The mention of psychedelic drugs often inspires thoughts of hippies and ‘bad trips,’ but the reality is far from that. Psychedelics range from naturally occurring drugs used by humans for thousands of years to a plethora of synthetic compounds produced in the last century. Their effect on thought, vision, and sound is sometimes subtle, and other times are all-encompassing. These psychedelic experiences can be profound, enlightening, and healing for the mind. Scientists have researched these effects over the last century to create a deeper understanding of their benefits. Sadly, psychedelic drugs and their therapeutic effects on the mind have had a bumpy history. However, in recent years, the future has begun to look brighter for patients and therapists looking to use psychedelics in psychotherapy for psychological healing.
A Brief History of Psychedelics
The traditional use of psychedelics has been traced back thousands of years. They are deeply ingrained in many cultures and religions from around the world. Evidence has been found of peyote in Mesoamerica, psychoactive mushrooms and saliva in Mexico, ayahuasca in the Amazon, and cannabis in the ancient populations of Central Asia and India. This traditional use of psychedelics was (and remains) limited to specific cultures and has never seen widespread use.
Modern developments in chemistry and pharmacology in the early 20th century led to a renaissance of psychedelic use when Albert Hofmann discovered the powerful effects of LSD in 1943. Days after accidentally exposing himself to a minute amount of LSD, Hofmann intentionally consumed 250 micrograms of the drug. He noticed its remarkable effects as he rode home on a bicycle with the help of his assistant. Little did he know that on that aptly named ‘Bicycle Day,’ his discovery would have a significant impact on the world of psychedelic drugs.
Hofmann’s work inspired the creation of many other psychedelic drugs in the last century, with a myriad of scientists, therapists, and hobbyists detailing their effects. Famous chemists like Hofmann and Shulgin discovered new drugs and immediately saw the value in their psychedelic effects. Alexander Shulgin synthesized dozens of new molecules, including the 2C-X and DOX families of drugs. He kept detailed notes, publishing his experiences with his wife Ann in their books PIHKAL and TiHKAL. Meanwhile, psychotherapists began exploring the potential of psychedelic drugs in therapy extensively.
The Rise of Psychedelic Therapy
Throughout the 50s and 60s, researchers all over the world began to delve into the therapeutic effects of psychedelic drugs. LSD, MDMA, and psilocybin were at the forefront of this effort. However, the widespread attention and increasing recreational use of these drugs soon drew unwanted attention. In the 70s, much of the research into psychedelics halted with the introduction of the U.S. Controlled Substances Act and changing global attitudes towards drug use.
Despite providing evidence showing the incredible benefits of psychedelic therapies, many psychedelic drugs were classified as having no therapeutic or medical research value. Successful treatments of alcoholism, cigarette addiction, depression in terminally ill patients, treatment-resistant anxiety and depression, and post-traumatic stress disorder (PTSD) were all reported, but the ban was still enacted. In the following decades, little academic research was performed with psychedelic substances. Meanwhile, clandestine research continued, but little data is available, and what can be found is unscientific and generally unreliable.
Decades later, a so-called ‘second wave’ of psychedelic research has arrived. This second-wave has been linked to a relaxing of attitudes towards drug use in the west and the growing realization that the war on drugs has failed. More and more research applications for studies involving psychedelics have been approved by government drug enforcement, and the media has begun to report the benefits of psychedelics in therapy. Popular books like Michael Pollan’s ‘How to Change your Mind,’ shows like ‘The Mind, Explained,’ and more have made people wonder: Could a psychedelic experience be right for me? Could there be more to psychedelics than just ‘tripping’ recreationally?
Currently, psychedelic therapies can be broadly grouped into two categories, one more direct, and the other supportive. Many methods have been explored in the last century, but psychedelic-assisted therapy and psychedelic-integration therapy have stood the test of time.
What is Psychedelic-Assisted Therapy?
