What happens in a person's mind when a conflict that has long seemed impossible to resolve suddenly becomes clear? And why does one insight remain a fleeting eureka moment, while another changes a person's behavior or worldview for years?

In his doctoral thesis, defended at the University of Tartu, Karl Kristjan Kaup sought a common explanation for these seemingly different experiences. In his approach, insight does not refer only to a sudden eureka moment, but more broadly to a change in thought accompanied by a sense that something important has fallen into place. This means that finding the answer to a crossword clue and an experience that profoundly changes a person's worldview can fall along the same continuum of phenomena.

Realization follows conflict

The birth of new ideas is often traditionally associated with relaxed idleness. In reality, Karl Kristjan Kaup said, a novel solution first requires an internal conflict. If a person feels no tension or contradiction, there is nothing to resolve. Tension signals that something needs to change or be reinterpreted.

The solution itself may eventually flash into mind while riding the bus or taking a shower, but it is preceded by a long period of mental work. "You're wrestling with the idea in your head. The more you wrestle with it, the more likely it is that the next time you get in the shower, you'll suddenly understand it," Kaup explained.

The same logic applies to changing behavioral patterns. A person may rationally understand that they should not become irritated in a particular situation, yet still react that way. Kaup said verbal knowledge needs to move from abstract understanding to concrete experience. This is made possible by emotional or experiential insight, which allows that knowledge to actually change behavior.

Eastern traditions have sought to apply the same principle through meditation for thousands of years. Through meditation, a person practices allowing thoughts to move more freely rather than becoming stuck in a particular pattern of thinking. This makes it easier for different mental contents to become associated with one another and for the tension between them to be resolved.

Psychedelics open new connections in the brain

Psychedelics can induce similarly profound states of immersion. Kaup said it is not yet known exactly why they alter a person's perceptual experience so profoundly.

In his doctoral thesis, he proposes the apical hypercontextualization model as one possible explanation. According to the model, communication between different regions of the brain and different mental contents becomes more intensive under the influence of psychedelics. Kaup said human brain studies suggest that different regions of the cerebral cortex begin exchanging information more actively under the influence of such substances.

As a result, the usual boundaries between information weaken, giving previously separate signals and mental contents more opportunities to become connected. At high doses, a person's entire perceptual experience can change. "The usual perception of the world and of oneself disappears, giving rise to a unified, paradoxical state of emptiness and totality, separateness and connectedness," Kaup said.

What makes psychedelics particularly interesting to neuroscientists, however, is that their effects may extend beyond the experience while the substance is active. Some act as neuroplastogens, increasing the plasticity of the nervous system and altering connections between brain cells.

This particular property of psychedelics could be important in treating depression and anxiety, as these conditions are often characterized by becoming stuck in repetitive patterns of thought and behavior. "In terms of brain activity, we can think of the habitual behavior characteristic of depression or anxiety as repetitive brain activity. It doesn't change, but keeps applying the same patterns over and over again," the researcher explained.

Psychedelics may help temporarily break out of this repetition. Under their influence, the brain begins to follow patterns and trajectories it would not normally use. If connections between brain cells also change at the same time, the brain may find it easier, once the substance's effects wear off, to avoid falling back into old patterns of thought or reaction.

Substance alone is not treatment

There is no magic pill for treating mental health problems, however. Psychedelics, too, primarily affect mental contents that a person already has and strengthen the connections between them. The course of the experience therefore depends both on the person's existing thoughts and memories and on the environment in which the substance is used.

"All of these things play a role in how the experience unfolds because the substance affects the mental contents that already exist in your mind," Kaup said.

That is why thorough preparation and a safe environment are important in psychedelic therapy. The relatively low physiological risks associated with psychedelics do not, however, mean their use is risk-free. Kaup emphasized the psychological risks in particular: In rare cases, the substances can trigger or exacerbate psychotic states or cause longer-term perceptual disturbances. "At the same time, professional therapeutic use in a controlled setting can reduce the risk of such lasting effects," the researcher added.

