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Binaries, Multitudes, and Beyond: A Client-Authored Case Study in Psychedelic-Assisted Therapy, Artificial Intelligence, and Narrative Agency

Mark A. Michaels

DOI: 10.2139/ssrn.6317678

Summary

AI-generated from the abstract

A client who is also the author documents a 10-week course of collaborative therapy that integrates EMDR, ketamine, MDMA, psilocybin, creative expression, and AI-assisted reflection and writing. Drawing on affect theory, mentalization, earned secure attachment, and Dabrowski's theory of positive disintegration, the paper analyzes how recognition of core affects, rupture-and-repair processes, and the reclamation of narrative agency contributed to rapid, positive change. Psychoeducation supported a deep exploration of these concepts. The case critiques traditional psychoanalytic framings, diagnostic overreach, and hierarchical therapeutic structures, arguing for a model emphasizing collaboration, agency, and narrative coherence. It also highlights the potential and limitations of generative AI as an adjunct in psychotherapy and narrative self-reclamation.

Study at a glance

Characteristics Autoethnographic case study Case report
Sample size 1
Population The author/client
Interventions EMDR ketamine MDMA psilocybin creative expression AI-assisted reflection and writing
Duration 10-week course of collaborative therapy
Key finding Recognition of core affects, rupture-and-repair processes, and reclamation of narrative agency contributed to rapid, positive change in a 10-week course of collaborative therapy integrating multiple modalities.

Abstract

This client-authored, autoethnographic case study documents a 10-week course of collaborative therapy integrating EMDR, ketamine, MDMA, psilocybin, creative expression, and AI-assisted reflection and writing. Drawing on affect theory, mentalization, earned secure attachment, and Dabrowski's theory of positive disintegration, the paper analyzes how recognition of core affects, rupture-and-repair processes, and the reclamation of narrative agency contributed to rapid, positive change. Psychoeducation supported a deep exploration of these concepts throughout. Data sources include session transcripts, journals, creative writing, and AI-mediated reflections; all substantive interpretation was performed by the author. The case critiques traditional psychoanalytic framings, diagnostic overreach, and hierarchical therapeutic structures, arguing for a model that emphasizes collaboration, agency, and narrative coherence. It also highlights the potential and limitations of generative AI as an adjunct in psychotherapy and narrative self-reclamation. Framed as an effort to "seize the means of therapeutic production," the study proposes a paradigm that moves beyond binaries toward a multidimensional understanding of identity, attachment, and transformation.

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