The document summarizes research on psychedelic-assisted psychotherapy. It discusses how psychedelics like LSD, psilocybin, and ketamine were widely used in psychotherapy in the 1950s and 1960s to treat addiction and depression, with largely positive results. However, psychedelics were banned in the 1970s. Recent research has started exploring psychedelic-assisted psychotherapy again. Studies discussed show psilocybin-assisted therapy helped alcoholics stay sober and helped smokers quit. Ketamine therapy was more effective for treating heroin addiction with multiple sessions compared to a single session. The document also reviews neuroscience research on how psychedelics affect brain activity and connectivity, particularly reducing activity in regions linked to depression.
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PROFESSOR DAVID NUTT - PSYCHEDELIC ASSISTED PSYCHOTHERAPY – NEW NEUROSCIENTIFIC APPROACHES TO ADDICTION AND DEPRESSION
1. David Nutt FMedSci
Imperial College London
d.nutt@imperial.ac.uk
profdavidnutt@twitter.com
Psychedelic assisted psychotherapy -
New neuroscientific approaches to
addiction and depression
4. LSD – the big breakthrough
LSD
synthetic and more potent psychedelic
wide medical and research use
Albert Hoffman – the
discoverer of LSD and
psilocybin - at 100
5. If the doors of perception were cleansed every
Thing would appear to man as it is, infinite.
For man has closed himself up, till he sees all
Things thro’ narrow chinks of his cavern.
William Blake, 1793
Aldous Huxley and mescaline
Peyote cactus
“The brain is an
instrument for focusing
the mind”
6. DepressionAddiction
The brain reconstructs
the image to what it
expects
But always with limitations
“Man sees thro’ the chinks of
his cavern” William Blake
1793
Neuroscience proves Huxley and Blake right
7. Early Psychiatric Uses for LSD
1. Psychotomimetic
2. Self-experimentation by mental health
professionals
3. Psychedelic Psychotherapy
• High dose single drug session
• Mystical / Peak experience
• Favoured in the US
4. Psycholytic Psychotherapy
• Low doses
• Frequent, regular sessions
• Favoured in the UK
7Ben Sessa
8. “To sink in hell or soar angelic
You’ll need a pinch of psychedelic”
Ronald David Laing: UK
Humphrey Osmond: UK CanadaUSA
Advice for those wishing to
become a psychoanalyst:
1.Read the works of Freud
2.Undergo personal analysis
3.Take LSD
Psychiatry protagonists
9. Clinical Interest in LSD in the
1950s and 1960s
• Hundreds of psychiatrists worldwide
• 140 NIH grants
• 1000 clinical papers
• 40,000 patients
• 40 books
• 6 International conferences
Results were overwhelmingly positive, describing safe and
effective treatments.
(Masters and Houston, 1971)
10. Pooled analyses in the 1960s
• 44 psychiatrists, 5000 subjects and 25,000 drug sessions:
Rate of psychosis: 0.2%
Rate of suicide of 0.04%
(Cohen S. (1960) LSD: side effects and complications. Journal of Nervous and Mental Disorders 130: 30-40)
• 700 psychedelic drug sessions:
One case of prolonged psychosis
(Chandler Al. & Hartman Ma. (1960) LSD-25 as a Facilitating Agent in Psychotherapy. AMA Arch Gen Psychiatry; 2(3):286-299)
• 350 patients over four years of outpatient treatments:
One attempted suicide
(Ling TM, Buckman J (1963) The Treatment of Anxiety with Lysergic Acid and Methylphenidate. Practitioner 191: 201-4)
• Review of 20 years of psychedelic therapy in the UK, 4000 patients and
50,000 psychedelic drug-assisted sessions.
