Objective: Several authors have suggested demands and requirements for teaching mindfulness and meditation. In the scientific literature there is however a lack of evaluation of mindfulness teachers and how to teach mindfulness meditation effectively. This study aims at providing deeper insight of the importance of the teachers in the field of mindfulness and meditation and it investigates how mindfulness and meditation teachers describe the prerequisites for teaching mindfulness and meditation.

Method: The method of Thematic Analysis, TA, was utilized to analyse the data from semi-structured interviews conducted with twelve experienced teachers, from different mindfulness and meditation traditions. The participants are mindfulness and meditation teachers from either within the Buddhist, secular or both Buddhist and secular contexts.

Results: The analysis resulted in three main themes and nine subthemes, such as for example the main theme; Teacher qualification with subthemes; Becoming teacher, Being teacher, Pedagogic skills and Social skills. The results suggest a flexible and pragmatic view on how mindfulness and meditation teaching should be provided. Instead of a fixed set of requirements for the teacher and the student, what makes mindfulness and meditation teaching effective has to do with the ability to recognize the potential in every unique situation with an understanding of the impermanent and interdependent relationship between teacher, student and context.

Conclusion: Being and becoming a teacher is a continuous process and anyone can assume the role of mindfulness and meditation teacher. It is dependent on the students and the context. A formalized education is not a prerequisite but what is required is sufficient compassion and insight. For the teacher’s compassion and insight to ripen and for the student to learn, non-ideal conditions and suffering, is required and it is helpful with supportive fellow practitioners, teachers, especially if they themselves practice what they teach and share what they know.

Several hundred new synthetic drugs, novel psychoactive substances (NPS) or “legal highs” have in recent years appeared on the drug market. These can effortlessly be obtained from on-line vendors, offering an easy access to a plethora of new and untested substances, often with unknown or dangerous effects. Several different attempts to reduce the availability of NPS and to prevent accidents and fatalities have been applied by governments around the world. Nonetheless this complex and constantly evolving situation provides palpable dilemmas and challenges to legislators and prevention strategists. One unintended consequence from prohibition and current drug policies occurs when possibly more precarious substances are used to substitute older and more well-known illicit drugs; so called “substance displacement”. We have performed extensive research on the use of NPS, by analyzing Internet resources (drug discussion forum, on-line questionnaires), and published several NPS studies. During our research we observed how substance displacement is a common issue, with implications for both clinical practices, drug prevention strategies, as well as for legislators. In the present review we discuss two common themes of substance displacement: 1) Synthetic cannabinoids replace herbal cannabis, and 2) Different attempts for self-medication using NPS. Incitements for substance displacement, that exposes the user to possibly more harmful substances, are founded both in legislation (availability of substances and fear of legal repercussions) as well as from certain policies or cultural perceptions of various medical conditions. We offer no obvious solutions to these complications, but would like to contribute to awareness of how these factors effects drug users and how measures intended to reduce harm in many cases have the opposite effects. Further studies on the divergent motivations and different groups of NPS users are highlighted as imperative to find new and realistic solutions going forward. 

Aim: The purpose of this qualitative study was to investigate the effects experienced by users of a novel psychoactive substance, the benzodiazepine flubromazolam, by analysing users' own accounts on the Swedish forum Flashback.org. Method: A thematic analysis of anonymous self-reports published on the forum was performed and generated five general themes describing effects and experiences by flubromazolam users. Results: The themes which emerged were: Onset and duration, Desired effects, Adverse effects and addiction, Loss of control, General estimations and evaluations. The main reported characteristics of flubromazolam were heavy hypnotic and sedative effects, long-lasting amnesiac effects and the rapid development of tolerance. Flubromazolam was also anxiolytic and acted as a muscle relaxant for many users. Some users experienced euphoria or intense wellbeing. Other prominent characteristics were loss of control (leading to poor choices and actions, with unpleasant consequences) and long-lasting, often severe withdrawals. There were also serious incidents where users had been admitted to hospital, acute psychiatric treatment or taken into custody by the police. Conclusion: Flubromazolam appears to be a highly addictive and precarious benzodiazepine with many, possibly severe, side effects. The substance is generally described as very potent and with long-lasting effects. Memory loss and loss of control are common adverse effects, and withdrawals appear to be severe for many users

Background: Psychedelic microdosing is the trending practice of using tiny repeated doses of psychedelic substances to facilitate a range of supposed benefits. With only a few published studies to date, the subject is still under-researched, and more knowledge is warranted. Social media and internet discussion forums have played a vital role in the growing visibility of the microdosing phenomenon, and the present study utilized YouTube contents to improve comprehension of the microdosing practice as well as the social interactions and discussions around microdosing. Methods: Microdosing self-disclosure in YouTube videos and their following comments were qualitatively analyzed by inductive thematic analysis. Various software was utilized to enable gathering and sorting relevant data. Results: Microdosing of psychedelic substances, primarily LSD and psilocybin, was used for therapeutic and enhancement purposes, and predominantly beneficial effects were reported. Many different applications and outcomes were discussed, and therapeutic effects for depression appeared especially noteworthy. Intentions for use were recognized as an influencing factor for the progression and outcomes of microdosing. The function of social interactions was mainly to discuss views on the microdosing phenomenon, strategies for optimal results, minimize risks, and share emotional support. Conclusions: Potentially, microdosing could provide some of the same benefits (for certain conditions) as full-dose interventions with less risk of adverse reactions related to the sometimes intense experiences of higher doses. Microdosing may well also mean additional benefits, as well as risks, through the repeated exposure over extended periods.

