Psychedelic therapy is entering a renaissance period. A time of renewed interest, scientific vigor, and newfound potential to help and assist those in need of health and healing.
Research and clinical studies being done on psychedelic medicines and therapeutic modalities are reaffirming and demonstrating the safety, efficacy, and profound potential of these healing experiences. When administered safely and properly, psychedelic medicines help treat a range of physical and mental health conditions.
But what exactly is meant by “psychedelic therapy?” What do the experiences look like? How are they done properly according to current science and collective understanding? This resource will provide some much needed clarity around the key mechanisms and protocols of psychedelic therapy, taking a look at its profile to date, what science is currently underway, and where psychedelic therapy is heading.
With a number of different experiences, practitioners, and modes of administration, the world of psychedelic therapy is nuanced. Understanding these nuances is of the utmost importance to help further collective understanding on how to best serve the communities that benefit from these experiences, and how to truly unlock the healing potential granted by psychedelic compounds, the associated experiences, and the wealth and wisdom of the practitioners who facilitate and administrate them.
The history of psychedelic therapy begins in the 1950’s, with the original coining of the term by Canadian psychiatric researchers, including pioneer Humphrey Osmond. Much like our earlier definition, it involved the application of a single high-dose of a psychedelic after a series of psychotherapeutic preparation sessions in the treatment of substance abuse disorders, largely related to alcohol in the early days.
Throughout the 40’s and 50’s a number of psychedelic compounds were being synthesized, or introduced in larger scales to the scientific and “psychonautic” communities. As these were introduced, a series of clinical and scientific study trials inevitably followed. The potential and promise of these substances was not ignored by the academic community in any way.
Despite the closing off of access and study in the 60’s and 70’s, psychedelic therapy and the potential of psychedelic compounds were favorably received and welcomed by the clinical and scientific community in the early days. Some researchers, such as psychedelic psychotherapeutic legend Stanislov Grof, came out with the statement:
“In one of my early books I suggested that the potential significance of LSD and other psychedelics for psychiatry and psychology was comparable to the value the microscope has for biology or the telescope has for astronomy.”
In other words, an important tool with the potential to significantly accelerate and move the entire psychiatric and psychedelic field forward.
Studies began and were completed across a variety of fields and factors: everything from addiction recovery, treating depression/anxiety, inducing mystical experiences, managing substance abuse, and mitigating end-of-life anxiety. Numerous sanctioned studies were done across the globe during these decades. In the process, a number of best practices, protocols, and programs were developed to help systematize and contain what has the potential to be an intense or provocative experience for the client. These studies are the birthplace of “Set & Setting”, a hallmark concept in psychedelic therapy today.
LSD was a focal point for many studies across North America and Europe during this time. This compound was a major focus, given the potency, the ability to synthesize easily in a controlled environment, and the reliability of the method of administration. It also proliferated into the public through illicit channels and became a central piece in the countercultural movements throughout the 60’s, influencing many major figures, and creating ripples in cultural consciousness that would last for decades to come.
After these ripples came large-scale lockdowns and bans against psychedelic compounds and associated research and studies. Alongside this “war on drugs” came sweeping laws and regulations preventing the access, possession, and study of these compounds. The scientific and clinical communities working in psychedelic therapy would enter a dark period for research that would last for over two decades across the majority of the world.
Then, beginning with Dr. Rick Strassman’s work to investigate the effects of N,N–DMT (DMT) in the 1990’s, the academic and scientific communities have increasingly been able to work more and more with these compounds and experiences in controlled studies with FDA oversight. Many have coined this period, leading up to the present day, a “psychedelic renaissance.” Researchers and organizations were able to pick up where the research left off, and continue exploring the profound potential of psychedelic compounds and therapies in service of helping and healing those who are in need of it.
At present, there are many funded studies underway across private organizations, research institutes, and universities. These institutions are looking at a variety of conditions —such as depression, anxiety, and PTSD— and finding the compounds, protocols, dosages, and experiences that will help alleviate their symptoms.
Funding and public attention is flowing into the space faster than ever before, more favorable legal and regulatory environments are taking shape, and the momentum for increasing access and awareness is gaining momentum.