Two completed suicides
Thirty-seven patients with a prolonged psychosis
(Malleson, N. (1971) ‘Acute Adverse Reactions to LSD in clinical and experimental use in the UK.’ Br J Psychiatry. 18(543): 229-30)
"Treatment with LSD is not without acute adverse
reactions, but given adequate psychiatric supervision
and proper conditions for its administration, the
incidence of such reactions is not great,"
11. Psychedelics for alcoholism?
Some years after his atropine-induced
sobriety conversion Bill Wilson, founder
of AA, came to believe that LSD could
help “cynical alcoholics” (those who did
not believe in a higher power”) achieve
spiritual awakening
12. Wilson’s psychedelic experience
“Suddenly the room lit up with a great white
light. I was caught up in an ecstasy which there
are no words to describe.
It seemed to me in my mind's eye, that I was on
a mountain and that a wind not of air but of
spirit was blowing.
And then it burst upon me that I was a free
man.”
14. 6 LSD trials in alcoholism
Effect size > = all current therapies
Since the banning – one clinical trial + only two neuroscience
studies - all in last two years
15. Psychedelics, used responsibly and with proper caution,
would be for psychiatry,
what the microscope is for biology and medicine,
or the telescope is for astronomy
Stan Grof
- but how do they work?
A necessary research tool?
16. Why were psychedelics banned?
Because the CIA were worried
about American youth refusing
to fight in Vietnam – and
cultural change (flower power)
Scare stories e.g. trying to fly
18. LSD scares in the
film media
The usual cocktail of sex
drugs and youth
moral outrage in the
old
19. LSD and all other psychedelics banned in
face of opposition from senators
Bobby Kennedy:
Why if [clinical LSD projects] were worthwhile
six months ago, why aren’t they worthwhile
now? . . . We keep going around and
around. . . . If I could get a flat answer about
that I would be happy. Is there a
misunderstanding about my question?
I think perhaps we have lost sight of the
fact that LSD can be very, very helpful in
our society if used properly.”
quoted in Lee & Shlain, 1985, p. 93)
Has there ever been a worst example of research
censorship?
Well not since …….
20. The banning of the telescope!
1616 The papal Congregation of the Index banned all books
advocating the Copernican system of explaining planetary motion
Not revoked until 1758
Galileo
Galilei
1564-1642
Giordano Bruno
1548-1600
Nicolaus
Copernicus
1473-1543
21. How the UN Conventions on drugs destroyed research
22. Read more about it
Nature reviews
Neuroscience 2013
March 2015
23. Fighting back – psychedelics for addiction
Modern replication study
Psilocybin-assisted treatment for alcohol dependence: A
proof-of-concept study
J Psychopharmacol March 2015 29: 289-299, first published
on January 13, 2015
Bogenschutz MP1, Forcehimes AA2, Pommy JA2, Wilcox
CE2, Barbosa PC3, Strassman RJ2.
27. Krupitsky et al. Ketamine Psychotherapy for Heroin Dependence
Single Versus Repeated Sessions of
Ketamine-Assisted Psychotherapy for
People with Heroin Dependence†
Evgeny M. Krupitsky, M.D., Ph.D.*; Andrei M. Burakov, M.D., Ph.D.**;
Igor V. Dunaevsky, M.D., Ph.D.***; Tatyana N. Romanova, M.S.****;
Tatyana Y. Slavina, M.D., Ph.D.***** & Alexander Y. Grinenko M.D., Ph.D.******
Abstract— A prior study found that one ketamine-assisted psychotherapy session was significa nt ly
more effective than active placebo in promoting abstinence (Krupitsky et al. 2002). In this study of the
efficacy of single versus repeated sessions of ketamine-assisted psychotherapy in promoting abstinence
in people with heroin dependence, 59 detoxified inpatients with heroin dependence received a ketamine-
assisted psychotherapy (KPT) session prior to their discharge from an addiction treatment hospital, and
were then randomized into two treatment groups. Participants in the firs t group received two addiction
