4 Different Therapeutic Techniques Used With Psychedelic Therapy
This article is clinically approved by Matthew Campeau, LPC
Within the field of psychedelic therapy, there are several therapeutic techniques that can be applied. These approaches differ in how they analyze an individual’s psychedelic experience. They can differ in terms of what the experience means for the client and how they can use it productively.
This article will outline four different therapeutic techniques used with psychedelic therapy. These are the following.
- Cognitive-behavioral therapy (CBT)
- Transpersonal therapy
- Somatic therapy
- Psychoanalytic therapy
Let’s examine these methods — and how they relate to psychedelic therapy — in more detail.
CBT is a therapeutic technique that explores the relationship between their thoughts, feelings, and behaviors. According to this model, all three are closely interlinked. CBT is useful for the treatment of depression, anxiety, and substance use disorders.
In the case of anxiety, you might have a catastrophic thought. For example, this could be imagining the worst possible outcome of a situation. Catastrophic thoughts can trigger the psychological and physical symptoms of anxiety, and this can lead to anxious behavior (e.g. the avoidance of a particular situation).
CBT therapists will help you change your problematic attitudes and behaviors. This first involves developing awareness of your thoughts, beliefs, and attitudes and understanding how these affect your emotions and behaviors. The next step is to challenge your negative thinking patterns as they arise so that they don’t lead to psychological distress and impairment. You achieve this by responding to distressing thoughts with a more rational and balanced way of thinking.
CBT and Psychedelic Therapy
In the context of psychedelic therapy, one group of researchers have argued the following:
“…psychedelics can facilitate the same acceptance-promoting learning process as that targeted by CBT interventions. This suggests that there are large potential synergies between CBT and psychedelic therapy. In line with this, it has been proposed that psychedelics could be fruitfully integrated within acceptance-based CBTs, most notably ACT…”
ACT — or acceptance and commitment therapy — is a form of CBT that teaches people to simply notice and accept their thoughts, feelings, and sensations, rather than try to control them. A study published in the Journal of Contextual Behavioral Science, for example, shows that psilocybin-assisted therapy for major depression using ACT is effective, noting a synergy between psilocybin and ACT, leading to greater psychological flexibility.
However, psilocybin-assisted therapy combined with standard CBT can also be effective in the treatment of certain conditions, namely, tobacco addiction. This combination leads to higher rates of smoking cessation than CBT alone.
Transpersonal therapy is a therapeutic technique that emphasizes the spiritual or transcendent aspects of the human experience. It involves an exploration of topics like:
- Alleviating personal suffering
- Re-connecting with who we really are
- Feeling more connected to others and the world
- Finding true worth and potential
A key aspect of transpersonal therapy is working with transpersonal experiences; that is, experiences that take us beyond our own self, where we feel connected to a greater whole. Mystical states and psychedelic experiences often have this feature. And transpersonal therapists believe the quality of these experiences can have therapeutic benefits. Indeed, existing research seems to confirm this.
Researchers at Imperial College London, for instance, demonstrated that the quality of a psilocybin experience predicts antidepressant effects. Other studies have indicated that mystical experiences are critical for sustained reductions in depression and anxiety.
In the context of psychedelic-assisted therapy, a transpersonal psychotherapist can work with clients who have had these types of experiences, with the aim of achieving greater personal growth, connection, and a sense of meaning.
Somatic therapy is not a common therapeutic technique associated with psychedelic therapy. It is currently not featured in the clinical trials on psychedelic-assisted psychotherapy. However, many psychedelic users and therapists believe it holds a great deal of promise.
Somatic therapy is a body-centered therapy that looks at the connection between the mind and the body. According to somatic therapy, sensations associated with past trauma can become trapped within the body. Somatic therapists help individuals become aware of these bodily sensations and learn how to use therapeutic techniques to release any tension that the body is holding. The somatic approach to psychotherapy has been explored in books such as The Body Keeps the Score by Bessel van der Kolk and Waking the Tiger by Peter Levine.
A somatic psychotherapy session investigates questions such as the below:
- What am I feeling?
- Where do I feel it in my body
- If this part of my body could talk, what would it say?
- What truth needs to be expressed?
The Psychedelic Somatic Institute
The Psychedelic Somatic Institute (PSI) offers training to therapists who want to integrate psychedelic therapy with the somatic approach. Focusing on the body can help patients in psychedelic sessions when they are stuck in the processing of their trauma.
Will Van Derveer, M.D., a clinical researcher in MAPS’ study of MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD), has said: “My orientation to the body’s essential role in PTSD recovery, from years of psychotherapy practice informed by Peter Levine’s Somatic Experiencing certainly informs my work in the MDMA sessions.”
Psychedelic-assisted psychotherapy involving a somatic approach tends to focus on the treatment of PTSD. And the common psychedelic drugs used in the treatment of this condition include MDMA, ketamine, and ibogaine.
Furthermore, the somatic therapeutic technique can also be useful during the process of integration. As Juliana Mulligan, an ibogaine integration specialist, states the following:
“Ibogaine treatment can begin a process of reconnecting to the body, but traditional therapy used post-ibogaine is often unable to fully support this process. Modern mental health treatment focuses on the mind and emotions as if they were a separate entity from the physical body. While working with a traditional therapist post-ibogaine can be immensely helpful, there must be some kind of work on the body and on the places in the body where trauma and emotions are stored. Somatic experiencing therapy is one technique that supports bridging this gap through the simultaneous use of talk and touch.”
Most famously associated with Sigmund Freud, psychoanalytic therapy is used to study the unconscious mind and how it influences thoughts and behaviors. Psychoanalytic therapy usually involves looking at early childhood experiences, trying to uncover how these events shape us as individuals and the way we currently act.
Another key aspect of this approach is examining our defense mechanisms, those unconscious psychological mechanisms that protect us from anxiety-inducing thoughts and feelings. Common defense mechanisms include denial, repression, projection, and rationalization.
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Psychoanalytic therapy was a therapeutic technique that influenced early research into psychedelic-assisted psychotherapy. In the 1950s and 1960s, psychedelic researchers believed that psychedelic drugs facilitated psychoanalytic processes. But modern researchers note that this therapeutic technique could still hold some value. As the authors of one paper remarks:
“…having a framework for understanding the “self” is particularly important when working with psychedelic experiences, and psychoanalytic theory offers many such perspectives (Engler, 1984). Psychedelics may function by dramatically reducing or shifting an individual’s defense mechanisms (Fischman, 2019). This can be useful for understanding both a patient’s distress during a psychedelic experience and their subsequent alleviation of symptoms.”
The treatments stated here are not the only therapeutic techniques that can be useful in the context of psychedelic therapy, but they should give you an idea of how diverse these treatments can be. As research into psychedelics continues, we will deepen our understanding of what therapeutic techniques will be most helpful to patients, as well as the approaches that best apply to specific conditions.