What is Psychedelic-Assisted Therapy?
Hello! Welcome to the Integrative Psychotherapy Colorado blog, written by Bianca Aarons, MA, LMFT, a Denver based therapist. Today, we'll delve into psychedelic-assisted therapy. Lately, various studies on psychedelic treatments have garnered attention in both the medical field and the news. To truly understand psychedelic-assisted therapy, it’s essential to explore the history of psychedelics and their long-standing illegality in the United States.
A Brief History of Psychedelics
Many psychedelics and psychotropic substances occur naturally in plants and animals, such as psilocybin mushrooms, peyote cactus, mescaline, 5-MeO-DMT (toad venom), iboga, ayahuasca, the marijuana plant, and the coca plant. These substances have been consumed by various species, including humans, to alter their state of mind. Additionally, scientists have synthesized psychedelics like LSD, ketamine, and MDMA in laboratories. Psychedelics, much like psychiatric medications, interact with brain chemicals that influence anxiety and depression.
Indigenous cultures have used psychedelics in communal, ceremonial, and religious contexts for thousands of years. These substances are relatively new to Western cultures. Synthetic psychedelics gained prominence in the 1950s for their therapeutic potential. The U.S. government’s MK-ULTRA program (1953-1964) involved non-consensual testing of LSD on civilians in San Francisco and New York, leading to severe consequences for unsuspecting participants. As psychedelics became popular in alternative communities, substances like LSD, psilocybin, and MDMA were explored for their mind-altering effects. MDMA was particularly used in therapeutic settings before the criminalization of psychedelics. Media coverage of isolated incidents of psychedelic misuse led to their portrayal as dangerous substances.
Psychedelics amplify emotions and mental states, which can sometimes trigger psychotic episodes, breaks, or suicidal thoughts in vulnerable individuals. Media reports of such incidents have fueled negative perceptions. Early studies conducted at institutions like Stanford and Johns Hopkins often involved participants with severe psychotic disorders, leading to misunderstandings. In 1968, Richard Nixon criminalized psychedelics, possibly targeting anti-war activists and people of color.
Psychedelic Preparation
Preparation involves emotionally, physically, and psychologically preparing a client for psychedelic-assisted therapy. This includes understanding their motivations, setting intentions, and managing expectations. Psychedelics are not a quick fix; they can open deeper issues that need to be addressed in therapy. Preparation also involves preparing one’s support network to assist during the vulnerable post-therapy period.
The Psychedelic Journey
Each individual's psychedelic journey is unique, lasting between three to ten hours. Some prefer silent introspection, while others engage in active therapy. Emotions such as joy, fear, and grief may surface, allowing individuals to access and release stored traumas. This process can be surprising and challenging, requiring participants to face the unknown.
Psychedelic Integration
Post-therapy integration is crucial for processing and incorporating the insights gained during the session. Individuals may feel raw or disconnected, making it essential to make sense of their experiences and develop new coping skills. Integration can reveal harsh self-criticism and foster self-compassion or highlight the need for greater emotional openness with others.
Benefits of Psychedelic-Assisted Psychotherapy
Research indicates that psychedelics can benefit a wide range of mental health issues, though they are contraindicated for certain personality and psychotic disorders. Here are four key areas where psychedelics have shown promise:
Ketamine and Severe/ Major Depressive Disorder: Ketamine, initially an anesthetic, provides dissociative and psychedelic effects, offering relief from severe depression and new perspectives over six to eight sessions.
MDMA and Post-Traumatic Stress Disorder (PTSD): The MAPS project (now Lykos) has shown an 80% efficacy rate for MDMA-assisted therapy in treating PTSD over 30 years. However, concerns about sexual abuse by researchers and underreporting of suicidal ideation have delayed FDA approval.
Psilocybin and Existential Anxiety: Psilocybin has effectively reduced existential anxiety and depression, particularly in end-of-life patients facing terminal illnesses. It is decriminalized in Oregon, the Bay Area, and Colorado due to its low toxicity compared to substances like alcohol and cigarettes.
Iboga and Addiction Treatment: Ibogaine, derived from the African Iboga plant, has shown high success rates in treating opioid addiction, with a lower risk of withdrawal symptoms. Despite its potential lethality in individuals with heart conditions, the opioid crisis has prompted reevaluation of its therapeutic use.
The Current Psychedelic-Assisted Therapy Climate
The focus of the war on drugs has shifted towards pharmaceutical companies and the opioid crisis. Psychedelic-assisted therapy, supported by studies from prestigious universities, is gaining recognition for its benefits. Ketamine, approved by the FDA for depression treatment in 2019, is used in therapeutic settings. Psilocybin-assisted therapy is legal in Oregon, with Colorado following suit. While MDMA and Ibogaine await FDA approval, psilocybin is accessible to end-of-life patients.
Conclusion
The path to mainstream acceptance of psychedelics involves rigorous research and verification of their safety and efficacy. For those curious about psychedelic-assisted therapy, I encourage you to explore the available research.
Bianca Aarons is a licensed therapist in California and Colorado, having completed Naropa University’s Psychedelic Assisted Therapy Training Program in 2023. With 11 years of experience in attachment-based, psychodynamic, and relational therapy, she is working towards her Psychedelic Assisted Therapy License in Colorado. Bianca offers preparation and integration therapy sessions, an end-of-life support group, and a bi-monthly psychedelic integration group remotely.
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