It’s been speculated by researchers that the therapeutic effects we are seeing may in fact be due to a physical change - specifically potent anti-inflammatory effects of 5ht-2a agonists, though this has been confirmed more for other psychedelic drugs such as DOI, at non-psychoactive dosages (and in rats) [1].

Hence the psychological narrative may be backed by an actual psychiatric, physiochemical change. An actual change, in “reality” - in other words, assuming some form of inflammation is involved in most depressive states...

[1] DOI: 10.1371/journal.pone.0075426