counseling sessions followed by two KPT sessions, with sessions scheduled on a monthly interval
(multiple KPT group). Participants in the second group received two addiction counseling sessions
on a monthly interval, but no additional ketamine therapy sessions (single KPT group). At one-year
follow-up, survival analysis demonstrated a significa nt ly higher rate of abstinence in the multiple KPT
group. Thirteen out of 26 subjects (50%) in the multiple KPT group remained abstinent, compared to
6 out of 27 subjects (22.2%) in the single KPT group (p < 0.05). No differences between groups were
Journal of Psychoactive Drugs 13 Volume 39 (1), March 2007
Abstract— A prior study found that one ketamine-assisted psychotherapy session was significa nt ly
more effective than active placebo in promoting abstinence (Krupitsky et al. 2002). In this study of the
efficacy of single versus repeated sessions of ketamine-assisted psychotherapy in promoting abstinence
in people with heroin dependence, 59 detoxified inpatients with heroin dependence received a ketamine-
assisted psychotherapy (KPT) session prior to their discharge from an addiction treatment hospital, and
were then randomized into two treatment groups. Participants in the firs t group received two addiction
counseling sessions followed by two KPT sessions, with sessions scheduled on a monthly interval
(multiple KPT group). Participants in the second group received two addiction counseling sessions
on a monthly interval, but no additional ketamine therapy sessions (single KPT group). At one-year
follow-up, survival analysis demonstrated a significa nt ly higher rate of abstinence in the multiple KPT
group. Thirteen out of 26 subjects (50%) in the multiple KPT group remained abstinent, compared to
6 out of 27 subjects (22.2%) in the single KPT group (p < 0.05). No differences between groups were
found in depression, anxiety, craving for heroin, or their understanding of the meaning of their lives. It
was concluded that three sessions of ketamine-assisted psychotherapy are more effective than a single
session for the treatment of heroin addiction.
Keywords—hallucinogens, heroin addiction, ketamine, psychedelics, psychotherapy, treatment
†This study was supported by the Multidisciplinary Association for
Psychedelic Studies (MAPS), Sarasota, Florida, USA and by the Heffter
Research Institute, Santa Fe, New Mexico, USA. The authors are also very
thankful to Rick Doblin, Lisa Jerome, Valerie Mojeiko, and Dr. George
Greer for assistance in editing the manuscript, and to Tatyana Volskaya,
M.A., for data management.
*Chief of the Research Laboratory, St. Petersburg Regional Center of
Addictions and Psychopharmacology, St. Petersburg State Pavlov Medical
University, St. Petersburg, Russia.
**Psychiatrist, St. Petersburg Regional Center of Addictions and
Psychopharmacology, St. Petersburg State Pavlov Medical University, St.
Petersburg, Russia.
***Anesthesiologist, St. Petersburg Regional Center of Addictions
and Psychopharmacology, St. Petersburg State Pavlov Medical University,
St. Petersburg, Russia.
****Clinical Psychologist, St. Petersburg Regional Center of
Addictions and Psychopharmacology, St. Petersburg State Pavlov Medical
University, St. Petersburg, Russia.
*****Psychiatrist and Medical Director, St. Petersburg Regional
Center ofAddictions and Psychopharmacology, St. Petersburg State Pavlov
Medical University, St. Petersburg, Russia.
******Director, St. Petersburg Regional Center of Addictions and
Psychopharmacology, St. Petersburg State Pavlov Medical University, St.
Petersburg, Russia.
Please address correspondence and reprint requests to Evgeny M.
Krupitsky, M.D., Ph.D., St. Petersburg Regional Center of Addictions and
Psychopharmacology, Novo-Deviatkino 19/1, Leningrad Region 188661,
Russia. Email: kru@ek3506.spb.edu
Psychedelic-assisted psychotherapy utilizes the acute
psychological effects of psychedelic, or hallucinogenic,
drugs to enhance the normal mechanisms of psychotherapy.