Psychedelic experiences in virtual reality

It was the complexity of using psychedelic substances that prompted Karl Kristjan Kaup's research group to look for a more accessible alternative. As part of his doctoral research, the group developed a virtual reality environment called Psyrreal, which seeks to replicate the audiovisual and experiential features of a psychedelic experience.

Before entering the virtual world, participants undergo a preparatory session with a psychologist and identify the issues they want to work on. They then put on a virtual reality headset and spend about an hour in the environment, moving through colorful patterns, dreamlike landscapes and multidimensional spaces.

The deeper aspects of a psychedelic experience, such as ego dissolution and an all-encompassing sense of connectedness, are difficult to replicate in virtual reality. Nevertheless, some users have described Psyrreal as resembling a psychedelic state on an experiential level as well.

The environment is not intended merely to replicate a psychedelic experience, but also to investigate its potential effects on mental health. To the researchers' delight, the first study did indicate a reduction in users' symptoms of depression. Kaup stressed, however, that the experiments did not include a control group that did not enter the virtual environment. The results therefore do not yet support far-reaching conclusions. The research group is currently conducting a more rigorously designed controlled study.

One advantage of virtual reality is its relative safety. Its effects are weaker than those of psychedelics, but that may not necessarily be a disadvantage. "If we compare it with psychedelics, the effect is probably weaker, but in some cases a weaker effect is actually more suitable because it is easier to manage and easier and safer for the patient," Kaup said.

The researchers also tested Psyrreal on people working in creative fields. In the experiment, they compared a virtual reality experience containing psychedelic elements with a more conventional one and found indications that an unusual experience could help people break out of a creative rut. Kaup stressed, however, that other experiences that disrupt routine — such as hiking and traveling — could probably have a similar effect if undertaken with the intention of finding answers to one's questions.

What matters, then, is not necessarily how an insight is induced, but what kind of change it produces in a person's thinking. This also carries a risk of its own. A person may become deeply convinced that a new understanding is true even when there is no way to verify its validity.

Not all realizations may be valid

A mental breakthrough can be accompanied by a powerful conviction that one has arrived at some fundamental truth. People can experience similar flashes of apparent omniscience during the early stages of psychosis or schizophrenia.

Some discoveries are easy to verify. A mathematician, for example, can test whether a solution that suddenly came to mind actually works. But such verification may not be possible for conclusions about metaphysical questions, memories or one's personal life.

"Often, these insights are more likely to be true and cases where they are not are rare. But because it can be difficult to verify whether they are true, it is useful to approach powerful insights with a balanced degree of skepticism," he explained. If the resulting beliefs become delusional or are associated with psychotic symptoms, psychiatric help may be necessary.

Long way to go until treatment

The wider use of psychedelic-assisted therapy is still in the research stage, however. One problem is that clinical trials are difficult to blind. When a substance causes a profound change in consciousness, participants can usually tell whether they received the active substance or a placebo. Kaup sees trials directly comparing the effects of psychedelics with existing antidepressants as one possible approach.

Virtual reality offers a simpler path because Psyrreal is not a drug and does not have to go through the same approval processes. However, researchers still need to establish how large and lasting its effects are and who is most likely to benefit from such an intervention.

For Kaup, however, the broader message of his doctoral research extends beyond psychedelics and virtual reality. In his view, they vividly demonstrate the importance of taking time to notice and reflect on one's thoughts, feelings and internal conflicts. Doing so does not necessarily require taking any substance. The same principle can simply mean finding quiet moments in everyday life for conscious reflection.

"I hope the most beneficial effect of these substances lies precisely in what they symbolize — the importance of introspection and reflection for individuals and society," Karl Kristjan Kaup emphasized.

Karl Kristjan Kaup defended his doctoral thesis, "Neural computations underlying psychedelic insight," at the University of Tartu on June 1. His doctoral research was supervised by Jaan Aru. The opponents were Enzo Tagliazucchi of the University of Buenos Aires and Manoj Doss of the University of Texas.

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