Treatment with psychedelics is psychotherapy: beyond reductionism
The Lancet Psychiatry December 12, 2023 Gerhard Gründer, Manuela Brand, Lea J. Mertens et al. 103 citations
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Laura Kärtner
Abteilung für Molekulares Neuroimaging, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, 68159, Mannheim, Deutschland.
5 papers in the library · 125 citations · publishing 2020-2026
Papers
The ego in psychedelic drug action – ego defenses, ego boundaries, and the therapeutic role of regression
Frontiers in Neuroscience October 6, 2023 Tobias Buchborn, Hannes S. Kettner, Laura Kärtner et al. 21 citations
The ego is central to psychedelic research and therapy but remains poorly defined. This theoretical review examines the ego through a psychodynamic lens, focusing on ego boundaries, defenses, and synthesis. Psychedelics can induce regressed ego states with reduced defenses, allowing early-life conflicts that created maladaptive patterns to emerge. The authors argue that lasting change requires psycholytic therapy to permeate the characterological core—the chronic, habitual patterns the ego uses to cope—not just transient ego regression. Emotional integration of formative early events is key to reshaping rigid character and defenses, aiming for more flexible ego patterns. This approach is compatible with third-wave cognitive behavioral therapies.
Author response: Self-blinding citizen science to explore psychedelic microdosing
December 11, 2020 Balázs Szigeti, Laura Kärtner, Allan Blemings et al. 1 citation
A self-blinding citizen science study tested whether psychedelic microdosing improves well-being and cognition beyond placebo. 191 participants who already planned to microdose were randomly assigned to receive four weeks of microdoses, placebos, or a mix. All psychological outcomes—including well-being, mindfulness, and life satisfaction—improved from baseline in the microdose group, but the placebo group also improved, and no significant differences emerged between groups. Small acute differences in mood, energy, and creativity were observed, but these could be explained by participants correctly guessing whether they took a microdose. The findings suggest that the anecdotal benefits of microdosing are likely due to the placebo effect.
Long-Term Efficacy of Psilocybin with Adjunct Psychotherapy in Treatment-Resistant Major Depression (EPIsoDE): 6- and 12-Month Naturalistic Follow-Up of a Phase 2b Trial.
Psychotherapy and psychosomatics May 27, 2026 Lea J Mertens, Felix Betzler, Manuela Brand et al.
A single 25 mg dose of psilocybin, or two such doses given six weeks apart, combined with psychotherapy produced a stable and clinically meaningful reduction in depression symptoms for up to twelve months in people with treatment-resistant depression. The average improvement on the Hamilton Rating Scale for Depression was about 7.9 points at six months and 7.7 points at twelve months, with no significant difference between dosing groups. Restarting standard antidepressant medication during follow-up was strongly linked to higher depression scores. This naturalistic follow-up of a phase 2b trial is the largest and most complete long-term assessment of psilocybin for depression to date.
[Mechanisms of action of antidepressive pharmacotherapy: brain and mind-body and environment].
Der Nervenarzt March 1, 2025 Moritz Spangemacher, Jonathan Reinwald, Hana Adolphi et al.
Classical and novel antidepressants may share a common mechanism: promoting long-term neuroplasticity and improving negative bias in emotional processing. Extrapharmacological factors—body, environment, and social interaction—appear necessary for these biological changes to produce an antidepressant effect. Rather than dismissing such factors as placebo, the authors argue they should be tested as essential components of treatment and integrated into clinical practice.