Many studies carried out in the 1950s and 1960s suggested
that psychedelic-assisted psychotherapy might be an effic
i
ent
treatment for alcoholism and addictions (Grinspoon &
Bakalar 1979). However, it is difficu l t to generalize across
these studies because of differences in methodology. After
they were scheduled in 1970, the use of psychedelic drugs
in research was strictly limited, significantly curtailing
Ketamine for heroin addiction
28. Ketamine one –v- three doses
heroin abstinence
Krupitsky et al. Ketamine Psychotherapy for Heroin Dependence
emotional support for the participant and carried out psycho-
therapy during the ketamine session. The psychotherapy was
existentially-oriented, focusing on assisting the participant
to consider and formulate a purposeful or meaningful life,
but also took into account the participant’s individuality,
ending or apocalypse, and often ended in an experience of
rebirth associated with oceanic, or positively experienced,
ego loss and boundlessness. All of these experiences were
emotionally intense and compelling. Many people reported
great diffic
u
l ty in expr essing their experiences in words. It
FIGURE 1
Kaplan-Meier Survival Analysis
P < 0.01
Krupitsky et al
2007
29. Ketamine for alcoholism
• Krupitsky, E. M., Grinenko, A. Y., Berkaliev, T. N., Paley, A. I., Tetrov, U. N.,
Mushkov, K. A., & Borodikin, Y. S. (1992). The combination of psychedelic
and aversive approaches in alcoholism treatment: The affective contra-
attribution method. Alcoholism Treatment Quarterly, 9(1), 99-105.
doi:10.1300/ J020V09N01_09
MRC-funded UK study in alcoholism underway in
UK
Celia Morgan and Val Curran with Krupitsky
31. LSD
Mescaline
Affinity for
5-HT2A
Potency in
manGlennon et al. 1984. Human dose data from Shulgin 1978
Resurrecting psychedelic research with psilocybin
All these drugs stimulate 5HT2A receptors
Psilocybin – magic mushrooms
Short acting if used iv = 30 min effect
33. Psilocybin fMRI: ONLY DECREASES in brain activity
+ regionally specific
Posterior
Cingulate
Thalamus
Anterior
cingulate
Carhart-Harris et al PNAS 2012
34. Psilocybin uncouples frontoparietal
connectivity (default mode network, DMN)
Saline – strong
correlations in
activity in these
regions
Psilocybin –
correlations lost
or even negative
Seed regionCarhart-Harris et al PNAS 2012
36. The default mode network & depression
A) PCC functional
connectivity
B) Greater PCC to SCC
(subgenual cingulate
cortex) connectivity in
depression
PCC - SCC functional
connectivity predicts
rumination
(Berman et al. 2011)
37. Brain sites of depression – PET imaging
“It is a positive and active anguish, a sort of
psychical neuralgia wholly unknown to normal life.
Cg25
F9 F9Cg24
Treatment Resistant
Depression
William James, revisited
So can we selectively
turn the active anguish
OFF?
Mayberg et al 2005 Neuron
Red = overactive region
Blue = underactive region
38. z = -4
z = +4
L
Deep Brain Stimulation – stops overactivity
Cg25
mF10
oF11
Cg24
hth
Cg25
F9
ins
F46
mF
ins
3 months DBS
CBF Change
Responders
Cg24
vCd
sn Cg25 Cg25
Cg24 F9F9
F47
hth
Baseline
CBF PET
All PT vs NC
Cg25
mF10
oF11
Cg24
hth
bs
Cg25
mFF9
ins
F9
F46
Cg31
6 months DBS
CBF Change
Responders
Helen Mayberg
40. Psilocybin
attenuates activity in
the brain region
linked to depression
Carhart-Harris PNAS 2012
fMRI BOLD image
Psilocybin attenuated mPFC activity
As do treatments for depression
SSRIs Kennedy et al. 01
CBT Goldapple et al. 04
Sleep deprivation Gillin et al. 01
ECT Bonne et al. 96
Placebo Mayberg et al. 02
Deep brain stimulation Mayberg et al. 05
Ketamine Deakin et al. 08
41. Meditation reduces DMN activity - basis of mindfulness therapy?
Coloured
bars
reflect
different
sorts of
meditation
Yale group
42. Mood and wellbeing
• Users often report enduring effects
• Formal studies – Roland Griffiths John
Hopkins – confirm this
• As did our subjects
Single high dose of psilocybin:
Two-thirds of participants rated
their experience as one of their top
5 most meaningful life experiences
(Griffiths et al. 2006)
Is this an antidepressant effect?
