An experimental medicine study of mental imagery re-scripting enhanced by psilocybin for young people who self-harm.

Self-harm affects around 20% of young people aged 16–25 at some point in their lives. Young people who self-harm often do so in response to difficult feelings, thoughts and situations. Current treatments are long, costly and do not suit all young people, so there is a need to develop new interventions that are faster and more accessible.

Approximately 80% of young people who self-harm experience self-harm-related mental images, often described as ‘seeing with the mind’s eye’. These mental images influence emotions and motivation; for instance, picturing something you desire can make you feel better and encourage you to pursue it, whereas picturing something scary can increase anxiety and discourage action.

Targeting self-harm-related mental images with a cognitive technique called ‘imagery rescripting’ (i.e. changing the mental image) has shown promise in reducing self-harm urges. However, it can be challenging and may require multiple repetitions. Some research suggests that low-dose psilocybin could make it easier and more effective.

Our study tests if adding a psycholytic/low dose (5mg) of psilocybin before imagery re-scripting reduces the emotions, thoughts, and urges that come with self-harm-related mental images, compared to placebo. This is a double-blind, placebo-controlled study designed to explore a future psilocybin-augmented imagery re-scripting intervention.

Inclusion Criteria:

  • Aged 16 to 25 years  
  • At least 2 lifetime episodes of self-harm 
  • Experience of self-harm-related mental imagery  
  • No previous experience with psychedelic substances

Exclusion Criteria:

  • Current or past history of psychosis or mania (self or a first-degree relative) 
  • Current severe suicidal ideation that presents a risk for participation
  • Currently taking antidepressant medication, including citalopram, fluoxetine, and sertraline

You can find the protocol from PsiloIMAGINE study here.

Getting involved: 

If you have questions, need more information, or would like to express your interest, we encourage you to contact the study team at imagine@imperial.ac.uk, follow the link to our Qualtrics survey and follow our Instagram page @mir_imperial.

Your participation could make a difference!