Background: Treatment resistant cluster headache and migraine patients are exploring alternative treatments online. The aim of this study was to improve comprehension regarding the use of non-established or alternative pharmacological treatments used by sufferers of cluster headaches and migraines.

Methods: A qualitative thematic analysis of the users’ own accounts presented in online forum discussions were conducted. The forum boards https://shroomery.org/, http://bluelight.org, and https://clusterbusters.org/ met the inclusion criteria and were used for the study.

Results: The analysis resulted in six themes: a desperate need for effective treatments; the role of the forum—finding alternative treatments and community support; alternative treatment substances; dosage and regimens; effects and treatment results; and adverse effects. The results provide an insight into why, how, and by which substances and methods sufferers seek relief from cluster headache and migraines.

Conclusions: These patients are in a desperate and vulnerable situation, and illicit psychoactive substances are often considered a last resort. There appeared to be little or no interest in psychoactive effects per se as these were rather tolerated or avoided by using sub-psychoactive doses. Primarily, psilocybin, lysergic acid diethylamide, and related psychedelic tryptamines were reportedly effective for both prophylactic and acute treatment of cluster headache and migraines. Treatment results with cannabis were more unpredictable. No severe adverse events were reported, but it was observed how desperation sometimes spurred risky behavior when obtaining and testing various treatment alternatives. The forum discourse mainly revolved around maximizing treatment results and minimizing potential harms. 

The aim of the study was to investigate whether or not 33 flotation sessions were more effective for stress-related ailments than 12 sessions. Participants were 37 patients, 29 women and 8 men, all diagnosed as having stress-related pain of a muscle tension type. The patients were randomized to one of two conditions: 12 flotation-REST treatments or 33 flotation-REST treatments. Analyses for subjective pain typically indicated that 12 sessions were enough to get considerable improvements and no further improvements were noticed after 33 sessions. A similar pattern was observed concerning the stress-related psychological variables: experienced stress, anxiety, depression, negative affectivity, dispositional optimism, and sleep quality. For blood pressure no effects were observed after 12 sessions, but there was a significant lower level for diastolic blood pressure after 33 sessions. The present study highlighted the importance of finding suitable complementary treatments in order to make further progress after the initial 12 sessions.

Introduction

The objective of this qualitative case report was to describe experiences of flotation-Restricted Environmental Stimulation Technique from the perspective of a woman with Attention Deficit Hyperactivity Disorder, Aspergers syndrome and experiences of depression and distress.

Case presentationThe respondent is a 36-year-old woman from Sweden, assessed and diagnosed by a neuropsychological multi-professional team in 2006. The 19-session flotation series prolonged during almost one year.

Conclusion

The positive development of arousal control, activity regulation, sensory integration and interpretation, cognitive functioning and emotional maturity created experiences of personal independence and quality of life. Flotation-restrictive environmental stimulation technique was experienced as a meaningful treatment. Additional studies of treatment for Attention Deficit Hyperactivity Disorder and comorbid disorders in adults using the flotation-restrictive environmental stimulation technique are strongly encouraged.

Our aim was to investigate whether or not highly sensitive persons experienced more nonordinary/altered states of consciousness (ASC) during 45 minutes of sensory isolation in a flotation tank, than did less sensitive persons. Psychology students (N = 57) were allocated to 1 of 2 groups (high and low levels of sensitivity) depending on their score on the Highly Sensitive Person Scale. Prior to the flotation session participants completed questionnaires to assess their degree of depression, anxiety, optimism, absorption, and how often they had experienced a mystical state. After the flotation session we assessed degree of ASC. The main finding was that the highly sensitive individuals experienced significantly more ASC during flotation than did the individuals in the low sensitivity group. Further, the highly sensitive participants had significantly more absorption and anxiety, and had experienced mystical states more frequently prior to flotation, in comparison to individuals with low-level sensitivity.

