Overview
Transformative experiences radically shift the beliefs, values, and understanding of self and others that constitutes the perception box. Dreaming is one of the most powerful innate routes to such experiences. We have recently shown that the anesthetic propofol can reliably induce dreams in both surgical patients and laboratory participants, and preliminary data demonstrate marked reductions in trauma-related symptoms after anesthetic-induced dreaming. Yet propofol dreams, while predominantly positive, show only moderate emotional intensity, vividness, and phenomenological complexity - the very qualities most strongly linked to therapeutic outcomes in psychedelic trials. This gap raises a critical question: can we deliberately engineer anesthesia dream phenomenology to maximize therapeutic benefit?
Aim 1 develops and validates pharmacological protocols for engineering anesthesia dream phenomenology. In Study 1 (N=15 healthy volunteers, within-subject), the centrally active acetylcholinesterase inhibitor physostigmine (0/1/2 mg i.v.) is titrated during propofol sedation; propofol is discontinued at peak physostigmine effect, allowing emergence from anesthesia, the state hypothesized to be associated with dreaming. We predict dose-dependent increases in dream recall frequency, complexity, emotional intensity, and vividness. In Study 2 (N=10, major depressive disorder, within-subject), psilocybin (0/10/25 mg p.o.) is administered before propofol induction; propofol is discontinued either at peak psilocybin effect to evaluate psilocybin-augmented propofol dreaming, or after psilocybin's peak to test whether psilocybin's perceptual effects can be masked. We predict dose-dependent phenomenological enhancement with low rates of challenging psilocybin experiences.
Aim 2 records simultaneous EEG and electrogastrography during Study 1, testing whether gastric infraslow oscillations and stomach-brain coupling explain variance in dream recall and phenomenological quality beyond EEG alone.
Aim 3, with the Johns Hopkins Center for Psychedelic and Consciousness Research, harmonizes phenomenological instruments across psychedelic, sleep-dreaming, and anesthesia-dreaming states, enabling the first quantitative cross-paradigm comparison.
Outputs include validated augmentation protocols, open multimodal gut-brain datasets, and an open-access altered-states measurement package.