Why We Should Take Our Time on Psychedelic Therapy – Psychology Today

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The question is not whether you’ll change; you will. Research clearly shows that everyone’s personality traits shift over the years, often for the better. But who we end up becoming and how much we like that person are more in our control than we tend to think they are.
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Posted October 28, 2022 | Reviewed by Tyler Woods
Though psychedelic therapy is not yet available to the wider public, and the psychedelics themselves are illegal for recreational purposes, there’s a lot of research being done on this type of therapy.
A big reason is why is that in many completed studies, the treatment results look promising for depression, anxiety, PTSD, substance use disorder, and other mental illnesses.
In my opinion, however, it is vital that we take the time to fully research these potent substances and not fast-track them into the drug treatment marketplace.
Psychedelic therapy uses psychedelic plant compounds that induce hallucinations. These compounds include LSD, psilocybin (mushrooms), mescaline, MDMA (Ecstasy), and others. The way the therapy is normally done, and the method that has proven to be most successful to date, is for a trained therapist to guide the patient verbally while they’re in a hallucinogenic state.
Doctors and researchers sometimes resort to psychedelic therapy with patients who have not responded well to more traditional drugs or therapies. This is often done via clinical trials.
Many researchers believe the real value of psychedelic therapy is not in the drugs themselves, but rather in the assisted therapy that happens during the heightened state. They believe the drug creates the “space” for the therapy to do its thing more thoroughly and profoundly than is normally possible in a therapy-only session. The psychedelic drug acts as a catalyst for a more enhanced therapy experience.
Afterward a psychedelic-assisted therapy session, patients receive what’s called “integration,” which is when the patient discusses with the therapist what they experienced.
One aspect that is most exciting about many of these study results is that patients often see an immediate improvement in their symptoms. Traditional medications for mental health conditions often take weeks to begin working.
The drug-as-catalyst model is the most likely scenario, but other factors may be playing a role as well. When psychedelic therapy works—and it doesn’t for everyone—one or more of these factors is the likely reason:
Researchers have used psychedelic therapy for people with terminal illnesses, eating disorders, depression, anxiety, addiction, and other conditions. Results have been promising in general, possibly most so with anxiety and depression. Some highlights:
Yes, many of the studies on psychedelic therapy have been promising. Yes, psychedelic therapy may work at certain times when traditional medications and therapies do not. And most of all, yes, I understand how desperate many long-suffering patients and their loved ones are to find relief and get their lives back.
However, it is urgent that we proceed with caution because, in my opinion, we didn’t do that with marijuana research over the last 10 to 20 years. The result of that haste is that marijuana is everywhere, and based on the overly positive hype around it, you would think it cures every ill under the sun. Also, you rarely hear about the potential risks—of which there are many.
For one, marijuana is a lot more powerful than it used to be. (Could psychedelics go down the same route?) A 2018 survey found that the average potency of weed was nearly four times what it was in the 1990s.
Also, marijuana is especially risky for adolescents and young adults, whose brains are still developing. Research has shown that people who begin using marijuana before age 18 are four to seven times more likely to develop cannabis use disorder than people who start using as adults.
My point here is that we’re finding out about some of these serious marijuana risks after the fact. After the horse had already left the barn. Now that marijuana is everywhere and is marketed as the be-all and end-all for everything that ails you, it’s too late to pump the brakes while we do more research.
It’s important to remember we have a lot of proven treatments in the mental health field. That’s certainly true in my area of addiction treatment.
Unfortunately, many treatments and therapies aren’t used as much as they should be. We need to be a lot better about that. Medication-assisted treatment (MAT) is a great example of a proven, evidence-based therapy that is underutilized, especially for opioid use disorder, but for other substance use disorders as well.
My bottom line: While we’re waiting for psychedelic therapy to get the proper signoff by the research community, let’s make the best use of the mental health drugs and therapies we currently have.
References
Spriggs, M.J., Kettner, H., Carhart-Harris, R.L. (2017). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology.
Fauvel, B., Strika-Bruneau, L., & Piolino, P. (2021). Changes in self-rumination and self-compassion mediate the effect of psychedelic experiences on decreases in depression, anxiety, and stress. Psychology of Consciousness: Theory, Research, and Practice.
Weston, N.M., Gibbs, D., Bird, C.I.V. et al. (2020). Historic psychedelic drug trials and the treatment of anxiety disorders. Depression & Anxiety.
Lantie Jorandby, M.D., is a board-certified psychiatrist with certification in Addiction Psychiatry and Addiction Medicine. She’s the Chief Medical Officer of Lakeview Health Addiction Treatment & Recovery in Jacksonville, Florida.
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Psychology Today © 2022 Sussex Publishers, LLC
The question is not whether you’ll change; you will. Research clearly shows that everyone’s personality traits shift over the years, often for the better. But who we end up becoming and how much we like that person are more in our control than we tend to think they are.

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