Among the anxiety disorders Generalized Anxiety Disorder (GAD) is currently the most treatment resistant, suggesting that treatment protocols could be enhanced. A promising treatment of GAD is flotation-REST (Restricted Environmental Stimulation Technique), which in earlier studies has been shown to alleviate symptoms in GAD. Although, research on flotation-REST as a treatment of GAD has shown promising results no study has explored how the treatment is experienced. By applying a phenomneological perspective the present study aims to characterize the experience of undergoing flotation-REST treatment while suffering from GAD. Nine participants with GAD, as defined with self-report measures, participated. Data was collected by semi-structured interviews that were conducted after the completion of a twelve session treatment profram with flotaiton-REST. The Empirical Phenomenological Psychological (EPP) method was usedfor gathering and analyzing the data. The analysis resulted in six themes that characterize the experience of undergoing a flotation-REST treatment while having GAD: (1) obstacles in treatment, (2) a relaxed and safe vantage point, (3) non-ordinary states of consciousness, (4) connecting with oneself, (5) new attitudes and coping strategies, (6) enhanced life-quality. The results highlights that flotation-REST treatment of GAD was experienced as a comprehensive processes that were both challenging and pleasant. The results indicated that the method positively affected symptoms and the core issue associated with GAD on an experiential level. The present study also genereated some initial understanding regarding potential mechanisms that migh mediate and maintain positive treatment effects when flotation-REST is applied as an intervention of GAD. 

Background: During Flotation-REST a person is floating inside a quiet and dark tank, filled with heated salt saturated water. Deep relaxation and beneficial effects on e.g. stress, sleep difficulties, anxiety and depression have been documented in earlier research. Despite that treatments for generalized anxiety disorder (GAD) are effective; it is till the least successfully treated anxiety disorder, indicating that treatment protocols can be enhanced. The use of Flotation-REST as a treatment of GAD has not been researched. The aim of the present study was to conduct an initial evaluation of the effects in a self-diagnosed GAD sample.

Methods: This study was a randomized, parallel group, non-blinded trial with 1:1 allocation ratio to waiting list control group (n = 25) or to a twelve session treatment with flotation-REST (n = 25). Inclusion criteria’s were: 18–65 years and GAD (as defined by self-report measures). The primary outcome was GAD-symptomatology, and secondary outcomes were depression, sleep difficulties, emotion regulation difficulties and mindfulness. Assessments were made at three time points (baseline, four weeks in treatment, post-treatment), and at six-month follow-up. The main data analyses were conducted with a two-way MANOVA and additional t-tests. Forty-six participants (treatment, n = 24; control, n = 22) were included in the analyses.

Results: A significant Time x Group interaction effect for GAD-symptomatology [F(2,88) = 2.93, p < .001, η2p = .062] was found. Further analyses showed that the GAD-symptomatology was significantly reduced for the treatment group (t(23) = 4.47, p < .001), but not for the waiting list control group (t(21) = 0.98, p > .05), when comparing baseline to post-treatment scoring. Regarding clinical significant change, 37 % in the treatment group reached full remission at post-treatment. Significant beneficial effects were also found for sleep difficulties, difficulties in emotional regulation, and depression, while the treatment had ambiguous or non-existent effects on pathological worry and mindfulness. All improved outcome variables at post-treatment, except for depression, were maintained at 6-months follow. No negative effects were found.

Conclusion: The findings suggest that the method has potential as a complementary treatment alongside existing treatment for GAD. More studies are warranted to further evaluate the treatments efficacy. 

Abstract. The purpose of the presented investigations was to study the phenomenology and effects of altered states of consciousness (ASC) induced through previous illicit use of psychedelic drugs as well as experimentally induced ASC through the flotation tank restricted environmental stimulation technique (flotation-REST) in a laboratory setting. Of special interest was the effect of flotation-REST induced ASC as a function of previous experiences of ASC and defined experimentally modified settings on creativity, stress and psychological subjective impact.



In Paper I it was shown that through a structured anonymous questionnaire of previous illicit psychedelic drug users that transpersonal experience clusters, as described by Stanislav Grof during therapeutic use of LSD, were well represented outside the therapeutic setting. The psychological implications and also adverse effects of ASC in non-supportive settings are discussed.



In Paper II it was shown that such mild techniques as that induced by so called flotation-REST to some extent may induce altered states of consciousness comparable with psychedelic drugs. These experimentally induced flotation-REST experiences are described in detail and the effect as a function of modified pre-flotation setting (fantasy/strict) and previous experiences of ASC was studied in Paper II. It was shown that "expectation" and "setting" had no significant effect on the subjective flotation-experience. Also, a significant elevation of mood and a pain-reducing effect were noted from prefloating to postfloating.



In Paper III, experimental modifications of both "setting" (stress/non-stress) and technique (chamber-REST versus flotation-REST) were performed in connection with measurements of creativity. Chamber-REST and flotation-REST were equally effective in reducing stress, but flotation-REST altered consciousness to a higher degree than chamber-REST. Floatation-REST induced more originality and impaired deductive thinking whereas chamber-REST induced more realistic and elaborated thinking. An interaction effect was noted in so far as participants stressed in the chamber-REST condition showed more realism than their non-stressed counterparts.



The results from the present investigations show that flotation-REST offers a safe and practical method of inducing altered states of consciousness in a controlled laboratory setting. In light of the presented findings, the technique is seen as a promising area for future research on stress reduction, pain treatment and personal development.



