Psychedelic Integration Therapy

A short outline of the different psychedelics currently being used in psychedelic integration therapy.

by Paul Jozsef

What is Psychedelic Integration Therapy? - Paul Jozsef Counselling & Coaching | Montreal

Psychedelics, specifically psychedelic assisted-therapy and psychedelic integration counselling, have re-emerged into the zeitgeist over the past several years. With Heath Canada legalizing the prescription of psychedelics, those in need can finally, legally gain access to these medicines to improve their mental health and overall wellbeing.

Prior to the US government’s moratorium on research and prohibition on use in the 1960s, psychedelics were once seen as a boon for treating mental illness. Today, there is somewhat of a ‘psychedelic renaissance’ occurring. With the stigma around the research and use of ‘classic’ psychedelics such as psilocybin and not so classic psychedelics such as MDMA, ayahuasca and ketamine being lowered, psychedelics are now becoming more accepted for the treatment of psychological indications where traditional pharmaceutical drugs have not been overly efficacious.

Below is a short outline of a few of the psychedelics that are currently being researched and used to treat mental health issues such as anxiety, depression and PTSD.

What Are Psychedelics?

Psychedelics (or otherwise somewhat inappropriately known as hallucinogens) are, according to the Alcohol and Drug Foundation, “a class of psychoactive substances that produce changes in one’s perception, mood and cognitive processes.” Psychedelics have the propensity to affect a person’s senses and perception of reality; they reliably trigger non-ordinary states of consciousness. These sensory distortions may include, but are certainly not limited to, synaesthesia, euphoria, a sense of connectedness, mystical experiences, as well as anxiety, dread and ‘existential emptiness.’

Brief History of the Therapeutic Use of Psychedelics

Psychedelics were first introduced to psychotherapeutic medicine in the early 1950s by psychiatrist Humphry Osmond. Along with his colleagues, Osmond discovered that LSD was a viable treatment for alcohol dependence and other mental health disorders. It was Osmond who coined the term, ‘psychedelics,’ which means “mind-manifesting.” Following Osmond’s work, LSD therapy became popular within the biomedical community.

During the 1950s and 1960s, researchers largely in America and Canada published 100s of articles showing the effects of LSD on anxiety, depression, and obsessive-compulsive disorder (OCD). Unfortunately, by 1966, LSD was made illegal and classified in the US as a ‘Scheduled 1’ drug. According to the Drug Enforcement Agency (DEA), a Schedule 1 drug has “no currently accepted medical use and a high potential for abuse.”

The Psychedelics Renaissance

Some 50 years after LSD’s scheduling, LSD made a comeback in psychedelic therapy. In 2009, the US FDA partnered with Swiss regulators to create protocols surrounding the use of LSD in an anxiety/mental illness study. Since then, the FDA and DEA have approved researchers to conduct psychedelic studies to learn more about its effects on mental illness. Research facilities worldwide, such as Johns Hopkins University and Imperial College London, have embarked on new endeavours to find novel treatments using psychedelics to treat ailments such as nicotine addiction, PTSD, and existential anxiety in cancer patients.

What is Psychedelic Integration Therapy?

Psychedelic integration therapy incorporates psychedelic harm-reduction psychoeducation along with traditional client-centred ‘talk therapy.’ Psychedelic integration therapy includes working with clients both before and after any psychedelic experience a client may have. That is, helping clients prepare for their ‘trip’ by exploring options, clarifying intentions, and learning self-care practices. It also involves talking with clients after any such experience. Psychedelic integration therapy helps clients make sense of their experience and helps them integrate said experience into their day-to-day lives.

What is Psilocybin?

Psilocybin is the psychoactive ingredient in so-called ‘magic’ mushrooms. The ingestion of psilocybin mushrooms, depending on species, origin, and whether they’re ingested fresh or dried, may induce changes in ordinary states of consciousness and sensory distortions. While many psilocybin mushroom trips can be peaceful, introspective experiences, they can also cause acute anxiety, which can lead to a ‘bad’ or challenging trip.

What is Psilocybin Used to Treat?

Current clinical research using psilocybin has focused extensively on existential anxiety and major depression. One should note that not everyone qualifies for psilocybin treatment. Psilocybin, as with all psychedelics, can exacerbate certain mental health disorders. To ensure safety, each participant is screened before and during any psychedelic experience.

How is Psilocybin Used?

