Combining psychedelic substances with group psychotherapy may enhance group connectedness and interpersonal learning, potentially improving prosocial behavior by providing direct opportunities to practice new behavioral patterns. Challenges include a more rigid therapy structure and possible loss of patient openness, which can be mitigated by adequate therapeutic training. The article analyzes existing clinical and neurobiological literature using Yalom's 11 therapeutic factors as a framework, aiming to support clinical research on this approach.
The noetic (insightful) quality of mystical-type experiences in psychedelic-assisted therapy may arise from changes in metacognition—the ability to monitor and evaluate one's own thoughts. Drawing on existing metacognition models, the authors propose that psychedelics activate procedural, performance-based metacognitive feelings, producing an 'Aha!' experience interpreted as a feeling of epistemic gain. This framework could help explain therapeutic mechanisms such as intention setting, music's role, traumatic memory recall, and spiritual bypassing. The paper reviews theoretical links between metacognition and altered states like meditation and lucid dreaming, then outlines future research directions.