If I told you we could condense years of successful therapy, safely, down to a few hours using currently illegal psychedelic drugs would you believe me?

This is the view of advocates, such as Brain Game’s Jason Silva, supporting a new research-backed psychedelic therapy movement, where accumulating evidence from psychedelic research is revealing remarkable results that could dramatically change psychotherapeutic and psychiatric practices.

What is psychedelic therapy?

The term “psychedelic” literally means “mind-revealing” or “mind-manifesting”, although colloquially the word has been synonymously linked with psychedelic drugs (hallucinogens). This is largely due to the idea that psychedelic drugs allow us to tap into our subconscious by altering the filtration of perceptions, thoughts and emotions from reaching the conscious mind.

Psychedelic therapy refers to an approach to treating mental health problems using psychedelic drugs as an adjunct to psychotherapy, arising in the early 1950s following the first published scientific study on lysergic acid diethylamide (LSD). As many psychedelics were pronounced illegal largely worldwide by the 1970s the practice was driven underground as board certified therapists risked losing their license.

Today, following publication of the few studies that have managed to break through the legal red tape, psychedelic therapy is making a rapid comeback and is gaining substantial media attention. As reported in a 2014 paper published in Therapeutic Advances in Psychopharmacology many researchers agree that:

“The evidence behind the proscription of classical hallucinogens to prevent harm to recreational drug consumers appears misguided at best, and frankly illogical when compared to alcohol and some legally available prescribed medications; moreover the freezing effect this has on clinical research is harmful, and with an untold cost.”

Nonetheless, recent research into psychedelic therapy has revealed potential uses of psychedelic drugs in the treatment of depression, various anxiety disorders, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD) and even drug addiction and cluster headaches, using drugs such as MDMA (ecstasy), LSD, iowaska, psilocybin, DMT, mescaline, ketamine and 2C-B.

A typical approach to psychedelic therapy involves patient participation in therapy prior to taking the drug and after, to screen the individual for any potential complications and help integrate their psychedelic experiences in a therapeutic manner.

For the actual psychedelic trip, therapists are nondirective and instead, simply support the patient in exploring their inner experience, usually followed by an overnight stay at the facility. A recent publication reporting enhanced suggestibility under LSD, and possibly other psychedelics, may have implications for its use as an adjunct to psychotherapy, where suggestibility plays a major role.

How does psychedelic therapy work?

The therapeutic effects predominantly shared by these hallucinogens are well-articulated in a recent article in the Oxford Journal of Psychopharmacology, exploring the use of LSD-assisted psychotherapy for anxiety associated with a life-threatening disease:

“Evaluations of subjective experiences suggest facilitated access to emotions, confrontation of previously unknown anxieties, worries, resources and intense emotional peak experiences à la Maslow as major psychological working mechanisms. The experiences created led to a restructuring of the person’s emotional trust, situational understanding, habits and world view.”

In other words, one predominant view is that psychedelics exert their therapeutic potential through providing access to peak experiences. The famous psychologist Abraham Maslow asserted that peak experiences, which are pure and positive experiences where all doubts and fears are consciously left behind, contribute to self-actualization, the most profound and esteemed human need as described in Maslow’s hierarchy of needs.

In line with Maslow’s theories, by providing a short-cut on route to self-actualization, psychedelic therapy reportedly includes giving patients access to acceptance and compassion for the self and others, a fresh appreciation of life, new-found confidence in one’s own perceptions, profound interpersonal relationships, comfort in solitude and a more proficient sense of reality.

How is it possible that such profound changes in consciousness can be achieved with psychedelic therapy in such a short time?

Looking to the brain for answers, a range of neuroimaging studies suggest that psychedelics may have the potential to rapidly change the functional connectivity and activity of brain regions implicated in providing a base for the normal state of consciousness, such as the default-mode network (DMN).

It is important to note that the potential dangers of using some psychedelics in therapy have been suggested, although as of yet have not been clinically demonstrated to my knowledge.

One view is that the stimulated release of neurohormones like cortisol may exacerbate distress in those with a prior psychiatric history. Although, as for the prescription of the myriad of psychiatric drugs used legally today, some of which are routinely administered with readily available knowledge of potentially debilitating side-effects coupled with questionable efficacy, a trained therapist would presumably restrict the chances of this occurring.

The future of psychedelic therapy?

While the study of drug-facilitated states and their subjective experience is fraught with challenges, we need to determine exactly how effective each drug is for treatment of specific conditions and develop optimal therapeutic practices that minimize any putative risks. Dr. Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS) graciously provided his profound look into the future of psychedelic medicine:

“There will be a future where the scientific evidence from randomized, placebo-controlled multi-site Phase 3 studies proves the safety and efficacy of MDMA-assisted psychotherapy for PTSD and psilocybin-assisted psychotherapy for anxiety related to a diagnosis of cancer. The FDA will approve legal access to these treatments on a prescription basis by specially-trained physicians and therapists working in specially-licensed psychedelic clinics. This will lead to the expansion of psychedelic medicine for a wide range of clinical conditions and to a growing acceptance of the public benefit of legalizing access to psychedelics for reasons of spiritual and personal growth experiences, couples therapy, creativity, innovation and even celebration and recreation. The use of psychedelics will no longer be stigmatized and our culture will become healthier and more spiritually grounded.

References

Carhart-Harris RL, Kaelen M, Whalley MG, Bolstridge M, Feilding A, & Nutt DJ (2015). LSD enhances suggestibility in healthy volunteers. Psychopharmacology, 232 (4), 785-94 PMID: 25242255

Danforth AL, Struble CM, Yazar-Klosinski B, & Grob CS (2016). MDMA-assisted therapy: A new treatment model for social anxiety in autistic adults. Progress in neuro-psychopharmacology & biological psychiatry, 64, 237-49 PMID: 25818246

Emerson A, Ponté L, Jerome L, & Doblin R (2014). History and future of the Multidisciplinary Association for Psychedelic Studies (MAPS). Journal of psychoactive drugs, 46 (1), 27-36 PMID: 24830183

Gasser P, Kirchner K, & Passie T (2015). LSD-assisted psychotherapy for anxiety associated with a life-threatening disease: a qualitative study of acute and sustained subjective effects. Journal of psychopharmacology (Oxford, England), 29 (1), 57-68 PMID: 25389218

Maji? T, Schmidt TT, & Gallinat J (2015). Peak experiences and the afterglow phenomenon: when and how do therapeutic effects of hallucinogens depend on psychedelic experiences? Journal of psychopharmacology (Oxford, England), 29 (3), 241-53 PMID: 25670401

Parrott AC (2014). The potential dangers of using MDMA for psychotherapy. Journal of psychoactive drugs, 46 (1), 37-43 PMID: 24830184

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