During an assisted psychedelic experience, the user is set up in a room specifically made for psychedelic experiences. There is a bed, access to a restroom, a sound system with headphones, etc. Essentially, a comfortable living room-type space. The user is given a capsule of synthesized psilocybin, a curated music playlist, and an eye mask to help them turn inward throughout the session. Each session generally lasts around six to eight hours, where the user is accompanied by a therapist. Following the session, the user and their therapist discuss the experience to integrate any insights that may have come up.

What is Ayahuasca?

Ayahuasca is a South American psychoactive brew that is traditionally made from the leaves of Psychotria Viridis, as well as the Banisteriopsis Caapi vine. Combined, the two primary ingredients N,N-Dimethyltryptamine (DMT) and a monoamine oxidase inhibitor (MAOI), produce an intensely potent psychedelic. Ayahuasca has been used for millennia by the indigenous peoples of the Amazon basin for spiritual and religious purposes.

The effects of ayahuasca can range from total bliss and spiritual unity to paralyzing fear and paranoia.

What is Ayahuasca Used to Treat?

Ayahuasca is commonly used to improve symptoms of depression, anxiety, addiction, and trauma, as well as to increase general wellbeing and spiritual connectedness.

How is Ayahuasca Used?

Ayahuasca is generally consumed during group ceremonies which are typically held at night. These ceremonies are typically facilitated by an experienced healer (curandero) to help guide the participants through their ayahuasca ’journey.’ Once the curandero has energetically cleansed the space, they administer the brew to each of the ceremony’s participants. Depending on the person and the dosage, the person may feel the effects within 20-45 minutes. The effects of the ayahuasca generally last for about four to six hours.

What is Ketamine?

Ketamine is generally used as a dissociative anesthetic to induce and maintain sedation during surgery. It was first approved for use by the FDA in 1970. It is considered an extremely safe drug; it is listed on the World Health Organization’s List of Essential Medicines.

Ketamine is also a robust and fast-acting antidepressant with its effects resulting in an improvement of depressed mood within 4-5 hours post-administration. However, the effects are typically relatively short-lasting, typically around 10-14 days.

What is Ketamine Used to Treat?

Ketamine can be used to treat treatment-resistant depression. That is a person who has unsuccessfully undergone two or more types of treatment for their depression symptoms.

How is Ketamine Used?

There are several forms of ketamine. One of the most commonly prescribed for depression is a nasal spray called esketamine (Spravato). The patient gets the nasal spray, typically administered by a healthcare provider at a doctor’s office or clinic. After the patient receives their dose, they are monitored by a healthcare provider for approximately two hours for any side effects, such as sedation or agitation. Patients typically get the nasal spray twice a week for one to four weeks. After that, the dose is lowered to once a week for five to nine weeks, then once a week following that.

Other forms of administration of ketamine (that are not currently FDA-approved) include intramuscular injections or intravenous infusions. Lozenges are another ketamine administration option, which is prescribed for at-home use in between infusions.

What is MDMA?

MDMA (3,4-Methylenedioxymethamphetamine), commonly known as ecstasy or molly, is a synthetic drug developed in 1912 by Merck. Ingestion of MDMA can create feelings of euphoria, an increase in one’s sense of empathy as well as heighten sensory experiences (i.e., dancing, touching others, listening to music, etc.).

What is MDMA Used to Treat?

MDMA is currently being trialled to treat PTSD under the auspices of the Multidisciplinary Association for Psychedelic Studies (MAPS). In 2015, MAPS found that MDMA is “sufficiently safe” when administered in relatively small doses. The FDA approved clinical trials of MDMA to a select group suffering from PTSD.

How is MDMA Used?

Under the MAPS protocol, During a session, the patient ingests 125 mg of MDMA, with the option for an additional half-dose, should they wish to prolong the experience. A session can last up to eight hours. During this time, the patient, accompanied by two trained therapists, may ‘revisit’ significant memories and emotions. There are typically 2-3 ‘medicine sessions’ along with a series of ‘normal’ talk therapy sessions to integrate any insights that may arise.

Psychedelic integration therapy has the potential to change the way mental health is treated in Canada. Research has clearly shown that psychedelics such as LSD and psilocybin, along with Ketamine and MDMA, can significantly reduce the symptoms and suffering of those with severe mental health issues. With Health Canada’s move to allow physicians to request restricted psychedelic drugs for patients as part of their psychotherapy, the tide is finally beginning to shift. The use of psychedelics is on the way to becoming a viable resource for the treatment of mental health disorders.

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