Psychedelic therapy, or psychedelic-assisted psychotherapy (PAP), combines traditional talk therapy with a psychedelic substance such as LSD, psilocybin, ayahuasca, or MDMA. Extensive research on the use of these conscious-altering drugs is currently underway, showing promising results for treating serious medical conditions. The research so far has been so encouraging that in 2019, the FDA called psychedelic therapy a “breakthrough therapy,” suggesting that it might not be long before this experimental practice becomes more commonplace.
Researchers have determined that some psychedelics, such as psilocybin, are safe to use as a supervised, clinical treatment and can produce substantial positive results on a person’s mental health and well-being.
What Is Psychedelic Therapy?
Traditional psychiatric practice typically involves psychotherapy, where mental health professionals talk with patients in order to work through issues that are causing them emotional distress. Psychedelic therapy takes it a step further, using psychedelic substances to supplement talk therapy to elicit profound and lasting mental and behavioral change.
Natural psychedelics have been used medicinally since ancient times. Indigenous communities have also used psychedelics in both religious and therapeutic practices for hundreds of years. Yet psychedelic therapy has only reached clinical settings in the West more recently. In the 1950s, scientists began experimenting with the use of the psychedelic substance LSD to treat certain mood disorders and addiction. However, legal restrictions put that research to a halt in the 1960s, despite initial promising results.
Around 30 years later in the 90s, human psychedelic research resurfaced, resulting in the use of brain imaging technology in clinical trials of LSD and psilocybin as potential treatments for depression. Since then, research into the potential of psychedelic therapy to treat serious medical conditions has been steady.
In 2019, when the FDA called psilocybin-assisted mental healthcare a “breakthrough therapy,” research into the potential of psychedelic substances began to speed up. Now, more and more clinical trials are looking into the use of psychedelic therapy to treat a wide range of serious mental health issues. Thanks to the promising psychopharmacological studies underway, certain psychedelics have become increasingly legal as well.
How Does Psychedelic Therapy Work?
Psychedelic therapy involves traditional talk therapy while the patient ingests a set amount of a predetermined psychedelic drug. Because psychedelics alter a person’s consciousness, the therapist acts as a guide through the experience with the goal of healing specific mental health issues.
Most commonly, there are three phases of psychedelic therapy. The first is preparation, where a therapist trained in psychedelic treatment gets to know the patient in several talk therapy sessions. The idea is to explore the patient’s individual nature and develop a strong sense of trust.
The second phase is the psychedelic therapy session in which the patient consumes the psychedelic substance. Emphasis on both mindset and setting are crucial to properly curate the experience. The patient’s mindset upon entering the session includes paying attention to their mood and expectations as well as taking their personality and past experiences into account. The therapist’s approach as a guide is typically to provide an inviting environment for openness through trust.
In terms of setting, the physical environment is also important. In clinical trials, the setting often looks like a comfortable space, such as a living room, to provide an area that feels safe and relaxing. Sometimes, a carefully crafted playlist of music is included in the background. During the session, the therapist takes a non-assertive approach, mostly listening, offering support, assistance, and guidance when appropriate. Most sessions take roughly eight hours from start to finish.
In the days following the session, the final phase of psychedelic therapy includes what is called integration. These are conversations between the therapist and the patient to process the session. The role of the therapist is to either provide or respond to the insight gained during the psychedelic experience.
Between the three phases, the intention of the overall experience is to help the patient cope with or heal from their mental condition.
The Different Kinds of Psychedelic Therapy
Several different psychedelic substances are involved in psychedelic therapy research. These include:
Psilocybin – Psilocybin, recreationally known as magic mushrooms, is a hallucinogenic substance found in specific kinds of mushrooms. It alters one’s consciousness, perception, and mood. Psilocybin studies are looking into its potential for treating anxiety, depression, post-traumatic stress disorder, and addiction.
LSD – Lysergic acid diethylamide (LSD) is a chemically-made hallucinogen that alters consciousness, perception, and mood. Research shows that it may be useful for treating anxiety, post-traumatic stress disorder, and addiction.
Ayahuasca, Mescaline, Peyote, and DMT – These four hallucinogenic substances can all be found naturally in different plant and/or animal species. Their effects include altered perception, consciousness, and mood. Studies have shown their potential to treat depression, addiction, and anxiety.
MDMA – Most commonly known as ecstasy, MDMA is a chemically-made drug that can induce euphoric feelings, altered perception, lowered inhibitions, and increased sociability and arousal. It may have therapeutic potential for treating post-traumatic stress disorder and depression.
How Can it Help?
The potential application of psychedelic therapy is abundant. Below are the primary conditions psychedelic therapy shows potential for treating:
Post-traumatic stress disorder (PTSD) – Research has shown that the psychedelic effect of MDMA, psilocybin, and LSD may be useful in treating PTSD, particularly in patients who have severe PTSD and show little improvement from other treatment options. Psychedelic therapy has provided promising results suggesting that PTSD patients have the potential to fully recover.
Anxiety, depression, and other mood disorders – A 2016 randomized, controlled, double-blind study found psilocybin to significantly reduce depression and anxiety in cancer patients. A 2021 report summarizes the research and potential of psychedelic therapy in treating mood disorders, showing promising results all around.
Addiction – Substance abuse, including alcoholism, opiate addiction, and others have been consistently on the rise in the past century. Evidence from current research shows the potential of LSD, psilocybin, and other plant-based psychedelics for treating substance use disorders. For example, a 2017 study found that psychedelic therapy can lead to the long-term psychological changes needed to fully recover from addiction and reduce the risk of relapse.
General well-being – Research shows that the use of psychedelic can also help with relaxation, social connections, introspectiveness, empathy, and overall well-being.
More clinical research consisting of much larger, controlled studies is necessary before any of these therapies are officially approved. In the meantime, psychedelic drugs will continue to be used for therapeutic research in clinical and non-clinical settings alike. The results not only appear to be effective but long-lasting as well.
Potential Risks
Psychedelic substances are powerful and mind-altering. For this reason, their use in clinical, therapeutic settings could prove to provide significant mental health benefits. Psychedelic drugs have been found to be extremely safe in clinical, supervised settings. Current data suggests negligible dependence and toxicity risks.
However, some psychological risks may limit who can safely engage in this type of therapy. For example, the use of psychedelic therapy is not considered safe for those with psychotic or certain mood disorders (such as bipolar). Furthermore, as psychedelic trips can cause anxiety, paranoia, and panic, this form of treatment may not be best for all personality types. It is up to the discretion of the mental health professionals to determine this.
Self-treatment, or the use of psychedelics in an unsupervised manner, can present psychological dangers to users. Without a properly curated environment and professional guide, psychedelic therapy may not have the desired results. Experiencing a “bad trip,” from the use of psychedelics is not uncommon, which can compound mental health issues rather than facilitate healing. Additionally, psychedelics found on the street may contain unknown, potentially harmful substances.
Jess Lakritz 