Psychedelics in Psychotherapy
Psychedelics have been used for thousands of years in traditional cultural and religious practices. However, in recent years, there has been a renewed interest in the potential therapeutic benefits of these compounds. The re-emergence of research into psychedelics has led to the development of new treatments for a wide range of psychiatric and behavioural disorders, including depression, anxiety, end-of-life despair, and PTSD. This article will explore the emerging trend of psychedelics in psychotherapy, including the use of MDMA and psilocybin, the safety of these compounds, and the training required for therapists.
Interest in the therapeutic potential of psychedelics began in the mid-twentieth century when countercultural forces combined with the rise of psychopharmacology to fuel optimism about psychedelic therapies. Between the 1950s and 1970s, psychedelics like LSD and psilocybin were given to tens of thousands of patients to treat conditions like alcohol abuse, depression, anxiety, and end-of-life distress. However, research into these substances largely halted once they were classified as Schedule 1 substances under the Controlled Substances Act of 1970.
Between the mid-1970s and mid-1980s, some therapists became interested in the promise of MDMA to kickstart psychotherapy. However, like psilocybin and LSD before it, MDMA’s therapeutic use was largely shut down when it too was made a Schedule 1 substance in 1985.
The Re-Emergence of Psychedelic Research
Despite being classified as Schedule 1 substances, research into the therapeutic potential of psychedelics has continued in recent years. The Johns Hopkins Center for Psychedelic and Consciousness Research is leading the way in exploring innovative treatments using psilocybin. The molecular structure of psilocybin, a naturally occurring psychedelic compound found in ‘magic mushrooms,’ allows it to penetrate the central nervous system, and the scientific and medical experts are just beginning to understand its effects on the brain and mind and its potential as therapeutics for mental illnesses.
The Potential of Psychedelic-Assisted Psychotherapy
Psychedelic-assisted psychotherapy offers the hope of a new treatment whose rapid onset and enduring efficacy could outpace that of other psychiatric treatments. The promise of psychedelic therapies, combined with their cultural and historical significance, has led to their garnering huge amounts of attention for a treatment that remains in an investigational stage. Psychedelic therapies are discussed on the front page of the New York Times, best-selling popular books, documentaries, and beyond. Headlines declare a “new age for psychiatry” while political leaders from across the political spectrum have endorsed therapeutic access to these once-maligned and still-criminalized compounds.
The Safety of Psychedelics
Beyond clinical trials, much of the knowledge about classical psychedelics’ safety comes from epidemiological studies among recreational users. In these settings, psychedelics account for the least emergency room usage of all recreational drugs. However, it is essential to note that psychedelics should only be used in a controlled environment after several hours of preparation of study participants and followed by multiple sessions to integrate the psychedelic experience. The improvement participants experience appears related to the often profound perspective changes experienced and seems unlike the improvements seen in the currently available care paradigms.
Ensuring client safety is a top priority in psychedelic-assisted psychotherapy. Therapists must receive specialized training in the use of these compounds, including how to manage adverse reactions. Additionally, clients must undergo extensive screening to ensure that they are suitable candidates for psychedelic-assisted psychotherapy.
The Use of MDMA in Psychotherapy
MDMA-assisted psychotherapy is currently being investigated as a treatment for PTSD. The Multidisciplinary Association for Psychedelic Studies (MAPS) has been at the forefront of this research and has completed Phase 3 clinical trials that have shown promising results. MDMA works by increasing feelings of trust and empathy, which may help individuals with PTSD confront painful memories and emotions.
The Use of Psilocybin in Psychotherapy
Psilocybin-assisted psychotherapy has shown promise as a treatment for a range of mental health conditions, including depression, anxiety, and end-of-life despair. Previous studies by Johns Hopkins Medicine researchers showed that psychedelic treatment with psilocybin relieved major depressive disorder symptoms in adults for up to a month. Now, in a follow-up study of those participants, the researchers report that the substantial antidepressant effects of psilocybin-assisted therapy, given with supportive psychotherapy, may last at least a year for some patients.
Therapist Training for Psychedelic-Assisted Psychotherapy
To provide psychedelic-assisted psychotherapy safely and effectively, therapists must undergo specialized training. The training typically includes an in-depth understanding of the pharmacology and effects of the psychedelic compound, strategies for managing adverse reactions, and methods for integrating the psychedelic experience into the therapeutic process. MAPS offers a comprehensive training program for therapists interested in providing MDMA-assisted psychotherapy, and similar training programs are likely to emerge for psilocybin-assisted psychotherapy.
The Future of Psychedelic-Assisted Psychotherapy
The emerging trend of using psychedelics in psychotherapy shows promise as a new treatment that could help individuals with treatment-resistant mental health conditions. As research into the therapeutic potential of psychedelics continues, it is likely that new treatment paradigms will emerge that are tailored to the specific needs of individual patients.
Psychedelic-assisted psychotherapy offers the hope of a new treatment whose rapid onset and enduring efficacy could outpace that of other psychiatric treatments. The re-emergence of research into psychedelics has led to the development of new treatments for a wide range of psychiatric and behavioural disorders, including depression, anxiety, end-of-life despair, and PTSD. Ensuring client safety is a top priority in psychedelic-assisted psychotherapy, and therapists must undergo specialized training to provide these treatments safely and effectively. As research into the therapeutic potential of psychedelics continues, it is likely that new treatment paradigms will emerge that are tailored to the specific needs of individual patients.
MsC, MoC,. Member of: ACA, BACP
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