43. Our MRC psilocybin depression trial
Grant awarded 2012
Ethics – took 3 iterations – 1 year
Drug supply – 30 months
Regulatory approvals – 32 months
Cost per dose = £1500!
46. Antidepressants and amygdala - meta-analysis
a et al. (2015), Molecular psychiatry
Reduced activity to negative emotional faces
47. Fearful Happy Neutral
Baseline and 1-day after therapy (“after-glow”)
Passively viewing
Blocks of 15 seconds
Amygdala in psilocybin assisted therapy
Roseman et al submitted
48. Fearful Happy Neutral Fearful>Neutral
y=-5 y=-2 y=-3 y=1
3.5Z=2.3
Amygdala activation increased
after psilocybin-assisted therapy
1-day after therapy > Baseline
Roseman et al submitted
49. More amygdala activation better
clinical outcome
Fearful > Neutral
Remitters (n=11) > Non-remitters (n=8)
y=-1
x=20
Remission (No depression)
BDI <= 9
1 week
3.5Z=2.3
Roseman et al submitted
51. Carhart-Harris and Nutt – Journal of
Psychopharmacology 2017 – free download
5-HT receptors in depression - our current model
52. Psilocybin changes attitude
They can change patients’ outlook
Normalised
post-treatment
P < 0.01
P < 0.01
Pessimism bias
pre-treatment
P < 0.01
“My outlook has changed significantly. I'm more aware now that it's
pointless to get wrapped up in endless negativity. I feel as if I've
seen a much clearer picture.”
[Patient from depression trial, male, aged 52, >20yrs depression]
Watts et al Journal of Humanistic Psychology 2017, Vol. 57(5) 520
53. It was like when you defrag the hard drive on your
computer, I experienced blocks going into place, things being
rearranged in my mind, I visualized as it was all put into
order, a beautiful experience with these gold blocks going
into black drawers that would illuminate, and I thought my
brain is bring defragged, how brilliant is that! (P11)
My mind works differently [now]. I ruminate much
less, and my thoughts feel ordered, contextualized.
Rumination was like thoughts out of context, out of
time; now my thoughts feel like they make sense,
with context and logical flow. (P11) “
“
Another quote
Watts et al Journal of Humanistic Psychology 2017, Vol. 57(5) 520
54. Self worth/self love: ‘I had an
experience of tenderness towards
myself, a feeling of true compassion I’d
never felt before (P16)
New perspectives: ‘She was so
eloquent, she kept calling me ‘my
darling’: “Life is to be lived my
darling” She talked to me in such a
loving way, all these things to say
about my life’ (P12)
Activities: ‘I started writing music again’
(P1) (jobs, driving, acting, building, flying,
volunteering, travel)
Inner therapist: ‘Its like ingesting your
own psychotherapist’ (P19)
“
“
Connected to self
Watts et al Journal of Humanistic Psychology 2017, Vol. 57(5) 520
55. Connection to the world
Connection to work 7
Connection to nature 11
Connection to spiritual principle 9
Before I enjoyed nature, now I feel part of it.
Before I was looking at it as a thing, like TV
or a painting. You’re part of it, there’s no
separation or distinction, you are it. (P1)
Watts et al Journal of Humanistic Psychology 2017, Vol. 57(5) 520
56. Talking therapy: disconnection:
I’m sick to the back teeth of telling people again and again the backstory.