Key words: Altered states of consciousness, ASC, Floating, Flotation, REST, Psychedelic, Pain, Creativity.

Abstract. The purpose of the presented investigations was to study the influence and effects of altered states of consciousness (ASC) induced through the flotation tank restricted environmental stimulation technique (flotation-REST) in a laboratory setting. The results from the present investigations indicate that flotation-REST may offer a safe and practical method of inducing altered states of consciousness in a controlled laboratory setting. Throughout, flotation-REST was experienced as a positive event by the participants. In order to optimize the conditions of flotation-REST, possible differences in the type of experiences due to different settings (strict/fantasy) applied in the laboratory were examined; no such differences were obtained. Nor were experiences in the flotation tank affected by participants earlier experiences of altered states of consciousness. Mental experiences reported from flotation-REST include deep relaxation, experiences of leaving or losing contact with the body, visual and auditory pseudo-hallucinations and transpersonal experiences. Comparisons between chamber-REST and flotation-REST indicated that the flotation-REST group experienced a significantly higher degree of ASC as compared to the chamber-REST group. The instrument, EDN-scale, was developed to allow these measures. Investigations of creativity indicated that flotation-REST induced more originality and impaired deductive thinking, in comparison to chamber-REST. Chamber-REST induced more realistic and elaborated thinking compared to flotation-REST. Comparison of these two conditions indicated that both flotation-REST and chamber-REST were equally effective in reducing subjectively experienced stress. An experimental pain procedure was arranged in order to study the experience of pain in connection with individuals experiencing ASC (induced by flotation-REST). A higher level of pain and stress was obtained in those individuals with high ASC in the flotation-group compared with those with low ASC (as measured with the EDN-scale). The individuals presenting high ASC also experienced duration of experimental pain as shorter compared with low ASC individuals, within the flotation-REST condition. Within the chamber-REST condition, there were no differences between the low ASC and high ASC individuals. To study the possible pain-alleviating effects of flotation-REST upon existing, chronic pain, a series of flotation-REST treatments over a three-week period was carried out. It was found that the participants most severe perceived pain intensity was significantly reduced, whereas low perceived pain intensity was not influenced by the floating technique. Further, the results indicated that the circulating levels of noradrenaline metabolite MHPG (3-methoxy-4-hydroxy-phenylethyleneglycol) were reduced significantly in the experimental group but not in the control group following treatment, whereas endorphin levels were not affected by flotation. Flotation-REST treatment also elevated the participants' optimism and reduced the degree of anxiety or depression; at nighttime, patients who underwent flotation fell asleep more easily. These findings describe possible alleviations in patients presenting with chronic pain complaints. Taken together, these studies on the flotation-REST technique offer a promising avenue of future research on stress reduction, pain treatment and personal development, hopefully elucidating regional brain implicit and explicit processes.





Key words: Altered states of consciousness, ASC, Floating, Flotation, REST, Pain, Creativity, Stress, setting.

This study aimed to compare the restorative effects of 30 minutes relaxation in a natural environment with an indoor simulation of the same natural environment. A repeated-measure design was carried out and 18 participants suffering from stress and/or burnout syndrome were counterbalanced into the two conditions. Both physiological measures and psychological instruments were applied. Further, qualitative descriptions of experiences were obtained. A phenomenological analysis of the qualitative data resulted in six categories for the natural environment: Intensified sensory perception; A feeling of harmony and union with nature; Well-being and quality of life; Renewed energy and awakening; Here-and-now thinking; and A sense of tranquillity, while for the simulated natural environment, there were five categories: Restlessness and anxiety; Lack of concentration; A sense of being cut off from natures sensory input; A longing to be in real nature; and Positive emotions. The natural environment yielded a significantly higher rating of degree of altered states of consciousness (ASC) and energy than the simulated natural environment. The results suggest that both environments facilitated stress reduction, with the natural environment additionally bringing increased energy and ASC, thus possibly enhancing and promoting restoration

The aim of the present pilot study was to get information whether or not a 10-week combined treatment program with relaxation in a flotation tank and subsequent psychotherapeutic sessions, may be beneficial for persons suffering from high stress-load and 'burnout syndrome'. Four women and two men between the ages of 33 and 57 years old took part in the study. They were all diagnosed as on the brink for sick leave and suffering from 'burn-out syndrome' with symptoms of fatigue and problems organizing daily life. All clients participated in the 10-week treatment program consisting of flotation-REST (Restricted Environmental Stimulation Technique) treatments and conversational therapy with a psychologist. During the treatment program they continued their usual work, but were able to leave for 4 hours a week for participating in the treatments. The results revealed a significant decrease in degree of depression and anxiety and an increase in positive outlook on life. There was also a significant decrease in extent of painful areas and a significant decrease in their experienced worst pain-intensity. After the treatment period, they all continued to work, and there was no need for sick-leave. The conclusion is that this combined treatment program is promising and should be further evaluated in a randomized control trial.

