4 Misconceptions About Psychedelic-Assisted Therapy
In the last decade psychedelic-assisted therapy has gone from underground to mainstream to big business. There are TV shows and podcasts about it, it’s written up in mainstream news publications, and the movement to legalize entheogens has notched important wins in several states with momentum continuing to build.
I’ve been fortunate enough to personally have access to psychedelic-assisted therapy for about half of that period and even in that short time I’ve grown frustrated with some of the ways it’s misrepresented. So I’d like to correct the record on a few things people frequently misunderstand.
It’s not like 10 years of therapy in one day
Talk therapy is a conscious, egoic, intellect-driven act. Psychedelic therapy is experiential. The difference between talk therapy and psychedelic therapy is like the difference between talking about skydiving and actually jumping out of a plane and feeling your stomach drop. But it’s not just that there’s a difference between intellectually knowing something and actually experiencing it: the two practices complement each other.
Talk therapy uses your logical mind to attempt to understand your emotional and subconscious patterns. You can apply frameworks or stories to your behaviors to explain why you act the way you do. For example: you can use attachment theory to understand your dating life. This can help identify and bring awareness to deep-seated emotional reflexes. But how do you actually go root around in your subconscious and change them?
That’s where psychedelics come in.
Psychedelics can enable you to experience your observing self — your seat of consciousness — as separate from your thoughts and feelings. The distance psychedelics create allows you to see your mind’s machinery constantly at work inventing petty dramas, projecting assumptions about others’ intentions, and creating stories about who you are or your worth in the world. Your mind is like an easily distracted puppy reacting to whatever appears in front of it. So when your mind reflexively surfaces a painful narrative in response to something happening in your life — maybe “I’m not good enough” if you get some critical feedback, or “no one likes me” if you’re alone at a party — it’s just this puppy reacting to a stimulus through its years of conditioning, reaching for a familiar story that it turns into your truth. But it’s no more true than any of the countless other things the mind continuously churns up: it’s simply this distractible puppy making noise. It doesn’t actually know what it’s doing. And psychedelics can viscerally imbue you with that knowledge.
If all of the stories your mind creates are just noise none of them are necessarily true. And if none of them are necessarily true then you can choose which ones you listen to — which ones you give meaning and power to — and which ones you ignore. You can observe a thought and ask yourself not just “is this true?” but also “is this helpful?” By selecting the stories you listen to and empower you can begin to create new thought patterns that reinforce an inner dialogue that enables your highest expression of self. You can reshape the lens through which you experience your life.
This is all well and good when you’re deep in a psychedelic state, but what about when you return to the default world?
In the days and weeks after a psychedelic experience, you experience a period of increased neuroplasticity during which you can reinforce these realizations and form new emotional and behavioral patterns. This integration period is exactly why continued therapeutic support is such a critical complement. While the psychedelic experience itself can grant you expanded awareness, the actual work to create lasting change comes when you apply that newfound knowledge to your day-to-day life. What requires actual courage is confronting situations that trigger your mind’s familiar painful stories and choosing different actions in the face of the discomfort and fear that arises. By doing so, you can use the new experiences to rewrite your conditioning. Having support in this process makes all the difference in the world.
Psychedelic-assisted therapy goes places talk therapy cannot, but its potential is squandered without the support talk therapy provides. Calling it “10 years of therapy in one day” simultaneously understates and overstates its impact. It’s like discovering there’s a whole new level of human existence you’ve never experienced before. And, like learning to walk, swim, ride a bike, or skydive, it benefits from support and practice to access and utilize this new ability well. Psychedelics are powerful tools but ultimately they’re just tools: they don’t change who you are, but they enhance and extend your powers. Creating actual change is up to you.
You don’t need to have a specific trauma to work on for it to be beneficial
A lot of the media coverage of psychedelic-assisted therapy focuses on its use for recovery from significant mental, emotional, and physical struggles: PTSD, depression, addiction, etc. In all likelihood, psychedelics’ legalization will hinge on their tremendous value in those situations. But that doesn’t mean that’s the only way they can — or should — be used.
What if, instead of just thinking about these as tools for healing, we thought about them more broadly as tools for growth?
What if we normalized engaging in psychedelic-assisted therapy even if you’re ostensibly “fine,” because it’s still a worthy aspiration to want your life to go from good to great?