All the talking therapies, each time you go for an 8 or 6 week course of
that stuff, you spend the first few weeks going over the stuff, they ask all
the questions again then its session 4, and then, you think who’s learning
something here, ‘cos I’m not. You are! (P13)
They all seemed to be trying to fit a person into a preconceived set of
patterns: ‘try to do this’, ‘make this your goal, and we’ll measure it’. But
just having these goals set for you is more pressure and when you don’t
meet those goals, you feel even worse because you’re letting them down,
and you already feel let down yourself! (P1)
TOO DIRECTIVE
TOO SHORT
“
“
I got up the courage to tell him, I’d never told anyone. And [the
psychiatrist] just looked at his shoes.’ (P16)
DON’T ADDRESS TRAUMA:
“
57. “Those who cannot change their minds cannot
change anything”
George Bernard Shaw (1856-1950)
Can our research help change peoples’ mind about psychedelics?
a new Enlightenment perhaps.....
58. Acknowledgements
Mendel Kaelen, Leor Roseman, Mark Bolstridge, Chris Timmermann, Tim Williams,
David Erritzoe, Ben Sessa, Suresh Muthukumuraswamy, Richard Wise, Luke Williams,
Kevin Murphy, Robert Leech, Eduardo Schenberg, Neiloufar Family, Matt Wall, Val
Curran, Karl Friston, Rosalyn Moran, David Nichols, Robin Tyacke, James Stone,
Laurence Reed, Nadar Abbasi, Enzo Tagliazucchi, Dante Chialvo, Roland Griffiths,
Katherine MacLean, Matt Johnson, Charlie Grob, Bill Richards, Jeff Guss, George
Goldsmith, Ekaterina Malievskaia, Celia Morgan, Mitul Mehta, Alexander Lebedev,
Pete Hellyer, Csaba Orban, John McGonigle, Remi Flechais, Michael Bloomfield, Steve
Pilling, Matt Brookes, Tim Nest, Paul Expert, Giovanni Petri, James Rucker, Camilla Day,
Shlomi Raz, Catherine Scrace, Kabir Nigam, John Evans, Peter Hobden, Wouter Droog,
Yvonne Lewis, Mark Tanner, Ineke de Meer; Alison Diaper, Ann Rich, Sue Wilson,
volunteers, patients and more…
Robin Carhart-Harris Amanda Feilding
59. Brain sites of depression – PET imaging
“It is a positive and active anguish, a sort of
psychical neuralgia wholly unknown to normal life.
Cg25
F9 F9Cg24
Treatment Resistant
Depression
William James, revisited
So can we selectively
turn the active anguish
OFF?
Mayberg et al 2005 Neuron
Red = overactive region
Blue = underactive region
60. z = -4
z = +4
L
Deep Brain Stimulation – stops overactivity
Cg25
mF10
oF11
Cg24
hth
Cg25
F9
ins
F46
mF
ins
3 months DBS
CBF Change
Responders
Cg24
vCd
sn Cg25 Cg25
Cg24 F9F9
F47
hth
Baseline
CBF PET
All PT vs NC
Cg25
mF10
oF11
Cg24
hth
bs
Cg25
mFF9
ins
F9
F46
Cg31
6 months DBS
CBF Change
Responders
Helen Mayberg
62. Bhagwager et al 2006 Am J Psychiatry
Recovered depressed patients have
increased 5HT2A receptors
Maybe an attempt to make up for deficiency of 5HT?
So would psilocybin
replace what’s missing ?
63. Figure 3a. 5-HT2A binding in frontolimbic regions
correlates with trait neuroticism in 84 healthy
subjects38
.
Figure 3b. Cortical 5-HT2A binding correlates with
dysfunctional attitudes (pessimism) in medicated
free depressed patients39
.
Figure 3c. Regions where 5-HT2A binding correlates
positively with pessimism in med-free depressed
patients39
.
More 5HT2A receptors pessimism
Meyer et al
Maybe an attempt to make up for deficiency of 5HT (serotonin)
Could psilocybin rectify this?
64. “The future may teach us
how to exercise a direct
influence, by means of
particular chemical
substances, upon …the
neural apparatus. It may
be that there are other
still undreamt of
possibilities of therapy.”