The focus of this study was to investigate experiences gained from treatment combining relaxation in flotation tank with psychotherapy for sufferers from burn-out syndrome. Six people participated in aten week program. They were all interviewed; the data were analyzed using the Empirical Phenomenological Psychological method. Five themes emerged: (a) direct experiences during flotation, (b) effects due to the treatment sessions, (c) psychological transformation, (d)reflections about the treatment program, and (e) demanding and rewarding psychological process over time. All participants went through psychological transformations and improvements in quality oflife. At the end of the treatment program, all participants were able continue working full time. This combined program seems to be more therapeutically beneficial than flotation tank treatment alone

The aim of this single-subject study was to report experiences from one and a half years of regular floating as described by a person with neuropsychiatric and mental health disorders. Floating, or Flotation Restricted Environmental Stimulation Technique, involves relaxation and sensory deprivation by means of resting in a tank with highly salted and body-tempered water. The subject, a 24-year-old woman diagnosed with attention deficit hyperactivity disorder, atypical autism, post-traumatic stress disorder, anxiety and depression floated regularly for one and a half years. Interviews regarding her experiences were analyzed and the main findings involved a subjective sense of improved quality of life, wellbeing and healthy behavior. There were no negative effects from treatment. Results suggest that floating may have beneficial therapeutic effects on mental health. Further studies that evaluate the efficacy and possible effects of floating with regard to mental health are needed.

Background: Self-care treatments with bed of nails or spike mats have gained increased popularity world-wide; advertised as a method for pain reduction and wellbeing. Scientific studies regarding effects are still lacking. The aim of the present study was to investigate if daily relaxation on a spike mat for three weeks could induce beneficial effects.Design and methods: Participants were 36 individuals suffering from muscle tension pains in their back or/and neck. They were randomly assigned to a control group or an experimental group, who were treated with 15 minutes daily rest during three weeks on the spike mat.Results: Significant reduced experienced worst pain intensity was found. There were no effects on normal pain intensity, optimism, anxiety, depression, stress, energy, or sleep quality. Conclusion: The participants appreciated the treatment, but their enthusiastic verbal reports of experienced beneficial effects could not be verified in the statistical analyses. The reduction of worst pain may be explained by the gate-control theory, where competing stimuli applied over the affected area produce a pain reduction. It can also be an effect of placebo or the relaxation. More research on relaxation on a spike mat is needed before its possible effects can be confirmed. No negative effects were found in the present study, but it has to be remembered no studies investigating risks for treatment on spike mats exist.

This study investigated the experiences gained from a 20-minute shamanic-like drumming session. Twenty-two persons participated and made written descriptions afterwards about their experiences. A phenomenological analysis was applied which generated 31 categories, that were organized into six themes: 1) The undertaking of the drumming journey, 2) Perceptual phenomena: visual, auditory and somatic, 3) Encounters, 4) Active vs. Passive role, 5) Inner wisdom and guidance, and 6) Reflections on the drumming journey. A multitude of detailed experiences were described such as visual imagery, hearing sounds, encountering animals, as well as gaining insights. Participants generally appreciated the drumming session and few negative effects were noted. The conclusion made is that shamanic-like drumming can be a valuable supplement to other psychotherapeutic techniques.

Spice is a smoking mixture containing synthetic cannabinoids with psychoactive effects similar to herbal cannabis. It is sold on the Internet and has become popular among young people. The purpose of the present study was to investigate experiences of intoxication induced by Spice, as described on a Swedish internet-based discussion forum.

Background: Two novel synthetic opioids, MT-45 and AH-7921, with mostly undocumented effects and risks, have emerged on the expanding market for recreational drugs on the Internet. The aim of the present study was to characterize the experiences of AH-7921 and MT-45 as described by the users on international drug discussion forums.

Methods: A systematic data search resulted in 96 self-reports which were collected from the leading edge resources of drug related information online. The data were analysed qualitatively using thematic analysis.

Results: The experiences of MT-45 and AH-7921 were characterized by the following themes: (1) Administration of the substances, (2) Well-being and energy, (3) Sedation and reduced here-and-now awareness, (4) Tolerance and withdrawal effects, (5) Side effects, (6) Evaluation of the effects, (7) Increased appreciation, sociableness and intimacy and (8) Self-medication. The experiences appeared to include not only the general and expected opioid effects like withdrawal, analgesia, euphoria, cough suppression, fatigue, constipation, itching, involuntary muscle spasm, nausea and pupillary constriction but also a noteworthy increase in energy. Furthermore, the users also experienced reduced inhibition and a facilitation of social situations. The results also showed that users engaged in different forms of self-medicating behaviour aimed at reducing pain or withdrawal symptoms from traditional opioid use.

Conclusion: The spread of unpredictable, potent and novel opioids constitutes a public health concern which needs to be further monitored in order to minimize potential harm. 