At its core, psychedelic therapy is a combination of therapeutic techniques with experiences through psychedelic compounds. These psychedelic compounds induce novel states of consciousness and emotion that assist and augment the therapeutic “containers” they are experienced within.
Let’s begin by looking at the two core terms involved: psychedelic, and therapy.
Psychedelic refers to a specific class of compounds that are proven to reliably and effectively induce certain non ordinary states of consciousness. There are classic characteristics of a psychedelic experience, including experiences and/or states such as:
Each individual’s experience will vary. Some, all, or none of these experiences may happen in an individual psychedelic therapy session. These are generally accepted as notable characteristics of the psychedelic experience and the compounds that reliably induce some or all of these states.
Psychedelic “therapy” draws largely on the frameworks of traditional or classic therapy programs and protocols such as psychotherapy, talk therapy, cognitive-behavioral therapy, and similar modalities.
Traditionally a client will enroll with a licensed practitioner and move through a series of sessions with the aim of unpacking, understanding, and healing any unresolved traumas or conditions.
Outside of working with a licensed therapist, there are other examples of “therapeutic experiences” which can provide similar experiences of personal healing and wholeness. One example is Somatic Experience techniques. This, and other novel conversational modalities, can be extended to specific experiences or programs that help individuals work through specific areas of themselves and their lives.
In combining psychedelics and therapeutic frameworks together, we can begin to see a larger picture of what psychedelic therapy currently is, and what it can become. By combining the rich experiences that psychedelic compounds provide —allowing safe access to novel experiences, feelings, and states of consciousness— with the rigor, expertise, and structure of therapeutic programs and protocols, a synergistic realm of healing opens up. This combination has been demonstrated to help previously treatment-resistant cases, and to accelerate and augment the progress and promise of existing therapeutic experiences.
There are a number of different psychedelic therapy modalities, including but not limited to: psychedelic-assisted psychotherapy, psychedelic therapy experiences and programs, and individualized psychedelic use with the intention of returning to healing, health, and wholeness.
Though all of these terms do involve the aforementioned combination of a psychedelic compound and a therapeutic structure, the specifics of administration —dosing, frequency of experience, practitioners involved, and supporting variables— vary between each of them.
Refers specifically to the use of a psychedelic compound either immediately preceding, or during, a classic psychotherapy talk session with a licensed therapist.
Through the emotional opening and novel states of consciousness provided by the compound and experience, practitioners and clients are often able to reach new depths in understanding, or cover ground that may have taken longer to arrive at in traditional talk therapy, or that was previously inaccessible to the client.
Whether through different therapeutic experiences such as at-home sessions, curated and personalized programming, or orchestrated by the recommendation of an experienced practitioner, psychedelic therapy programs are similar to psychedelic-assisted psychotherapy.
They do not include psychotherapy sessions specifically, and may not involve a licensed psychotherapist. There is often supporting integration work to help understand the experience, it is an important distinction to make that these programs and protocols do not involve licensed psychotherapists.
These can take the form of healing retreats, personal or recreational individual undertakings, or participation in ongoing clinical research studies. This is a category of experiences that may include only individual sessions, exist outside of a clinical environment, or be part of an on-going study to research and validate safety or efficacy profiles for new compounds or techniques that are actively being researched.
If you are considering embarking on a psychedelic therapy program, it is important to know what you are signing up for, the scope and support involved, and to be clear on your own intentions and capacities for the experience. The more clear you are on what is involved, the more personalized the programs become, and the greater potential you have to achieve the results and healing that you wish to experience.
On the whole, psychedelic compounds are noted to be safe, both to the individual and the societies that they are taken within.
Published by the Lancet, a pioneering journal in the UK, both LSD and psilocybin come in as some of the lowest risk endogenous compounds commonly consumed in modern society. When compared to tobacco/nicotine, alcohol, and caffeine, classic psychedelic compounds have a remarkable safety profile for the individual ingesting them for the experience.