From An Outline of Psychoanalysis
Sigmund Freud
London 1938.
64
But we were not the first!
Was Freud the forefather of psychedelic therapy?
65. If the doors of perception were cleansed every
Thing would appear to man as it is, infinite.
For man has closed himself up, till he sees all
Things thro’ narrow chinks of his cavern.
iam Blake, 1793
Aldous Huxley and mescaline
Peyote cactus
“The brain is an
instrument for focusing
the mind”
66. DepressionAddiction
The brain reconstructs
the image to what it
expects
But always with limitations
“Man sees thro’ the chinks of
his cavern” William Blake
1793
Neuroscience proves Huxley and Blake right
67. By switching of the “control centres” psilocybin
increases brain connectivity
Petri et al J. R. Soc. Interface 11: 20140873. http://dx.doi.org/10.1098/rsif.2014.0873
Normal Psilocybin
Editor's Notes
This study also showed decreases in visual cortex at the acute state
Most participants for whom it was effective (really out of 17) described a mental Reset, reboot, their mind being reconfigured. Many of them used these terms.
Some quotes. And where I give quotes I’ll give an example of that theme happening during the session, and then how that theme looks 6 months down the line.
So here, P11 talking about his mind being reset during the experience, and then his experience of his mind still feeling kind of optimised, improved 6 months later: freeflowing, more orderly, ruminating less. Less stuck
Inner therapist: sense of knowing what’s best for the self
Some of them were also offered therapy: typically 5-8 sessions of CBT or counselling. And it hadn’t worked for any of them. Many of them had gone back time and time again to get another course of the same 8 sessions of CBT. One person had 6 courses of therapy. So that’s 48 sessions, a year of therapy, but chopped into 6 little chunks of hello and goodbye with 6 different people. I trained as a clinical psychologist so that I could be talking therapist, and I believe in this process, when it is done properly. Susie Orbach, a British psychotherapist and writer describes how therapy works when it does work (which is only about half the time): ‘therapists don’t so much solve issues as attempt to open up new doors- emotional intelletcual physical, - to expand their notions of the roots and interplay of their difficulties so that they can intervene with themselves and others differently’ But that takes time and well trained therapists, and many of participants described a process where they had been subjected to ‘therapy’ without either of these things. So when I interviewed them, they described three main reasons that the therapy they received had actually made them feel worse, more disconnected. QUOTES
(too directive: QUOTES) All coming from the therapist, therapist is the expert, patient feels disempowered. There were some really sad stories, t people felt patronised, condescended to, ignored. But even those who had quite good rapport with their therapists still felt that the motivation and ideas about to change were kind of being imposed from the outside, not coming from inside. The ideas were often coming from a textbook or what the therapist thought would be good for the patient, rather than a genuine process of inner transformation.
(trauma) this participant had suffered from childhood sexual abuse, talking about a short series of sessions he’d had: and he was not alone. Three of them described similar things happening. And probably the health professionals involved were well meaning, but a lot of the short term therapy manuals do emphasis keeping sesison content to the here and now, which can mean steering people away from talking about early trauma. So rather than therapy bringing moments of connection, it was actually bringing moments of disconnection and shame, that were then remembered for years,
So, ADS and therapy were repeating and reinforcing the disconnection that they knew was a fundamental feature of their depression. Treatments were seen as promoting a view of psychological pain as something that should be systematically suppressed, rather than explored as a symptom of an underlying problem that needs to be accessed and processed And that was one of the reasons why they preferred psilocybin treatment (all of them said they preferred it to any other treatment tried): they valued the chance to connect with their emotions in a safe space: the guides just there to support them, not direct them, as they connected to themselves in a genuine real way, in the way that was right for them, as an individual, no textbooks, no preconceived sets of patterns, no preconceived goals, no steering away from pain.
We’ve used 3 different imaging modalities to understand the brain effects of psilocybin and now also LSD.
Also, done fMRI work with MDMA but I will focus on the classic psychedeout lics in the presentation.
And particularly LSD.