Psychedelic-Assisted Psychotherapy: When Two Traditions Meet

Summary

After a long pause since the 1970 Controlled Substances Act, research on psychedelic compounds for therapy has revived. Two traditional psychological approaches have emerged: psycholytic therapy, using low to moderate doses with psychoanalytic talk therapy to release emotional content, and psychedelic therapy, using high doses for an overwhelming experience followed by integration sessions. It remains unclear which is better, and they are often mixed as psychedelic-assisted psychotherapy. To provide anchor points and warn of limitations, the authors draw on anthropological observations of cultures with long-standing psychedelic use, where administration occurs in a tight community with shared cosmology (set) and ritual context (setting)—conditions difficult to replicate in Western traditions.

Study at a glance

Abstract

Introduction After a long moratorium since the Controlled Substances Act was passed in 1970, there has been a resurgence of research on the potential therapeutic benefits of psychedelic (PE) compounds. It has been widely believed that the PE effect is a result of the interaction between the drug and the mindset of the patient (the “set”) with the external physical and social conditions (the “setting”). In order to control non-pharmacological variables and improve therapeutic outcome two types of psychological approaches to PE use have emerged traditionally. One is based on psychoanalytically informed talk therapy with low to moderate doses of a PE agent with the goal of facilitating a discharge of emotionally charged mental contents (psycholytic therapy). The other used one or several high doses of a PE to create an “overwhelming experience,” which was then followed up in integrative sessions (psychedelic therapy). Objectives Currently, it is unclear which one is better than another, these two methods are frequently mixed, and all-together carry the name of psychedelic-assisted psychotherapy. There has also been some discrepancy about what is the right “set” and “setting”. Methods To add some anchor points for (and at the same time warn about the limitations of ) the reemerging field of psychedelic-assisted psychotherapy the authors refer to anthropological observations in cultures, where PE use has a long practice historically. Results As part of healing ceremonials PE has usually been administered in a tight community with shared cosmology (“set”) and ritual context (“setting”). Conclusions These are difficult-to-reach conditions for someone coming from Western tradition. Disclosure No significant relationships.