That is not to say that these are panaceas or can be taken by just about anyone. On the contrary, some compounds do have a powerful body load, or direct impact on the body’s natural systems, to contend with. As is the nature of psychedelics, these are extremely potent compounds for the psyche to handle, and must be taken with care and respect to avoid doing more harm than good for the client.
Beyond the general safety profile, the biggest mark and way to ensure client and practitioner safety in psychedelic therapy is honoring and respecting the contraindications of the particular medicine or compound. Contraindications are physical or mental indicators that mean this medicine is not appropriate for the individual.
Each medicine and compound will come with its own list of specific contraindications, so it is important to review these, and to be honest with the practitioner during the intake/screening process.
This list is by no means exhaustive, and does not address specific contraindications for particular compounds, but can provide a general overview as there is a body load from psychedelic compounds (heart rate, blood pressure), and a psychic load from the psychedelic experience. These compounds temporarily alter neurochemistry, so one must be very careful when they are actively taking other medications that work on similar pathways or with similar neurotransmitters.
When taken within a safe and conducive environment with trained and licensed practitioners, psychedelic compounds and psychedelic therapies can be physically and psychically safe.
This is also an entire field of ongoing study, and the first stage of testing for public approval through the FDA — looking at the safety, dosages, quality, and best methods of administration for certain compounds and experiences. As more research is done, these safety precautions and knowledge will expand, continuing to further the efficacy of treatments and ensure the safety of clients and practitioners.
Around the world, the legal environment for psychedelic therapy is starting to open up after widespread bans across the public and private sectors for the past few decades. Fortunately, legal access is emerging for both clients who wish to work with psychedelic therapies personally, and for academics and researchers who wish to use these compounds for studies to expand the scope of scientific knowledge around these medicines and experiences.
Currently, ketamine treatment is the only legal, clinician-prescribed psychedelic therapy option available to the public.
There are legal avenues to work with other compounds in the context of clinical research studies, but there are nuances to research studies that you should be aware of before signing up.
As for the academic and research worlds, legal access has been steadily opening up for study of the compounds themselves, and to conduct clinical research trials for their safety and efficacy in the treatment of different conditions or ailments.
All of the “classic” psychedelic compounds —psilocybin (Mushrooms), LSD, and MDMA for example— currently are labelled as Schedule 1 Controlled Substances by the DEA, meaning they have no currently accepted medical value and a lack of accepted safety for use under medical supervision. Other compounds with psychedelic properties are available for licensed practitioners to prescribe only, as is the case with ketamine.
There are organizations like MAPS (Multidisciplinary Association for Psychedelic Studies), who are pushing towards the reclassification, decriminalization, or legalization for medical use of these different compounds. A number of these compounds are moving through the FDA approval process now, and more on this is covered below in the “Compounds” section.
In the United States, there are local initiatives underway pushing psychedelic legalization movements forward, as well. The recent decriminalization of psilocybin in Denver, CO, as well as Oregon state, and the decriminalization of all entheogenic plants in Oakland, CA, are significant first dominoes to fall in the movement towards increasing accessibility and awareness of the potential of psychedelic compounds and psychedelic therapy programs.
Given the different modalities and methods of psychedelic therapy, whether that be psychedelic-assisted psychotherapy, or individual psychedelic therapy sessions, the exact programs and protocols may vary considerably.
It would be a disservice to present a single, unified picture of a psychedelic therapy protocol, though that does not mean that these programs and protocols do not follow a broad experiential arc from beginning to end. It is this experiential arc that will be explored and outlined below.
Any psychedelic therapy program or experience will begin with an intake and eligibility process.
There are a number of contraindications for each compound, as well as eligibility criteria on top of this. This is to ensure the safety of the client and that they are receiving the right treatment for their specific area of focus.
These initial meetings and conversations will be done with a licensed practitioner who will review medical history, discuss intentions and aims, and help provide an overview of the experience and the specific program that the client would be embarking on. If a fit is determined by the clinician, the individual can sign up for the program and begin moving through the experience.
Each individual’s experience will vary. Some, all, or none of these experiences may happen in an individual psychedelic therapy session. These are generally accepted as notable characteristics of the psychedelic experience and the compounds that reliably induce some or all of these states.
