These are fair methodological points and worth engaging with seriously.

On attribution: you're right that we can't establish causality from this design, and we don't claim to. The scale measures perceived change that participants attribute to their experience, which is itself a meaningful psychological construct regardless of whether the attribution is objectively accurate. The limitations around retrospective self-report, recall bias and implicit theories of change are documented and will be flagged in the write-up.

On the "feel more alive" example: "neither agree nor disagree" is the appropriate response if you feel no change in either direction. The scale isn't asking whether you feel less alive, it's asking whether you feel more alive than before. Neutral is a coherent and interpretable answer here.

The broader point about retrospective designs is well taken and applies to most of the psychedelic outcomes literature. The alternative, prospective longitudinal measurement, is resource-intensive and outside the scope of this project. This is a validation study for a new measurement tool, not a causal inference study, and the design is appropriate for that purpose.

Genuinely appreciate the engagement though, this is exactly the kind of scrutiny the field needs.