Rosalind Watts

Rosalind Watts was a clinical psychologist working for the National Health Service when an article about psychedelic therapy in the New Yorker prompted her to contact Robin Carhart-Harris. The possibility of treating mental illness rather than merely managing its symptoms drew her into the Imperial College London depression study, the laboratory’s first move into clinical research. Watts helped guide several psilocybin sessions, then interviewed every volunteer six months after treatment. Her work shifted attention from the question of whether symptoms changed to what participants felt had happened within them: how depression shaped their relation to the world, and what the drug session made newly possible.

From clinical interest to the depression study

Watts entered the project with a question that was both clinical and experiential. The volunteers’ outcomes mattered, but so did the texture of the change: what had felt inaccessible before treatment, what became vivid during or after it, and what remained months later. By conducting qualitative interviews with all participants at the six-month point, she could compare individual accounts and identify patterns that a symptom score alone would not describe.

The study’s results gave those accounts a consequential setting. After a week, all twelve volunteers in the initial group showed improvement, and two-thirds were free of depression; seven still showed substantial benefit at three months. The research later expanded to twenty participants. At six months, six remained in remission, while others had relapsed to varying degrees. The study was small and not randomized, so its results could not settle whether psilocybin was an effective treatment. It did, however, report rapid improvement, good tolerability, and no adverse events in this group. Watts’s interviews addressed a complementary problem: why the experience might matter to participants, and why its effects could be profound yet not necessarily permanent.

Disconnection and the return of experience

Watts identified two master themes in the interviews. The first was disconnection. Participants described depression as separation not only from other people, but from earlier versions of themselves, their senses and feelings, their central beliefs and spiritual values, and the natural world. Some characterized their condition as imprisonment; others described being stuck in repetitive rumination, as if thought had become a gridlocked road with no exit. These were not merely images of sadness. They conveyed a constriction of the person’s available world: life continued, but felt distant, narrowed, or inaccessible.

That distance could reach into ordinary perception. One participant explained to Watts that orchids still registered intellectually as beautiful, but no longer produced an experience of beauty. The distinction captures what depression had taken from the person: not the ability to recognize what should be moving, but the felt connection through which recognition becomes an encounter. Watts’s findings resonated with Carhart-Harris’s hypothesis that depression might involve an overactive default mode network, where rumination appears to occur. The interview themes gave that proposed neural pattern a human description without reducing the participants’ accounts to it.

For many volunteers, the psilocybin session interrupted the enclosure, at least temporarily. Participants described an interval in which they were no longer immersed in their usual patterns of thought and felt freer, reenergized, or newly able to experience their surroundings. Some reported that this change outlasted the immediate session: their thinking felt less ruminative and more ordered, and the world seemed connected to rather than set apart from the self. Watts’s account thus presented relief not simply as the absence of depressive symptoms, but as a recovery of contact—with sensation, thought, other people, and nature.

Difficult emotions and Ian Rouiller

Watts’s second master theme was renewed access to difficult emotions. She proposed that relentless rumination can narrow a depressed person’s emotional range; in other cases, painful feelings may be held at bay because experiencing them seems intolerable. This made the return of emotion more complicated than a simple turn from sadness to happiness. In the accounts Watts gathered, improvement could mean becoming able to encounter feelings that had been avoided, including fear, grief, and pain.

The case of Ian Rouiller, a music journalist in the study, made that theme concrete. Watts introduced him to the reporter. Rouiller had been abused by his father in childhood, as had his older sister; as adults, the siblings brought charges that led to their father’s imprisonment for several years. The legal consequences had not lifted the depression that had followed Rouiller through much of his life. Antidepressants had helped for a time, but he described their effect as covering a wound rather than healing it.

During his psilocybin experience, Rouiller confronted an image of his father as a frightening military horse, upright on its hind legs, dressed in uniform and holding a gun. He initially wanted to push the image away, but stayed with it and looked it in the eyes. The encounter turned when its absurdity made him laugh. From there, he described being able to experience positive and negative emotions without sorting one kind as acceptable and the other as something to suppress. Thinking about Syrian refugees in Calais, he began to cry; the emotion itself was no longer evidence that the experience had gone wrong. He came to understand resistance as something that could amplify feeling, and described reaching a state of deep contentment and compassion that included himself.

Relief, persistence, and the limits of a session

Rouiller experienced several months of relief and a perspective on his life that antidepressants had not given him. In his six-month interview with Watts, he compared the shift to zooming out on Google Earth: for several weeks after the session, he felt connected to himself, living things, and the universe. The image of distance offered a striking counterpoint to the mental enclosure he had described. Yet the overview perspective gradually faded, and he returned to Zoloft.

A year later, Rouiller said the immediate brightness of life had diminished, while the insights from the trial remained, though they felt more like ideas than a lived state. He reported doing better than before and being able to hold down a job, but his depression had returned. Because another Imperial session was not then available to him, he sometimes meditated while listening to the session playlist, which he said helped restore something of that earlier perspective. His account preserved both sides of the result: the experience did not permanently remove his depression, but neither did the return of symptoms erase what he had learned or the period of relief he valued.

That pattern informed Watts’s view of the treatment’s promise and its uncertainty. More than half of the Imperial volunteers eventually experienced a return of depressive symptoms. She therefore described psychedelic therapy not as a guaranteed one-time cure, but as a possible shock to the system—a reboot that might need repeating, if repeated treatment proved effective. She believed the approach could revolutionize mental health care, a conviction she shared with other researchers interviewed in the book. Her interviews made that hope specific while resisting an easy triumphal story: they recorded renewed connection and emotional openness, but also the fading of benefits, the return to conventional medication, and the continuing need to understand what a powerful session can—and cannot—change.