A core component of a beneficial psychedelic therapy session and program is the preparation. Psychedelic therapy is not a magic pill, it requires a level of energetic investment from the client as well as the practitioner to ensure safety, comfort, and positive short and long-term outcomes as part of these powerful experiences. Preparation can include:
Depending on the scope of the psychedelic therapy protocol the client is embarking on, the sessions can be anywhere from a single experience to several sessions spaced out over a number of weeks.
This is dependent on:
Each session involves preparation, the experience itself, and integration. Integration can be done individually, with a Guide or support, or with the practitioner/clinician themselves.
Again, this is dependent on the specific program and will vary based on the individual.
Integration is the process of beginning to explore the insights, experiences, or feelings that arose during the session, and determining how to bring those lessons back into day-to-day life. This is done in the service of personal healing, transformation, and growth.
There will be space for integration after each session, but also at the end of the program’s final session, to begin integrating the entire experience and program as a whole.
Once the client has arrived at the end of the final session or integration phase, it is highly contextual to the individual as to what happens next.
Working with the clinician, the client can determine the next appropriate course of action, which is often one of the following:
As this is highly dependent on the individual, their results during the course of treatment, their intentions for the program, and the discretion of the clinician, this step will look different for each individual.
This is a high-level overview of a classic psychedelic therapy program. As new science is introduced, new best practices are established, and this experiential arc continues to evolve and adapt. It also leaves room for personalization, as some individuals may require or want additional integration in-between sessions, for example.
Much like traditional therapeutic contexts, the exact shape and scope of the program will depend on what the practitioner and the client agree upon together, but this provides a generalized insight into an experience with psychedelic therapy in safe and legal contexts.
Everyone’s experience of psychedelic therapy and the results that they see by the end of the programs will be different. They are not guaranteed and the compounds themselves are not magic pills.
The therapeutic container that is established, the level of trust, safety, and readiness the client feels when going into the experience, and the level of preparation, intention-setting, and integration afterwards all play a significant role in driving enduring results to the program.
There are a number of subjective effects or benefits that are being studied as powerful agents for change in the world of managing mental health, which psychedelic therapy can reliably help facilitate in individuals.
Here are some of the positive phenomenological healing effects that can come through psychedelic therapy:
These effects, when paired with a safe and effective therapeutic container, can provide a powerful catalyst for personal transformation and healing.
When combined together, clients can see small and reliable progress, or sometimes have profound experiences that serve as definitive moments in their healing journeys. Part of the continued research and study into psychedelic therapy is establishing the best practices and approaches that reliably and responsibly bring about the greatest experience and outcomes for each individual.
Despite all of the activity, potential, and research currently underway and outlined above, we’re still in the early days of the psychedelic therapy renaissance.
With more favorable regulatory environments, renewed academic and scientific interest in psychedelic compounds, and a growing need to return to individual healing and wholeness, the future of psychedelic therapy has a lot of open room to explore further. Given this, there are a few things one can expect to see in the future.
With a number of psychedelic compounds moving through various stages of the regulatory approval process, in the coming years and decades there will likely be more compounds and types of experiences available and accessible to the public.
This allows more personalized programming options, allows new or previously underserved conditions to be treated with psychedelic therapy, and expands the scope and scale of the science of psychedelic therapy overall.
With the onset of new science and studies, the therapeutic space will begin to refine best practices, hone in on qualifications and skill sets for practitioners, and determine ways to maximize the efficacy of psychedelic therapy programs.
This is all in service of driving exceptional client outcomes and returning more people to health and wholeness faster, more reliably. Alongside this lives the possibility for new experiences altogether, more personalized programming options, and creation of opportunities to merge solid clinical outcomes with artful, human-centered experiences.
All of the psychedelic compounds and therapeutic experiences come with their own unique strengths and areas of best applications.
In the future, clients and practitioners may be able to work together to curate a truly personalized healing journey, working with the best modalities and the best compounds to drive safe, reliable results for clients that are truly life and world-changing.
These touch on but a fragment of the potential that renewed interest and study of psychedelic therapy can bring to the public moving forward. We’re excited to play a part in that journey, and walk towards a bright future together.