Psychedelic-assisted therapy (PAT) is the professionally supervised use of psychedelic drugs as part of a therapy treatment. PAT typically involves a dose of the selected drug (commonly MDMA or psilocybin mushrooms) to produce an altered state of consciousness. The patient is supervised throughout their experience but typically is left uninterrupted to explore their ‘inner world’ in a safe environment. Therapy sessions before and after the experience are used to guide the patient toward a positive outcome. PAT relies on the impact of a few potent psychedelic experiences alongside therapy to achieve its effect. Another similar method of treatment is psycholytic therapy, wherein a low dose of the psychedelic drug is administered to facilitate access to the unconscious mind.
Unsurprisingly, given the legal status of psychedelic drugs in most countries, PAT is illegal and still considered controversial. Detractors argue that the historical data available does not meet the rigorous standards of today and so the benefits of psychedelics in therapy are overstated. For now, legal PAT is left to those in heavily regulated and restricted clinical trials, but an alternative does exist.
What is Psychedelic-Integration Therapy?
Despite the controversies of psychedelics in therapy and the illegal nature of PAT, people still seek psychedelic experiences for their beneficial effects on the mind and body. Psychedelic-integration therapy (PIT) provides users with a safe place to talk through and explore their experiences. The main difference is that with PIT, the drugs are not prescribed or provided by the therapist. Instead, the professional helps the user prepare for their experience and then helps them make sense of their experience afterwards.
While many users report positive psychological benefits to recreational psychedelics, their experiences often turn into stories to be shared with friends after their ‘trip.’ They are only able to see the tip of the iceberg when it comes to their psychedelic experience. The main benefit of PIT is the use of psychedelics with structure and the help of a professional to allow users to unpack their journey and integrate it into their day-to-day lives constructively. Even so-called ‘bad trips’ that would have been considered a waste or too frightening to talk about can be reinterpreted as ultimately positive and valuable experiences with the support of a professional therapist.
Beyond getting the most out of their psychedelic experiences, PIT also allows patients to access the other benefits of psychedelic therapy. Patients suffering from depression or anxiety have reported improvements in their mental health after PIT. These improvements can be long-term and sometimes even permanent. Similarly, patients struggling with alcohol or nicotine addiction have reported positive progress towards overcoming their addiction thanks to PIT. There are reports of users overcoming cigarette addiction after only one psychedelic experience. The altered state of consciousness afforded by psychedelics, when supported by a professional, allows patients to see new perspectives about the challenges they face in their lives. Even healthy individuals can gain positive outcomes from a psychedelic experience, with long-lasting benefits to their outlook on life.
PIT also supports harm reduction by providing users a chance to prepare for and better understand what their psychedelic experience may entail. Those with a history of (responsible) psychedelic use will know the phrase ‘set and setting,’ but new users can get an extra level of support to get the most out of their psychedelic journey. The act of preparing a patient for their journey helps minimize the risk of a negative experience.
Patients are also prepared by the professional for the potential adverse effects they may encounter during their psychedelic journey. This further reduces the risk of a negative experience. Adverse effects vary based on the substance the patient consumes.
Finally, patients will benefit from the insight provided by a professional in terms of safely dosing psychedelic substances. While most psychedelics have a low potential for harm, one can still have a relatively negative experience. Furthermore, the recreational use of psychedelics has led to a wealth of misinformation online about psychedelic use. To get the most out of their psychedelic journey, patients should always make informed decisions about the dose and purity of the substances they consume.
With organizations such as the Multidisciplinary Association for Psychedelic Studies (MAPS), and the mainstream attention the benefits of psychedelics are getting, psychedelic therapy is beginning to return to fill a gap in the toolkit of therapists for treating patients. PIT can act as a powerful tool for patients who want safe and beneficial psychedelic experiences. This allows patients to access the enlightening and remarkable therapeutic effects of psychedelic drugs while PAT remains illegal. Given the recent legalization of cannabis in Canada and changing attitudes towards drugs, psychedelics (and PAT) may become legal one day in the not too distant future.