There’s no limit to human flourishing. We should celebrate and encourage people who want to responsibly apply these transformative medicines as tools to enable them to reach a fuller expression of their human potential. After all, sometimes people think they’re fine only to realize, when the strictures of consciousness are loosened by entheogens, how much more room they have to be a better friend, son, daughter, partner, parent, or person.
It’s okay to just play and explore — with intention and support — and see what psychedelics can teach us. Not everything has to be healing or work. After all, who knows what growth we might uncover?
Psychedelic medicines are not interchangeable
When people inexperienced with their use hear the term “psychedelics” they may think you’re just getting blasted out of your mind to explore the astral plane — and one blast-off, to someone who hasn’t experienced any, is indistinguishable from another. (Let’s leave aside the fact that many psychedelic medicines are used at dosage levels where the person experiencing them is very much lucid with their ego intact, consciously processing thoughts, feelings, and memories and holding conversations with their therapist or guide.) Both subjectively and empirically, different psychedelic medicines are best used in different specific situations and have been shown to have different effects.
For example: MDMA is under clinical study for treating PTSD, ketamine is most often used for treatment-resistant depression, and ibogaine has shown efficacy as a treatment for opioid addiction. Three substances, three very different uses.
And that’s just the beginning. People also use psilocybin, ayahuasca, 5meO-DMT, San Pedro, and other medicines in intentional, guided settings. Each offers a different subjective experience that, coupled with its biochemical and neurological impact, facilitates different kinds of emotional and spiritual exploration, growth, and healing. From trauma and addiction to depression, end-of-life anxiety, couples’ therapy, or just wanting some clarity on one’s life there are many reasons people come to psychedelic-assisted therapy. Psychedelics are very potent tools and when used inappropriately they can cause as much harm as they can good. Their benefits are maximized and harms reduced when we honor their unique gifts and engage the best medicine for each circumstance.
It’s not a one-off experience, and it’s certainly not linear
The first time I participated in psychedelic-assisted therapy was the single most transformative experience of my life. And in the days after it dawned on me how many more questions I had that I hadn’t even considered. That single session both helped me resolve some deep emotional pain and awakened me to the knowledge that my journey was only just beginning.
Since then my experiences have run the gamut from transcendental to the point of tears of joy all the way to stubbornly vexing. Sometimes it feels like I’ve resolved all of my life’s most pressing problems — or that I simply don’t have any real problems. Other times there are no clear answers. Each experience is valuable. Even when uncertainty prevails you can learn to be patient with yourself and build trust that you will figure things out in their own time, safe in the knowledge that regardless of what happens you are okay. Psychedelics are unpredictable. Our minds are unpredictable. This is part of the process.
Every experience is a step down the path of learning a new way of relating to your mind. You’re learning to surf on the waves of your consciousness, watching your thoughts and emotions rise and fall without letting them carry you away. It takes time, practice, and patience to use this new ability well. Honing it is the work of a lifetime, and it’s as worthwhile a pursuit as you’ll ever find.
These misconceptions don’t arise out of malice or ignorance but owe to the ineffable nature of psychedelic experiences. (Well, that and their legal status encouraging reductive moralistic or titillating stories about their use and misuse.) Psychedelics frequently transcend our ability to describe or analogize them and are incredibly powerful and life-altering in the most positive ways imaginable. Many who try psychedelic-assisted therapy become immediate advocates and proselytize to anyone who will hear them — I among them. It has touched and enhanced virtually every aspect of my life from friendships to romantic relationships to family, work, and especially my relationship with myself. Nothing would make me happier than for everyone I know to have access to safe and affordable psychedelic-assisted therapy — and I think few things would be better for the future of humankind.
There’s a lot of work still to be done before that’s possible. Psychedelics are still very much in a “wild west” phase. Because of their semi-underground status, bad — ego-driven — actors can take advantage of people seeking help for their own gain. This is what a friend of mine calls “spiritual materialism”: using the guise of spirituality to strengthen egocentricity. At best these pseudo-gurus financially enrich themselves at the expense of others. At worst it can lead to psychological, emotional, and physical harm or even death. The powerful nature of these substances attracts people seeking healing as well as those seeking control — and the line between the two is blurry.
Despite this, it’s hard not to be optimistic. These problems can and will be solved. And when they are, the effects of these powerful medicines on human potential will be transformative. It won’t happen all at once, but the door will be open. The future is so, so bright.