Methoxetamine (MXE), a ketamine analogue, is one of the new “legal highs” sold on the Internet. The aim of this qualitative study was to provide an initial understanding of what character- izes the experiences induced by MXE. Anonymously written reports (33 persons) on the effects of MXE were collected from public Internet forums and analyzed using the Empirical Phenomenological Psychological Method. The analysis generated 10 themes: (1) preparation, motivation and anticipation; (2) initial effects; (3) malfunction of cognitive processes stabilizing normal state; (4) inner personal processes and learning; (5) emotional processes; (6) altered sensory perception; (7) dissolution and transition; (8) spiritual and transcendental experiences; (9) effects and processes after the experience; (10) re-dosing and addiction.

MXE induced a heavily altered state of consciousness. The effects were similar to those induced by classic hallucinogens (such as LSD, psilocybin) and the dissociative ketamine. MXE seemed to have quite a high abuse potential. Beside the positive effects described, negative effects like fear and anxiety were also reported. Acceptance was considered the best coping strategy. Dissolution of iden- tity and body often culminated in spiritual and transcendental experiences. More research is needed on safety issues, how to minimize harm, and the motivation for using legal highs. 

Introduction: Some therapies described within alternative and complementary medicine are advertised as sleep-promoting, including flotation-REST (Restricted Environmental Stimulation Technique). Flotation-REST induces deep relaxation through sensory isolation in a water-filled tank and is plausibly reported to mitigate insomnia problems, which have consistently been associated with stress, worry and arousal. However, the effects of flotation-REST have not been previously summarised. The aim of this systematic review was to investigate the efficacy of flotation-REST on sleep in clinical and non-clinical samples. Methods: A systematic search for studies on flotation-REST, involving at least one sleep-related variable, was conducted in the databases PubMed, Google Scholar, Web of Science and PsychINFO. Thirteen full-text articles met the inclusion criteria and were considered for eligibility. Nine were included in the current review. The methodological quality of the studies was assessed using a structured checklist, and a standard data extraction sheet was used to summarize the ratings. Results: In all included studies, flotation-REST demonstrated beneficial effects on sleep, both in clinical and nonclinical samples. In two studies, the effects were maintained 4 or 6 months post-treatment. The quality of the sleep outcome measures were, however, low in most studies, particularly regarding the participants' nightly sleep habits, self-reported sleep problems and insomnia diagnosis. Conclusions: Flotation-REST may be a promising treatment for insomnia symptoms, but more controlled studies with established sleep measures, and on populations with clinically verified insomnia, are needed.

Introduction: Some therapies described within alternative and complementary medicine are advertised as sleep-promoting, including flotation-REST (Restricted Environmental Stimulation Technique). Flotation-REST induces deep relaxation through sensory isolation in a water-filled tank and is plausibly reported to mitigate insomnia problems, which have consistently been associated with stress, worry and arousal. However, the effects of flotation-REST have not been previously summarised. The aim of this systematic review was to investigate the efficacy of flotation-REST on sleep in clinical and non-clinical samples.

Methods: A systematic search for studies on flotation-REST, involving at least one sleep-related variable, was conducted in the databases PubMed, Google Scholar, Web of Science and PsychINFO. Thirteen full-text articles met the inclusion criteria and were considered for eligibility. Nine were included in the current review. The methodological quality of the studies was assessed using a structured checklist, and a standard data extraction sheet was used to summarize the ratings.

Results: In all included studies, flotation-REST demonstrated beneficial effects on sleep, both in clinical and nonclinical samples. In two studies, the effects were maintained 4 or 6 months post-treatment. The quality of the sleep outcome measures were, however, low in most studies, particularly regarding the participants' nightly sleep habits, self-reported sleep problems and insomnia diagnosis.

Conclusions: Flotation-REST may be a promising treatment for insomnia symptoms, but more controlled studies with established sleep measures, and on populations with clinically verified insomnia, are needed.

Ayahuasca is a psychoactive brew used by the indigenous populations of the Amazon. The aim of this qualitative study was to gain insight into the experiences of western users of ayahuasca, as well as to ascertain the experienced meaning that participants felt by their participation. Twenty-five people from Northern Europe with experiences of group sessions with ayahuasca wrote anonymous descriptions of their experiences. The Empirical Phenomenological Psychological method was used for this analysis. The analysis resulted in 33 categories which were assembled into six general themes: (a) motivation and aim, (b) contractile frightening state (c) sudden transformation of the experience, (d) limitless expansive states with transcendental experiences, (f) reflections, and (g) changed worldview and new orientation to life. These themes provided a new structure, called the transcendental circle. Participants reported many positive psychological and physical improvements that indicate that ayahuasca could be of potential interest in the development of new medicines and therapies.

