The recent renaissance in research and understanding of psychedelics is shining a spotlight on their potential therapeutic use. Today, we delve into the realm of what constitutes “Good Psychedelic Therapy.”
Psychedelic Therapy – A Quick Overview
Psychedelic therapy is gaining acceptance in mainstream medicine for treating various mental health conditions. Certain states, such as Oregon and Colorado, have even legalized the use of psilocybin, the psychoactive compound in hallucinogenic mushrooms. Meanwhile, the FDA is anticipated to approve MDMA (Ecstasy) for the treatment of depression and PTSD by 2024.
Despite promising results, the therapeutic component of psychedelic therapy has not been as thoroughly scrutinized as the dosages of the drugs used. This lack of scientifically backed best practices has prompted calls for a critical examination of the therapy part of the treatment.
Choosing the Right Therapist
In most parts of the United States, enrolling in a clinical trial is the only legal method to try psychedelic therapy with psilocybin or MDMA. In this scenario, the mental health professional you choose should ideally specialize in your condition and be certified in psychedelic therapy.
Before selecting a therapist, it is crucial to ask about their training, professional certifications, and expertise. Furthermore, feeling safe and comfortable with the therapist is essential, which is why preparatory sessions are critical for establishing trust and rapport.
Preparatory sessions are essential before administering the drug. During these sessions, the therapist should explain the treatment in detail, particularly the physical and psychological effects of the drug. They should also inquire about your history, symptoms, and treatment goals.
The therapist may recommend adopting a particular mindset or teach breathing and meditation techniques to use if uncomfortable emotions or physical sensations arise during the therapy. A crucial aspect of these sessions is gaining informed consent for potential occurrences during the drug session.
The Drug Session
The patient typically lies down with closed eyes and listens to music during a drug session with ketamine, MDMA, or psilocybin. The experience is more internal for the patient, involving minimal talking. If anxiety arises or traumatic memories surface, the therapist might offer reassurance or guide the patient through a breathing exercise. The aim is to help the patient “stay with it” instead of avoiding or getting distracted from the experience.
It’s important that therapists don’t push their own experiences onto patients; instead, they should follow the patient’s direction. However, encouraging patients to confront distress uncritically could potentially cause more harm than good. The goal isn’t to label a practice as good or bad, but to understand in which contexts it could be beneficial or harmful.
The integration sessions, in which the patient processes their experience in the days and weeks after the trip, closely resemble traditional therapy. During these sessions, the therapist helps the patient understand the feelings, insights, and memories that surfaced while on the psychedelic.
An open-ended approach is common here, with the therapist asking questions like: “How did the experience shift your relationship with yourself?” The goal is to incorporate these lessons into the patient’s life, operating under the philosophy that “the patient has their own wisdom, the psychedelic experience has its own wisdom.”
The Need for Standardization
What the field needs to standardize now are the general therapeutic principles while continuing to test whether the overall treatment is safe and effective. There are also calls for more research into what constitutes safe and ethical practice.
In conclusion, a good psychedelic therapy session involves careful selection of a therapist, thorough preparation, an individualized approach during the drug session, and thoughtful integration sessions. These components, combined with the need for standardization, form the core of effective psychedelic therapy.