But maybe, someday, try this under the supervision of trained and certified professionals.”
All proceeds from the sale of Autism on Acid: How LSD Helped Me Bridge the ASD-Neurotypical Divide by Aaron Paul Orsini (@AutismOnAcid) will be donated to psychedelic research organisations