The aim of this study was to investigate if the highly sensitive personality variable affects the occurrence of mystical experiences and degree of altered states of consciousness during sensory isolation in flotation-tank. Forty-eight persons (20 men, 28 females) were included. Background variables and the Highly Sensitive Personality Scale (HSP) were assessed. The independent variable was derived from this scale, where two groups were formed: low sensitivity and high sensitivity. The treatment lasted 45 minutes in the flotation tank. Dependent variables were assessed through scales measuring mystical experiences and degree of altered states of consciousness. The group with highly sensitive persons experienced significant more mystical experiences and higher degree of altered states of consciousness during the treatment compared to the other group. Also the highly sensitive persons exhibited more stress and anxiety at arrival, but no differences of depression and optimism were found between the groups

The aim of the present study was to investigate whether the experiences and effects of 45 minutes relaxation in flotation tank were influenced by breathing instruction or by a sensitive personality. A sample of 48 persons, 20 men and 28 females (mean age 27.40 years) were randomized into two groups; with or without a breathing relaxation instruction. The second independent variable was sensitive personality (low, high) derived from the Highly Sensitive Person Scale. Dependent variables were Subjective Flotation Experience (Kjellgren, Sundequist, Norlander, & Archer, 2001) and detection threshold and upper threshold pain endurance. Main results indicated that experiences during flotation with regard to comfort and stress reduction were not influenced by instructions or by sensitive personality. These results are in line with earlier findings indicating that flotation-REST is not particularly affected by expectancies, earlier experiences, personality or surroundings in the laboratory

The psychoactive substance 4-HO-MET (4-hydroxy-N-methyl-N-ethyltryptamine) with psychedelic qualities is one of many legal so-called Internet drugs. The aim of this qualitative study was to establish an understanding of what characterizes its recreational use. Very little is known about the effects of this substance. Twenty-five anonymous Swedish experience reports (from persons aged 18-30 years) from public Internet forums were analyzed using the Empirical Phenomenological Psychological Method. The analysis produced 37 categories that were compiled into nine general themes: (1) motivation, preparation and expectation; (2) initial effects; (3) change of perception; (4) unfiltered awareness and intensified flow of information; (5) lateral cognition; (6) border between subject and object is erased; (7) heaven; (8) hell; and (9) subsiding effects. An understanding of the chronological happenings, called The Process, appeared out of the general structure. Drastic changes in cognitive, emotional and bodily functions were described. The motivation for use seemed to be driven by a strong curiosity. The experiences shifted between "heaven" and "hell", but participants appeared satisfied and ready to repeat the experience. The experiences described show great similarity with classic psychedelic substances as LSD or psilocybin. More research is needed about health hazards or possible therapeutic potentials

This phenomenological study into Zen practitioners experiences of zazen meditation is based on eight semi-structured interviews with four experienced and four inexperienced zazen meditators. The respondents descriptions were analysed using a five-step Interpretative Phenomenological Analysis (IPA) process into thirteen super-ordinate themes. The phenomenological analysis revealed differences between the two groups. Some experienced meditators reported differences that might be interpreted as trait changes due to meditative practice. These included the ability to remain conscious in the dream and deep sleep state as well as greater clarity, greater serenity, and more compassion in the waking state. Supplementary quantitative data gathered by a questionnaire indicated that inexperienced meditators perceived a greater difference between meditation and a normal waking state than did experienced meditators. This finding might indicate that the experienced meditators have integrated the meditative state into their daily life as a normal state, an area warranting future inquiry

Background: Sensory isolation in a flotation tank is a method known for inducing deep relaxation and subsequent positive health effects for patients suffering from e.g. stress or muscle tensions pains. Very few studies have investigated this method as a preventive health-care intervention. The purpose of this study was to evaluate the effects in healthy participants after receiving a series of flotation tank treatment.

Methods: Sixty-five participants (14 men and 51 women) who were all part of a cooperative-health project initiated by their individual companies, were randomized to either a wait-list control group or a flotation tank treatment group where they participated in a seven weeks flotation program with a total of twelve flotation sessions. Questionnaires measuring psychological and physiological variables such as stress and energy, depression and anxiety, optimism, pain, stress, sleep quality, mindfulness, and degree of altered states of consciousness were used. Data were analysed by two-way mixed MANOVA and repeated measures ANOVA.

Results: Stress, depression, anxiety, and worst pain were significantly decreased whereas optimism and sleep quality significantly increased for the flotation-REST group. No significant results for the control group were seen. There was also a significant correlation between mindfulness in daily life and degree of altered states of consciousness during the relaxation in the flotation tank.

Conclusions: It was concluded that flotation-REST has beneficial effects on relatively healthy participants. 

