Psilocybin, a classic psychedelic drug, has gained research interest as a possible treatment for mood and anxiety conditions. Initial phase 2 trials of psilocybin with psychological support for major depression and treatment-resistant depression (TRD) showed basic safety, confirmed by a large healthy-volunteer study. The first international multi-centre randomized controlled trial in 2022 found signs of efficacy for a 25 mg dose in people with TRD compared to an active placebo. Phase 3 trials in TRD are scheduled for 2023. Early evidence suggests single doses with psychological support induce rapid improvement in depressive symptoms lasting weeks.
The psychedelic state is an interdependent intrapsychic, somatic, interpersonal, and spiritual happening that can bring forth unconscious desires and traumas, experienced as both cathartic and anxiety-provoking. In clinical trials, these effects often co-occur. Amid renewed interest in psychedelics for mental health, gaps remain in understanding extra-pharmacological factors and therapeutic models. Drawing from psychoanalytic perspectives, this paper explores intersections between psychedelic therapy and psychoanalysis for traumatic stress. It considers the psychedelic state as an attempt to make the unconscious conscious by immersing in a bewildering waking-dream, a willful vulnerability to build trust, and an indescribable experience to redescribe the traumatic past.