Background: Burnout is a hidden productivity killer in organizations. Finding a solution to efficiently measure and proactively prevent or rehabilitate employees with burnout is a challenge. To meet this unabated demand, companies and caregivers can focus on proactive measures to prevent "Burnout as an Occupational Phenomenon." Objective: We aimed to address effectiveness, reliability, and validity of the empowerment for participation (EFP) batch of assessments to measure burnout risk in relation to the efficacy of web-based interventions using cognitive behavioral therapy (CBT) and floating to improve mental health and well-being. We introduced three risk assessments: risk for burnout, risk of anxiety, and risk for depression. Methods: We used an interventional, empirical, and parallel design using raw EFP psychometric data to measure the effectiveness of web-based therapy to reduce the risk of burnout between a control group and web-based therapy group. A total of 50 participants were selected. The rehabilitation and control groups consisted of 25 normally distributed employees each. The rehabilitation group received therapy, whereas the control group had not yet received any form of therapy. IBM SPSS was used to analyze the data collected, and a repeated measures ANOVA, an analysis of covariance, a discriminant analysis, and a construct validity analysis were used to test for reliability and validity. The group was selected from a list of employees within the My-E-Health ecosystem who showed a moderate or high risk for burnout. All assessments and mixed-method CBT were web-based, and floating was conducted at designated locations. The complete EFP assessment was integrated into a digital ecosystem designed for this purpose and therapy, offering a secure and encrypted ecosystem. Results: There was a statistically significant difference between pre- and postassessment scores for burnout. The reliability of the burnout measure was good (Cronbach alpha=.858; mean 1.826, SD 3.008; Cohen d=0.607; P<.001) with a high validity of 0.9420. A paired samples 2-tailed test showed a good t score of 4.292 and P<.001, with a good effect size, Cohen d=0.607. Web-based therapy reduced the risk for burnout in participants compared with the control group. Tests of between-subject effects show F=16.964, a significant difference between the control group and the web-based therapy group: P<.001, with movement between the group variables of 0.261 or 26.1% for the dependent variable. Conclusions: This study suggests good reliability and validity of using web-based interventional mixed methods CBT to reduce the risk of burnout. The EFP batch of web-based assessments could reliably identify morbidity risk levels and successfully measure clinical interventions and rehabilitation with consistently reliable results to serve as both a diagnostic and therapeutic tool worthy of major research in the future.

The purpose of this project was to do a qualitative study of an integrated and flexible ACT model, the Resource Group Assertive Community Treatment (RACT), as seen from the perspective of case managers in training. The resource group normally consists of the client, the case manager and other available personnel in the medical and support areas, as well as family members. Nineteen theses were randomly chosen from a set of 80 theses written by a group of Swedish trainee case managers. The exams were conducted as case studies and concerned 19 clients with psychotic problems, 11 men and 8 women. “The Empirical Phenomenological Psychological Method” was used in the analysis, which generated five overarching themes: (a) the RACT program; (b) the resource group; (c) the empowerment of the client; (d) progress in treatment; and (e) the case manager. These together constituted a “therapeutic circle,” in which methods and tools used within the RACT made it possible for the resource group to empower the clients who, as a result, experienced progress with treatment, during which the case manager was the unifying and connecting link.

Objectives: Flotation-REST is a treatment for deep relaxation, where a person is contained in a stimuli-restricted environment and floats in water with high salt content. The aim was to investigate the effects from flotation-REST on people with insomnia diagnosis, as previous studies of flotation-REST have demonstrated some effects on sleep but have limitations regarding sample selections and sleep measures. Material and Methods: Six participants were recruited through an outpatient psychiatry clinic and posters on a university campus. All participants fulfilled criteria for insomnia diagnosis and four fulfilled criteria for major depressive disorder. Using a single case experimental design, daily changes were investigated on sleep logs regarding sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), and sleep efficiency over the course of 12 sessions consisting of 45 min of flotation-REST. No other treatments were offered simultaneously. Questionnaire data on insomnia severity (the ISI) and depressive severity (the MADRS) were also collected. Results: Three participants improved on their most salient insomnia symptom (long SOL or WASO), and two improved on sleep efficiency. The improvements were maintained 2 months after treatment. Insomnia severity decreased for three patients, whereas depressive severity decreased for five. No changes in TST were found and two patients did not improve on any sleep measure. The two participants who benefitted the most were students in their 20s. Discussion: The results were mixed. Flotation-REST may be beneficial for young adults with sleep-onset insomnia but more research is warranted.

Abstract

The purpose of this study was to investigate if experiences induced by flotation-REST (in flotation-tank) are affected by settings or subjects earlier experiences of altered states of consciousness (ASC). No such significant differences were found. Significant effects owing to flotation-REST were found regarding reduction in experienced pain and enhancement of mood. Flotation-REST was considered a pleasurable technique. Different kinds of visual and acoustic effects, altered time perception and a sense of weightlessness have been reported. Also deep transpersonal experiences were quite common, these could be distinguished into three types: experiences of one's own childbirth/delivery, feeling of cosmic unity and experiences of losing contact with the body or out-of-body-experiences. Flotation-REST must be regarded as a consciousness-altering method with promising potential for clinical and therapeutic use.



Key words: Flotation-REST - Setting - Drug experience - Pain - Mood - Verbal analysis - Altered state of consciousness.