Psychedelic Psychotherapy Insights From 25 Years of Research

This review (2016; presented in 2013) focuses on the “cartography of inner space”; the unique therapeutic potential of transcendental states of consciousness; the entelechy of the interpersonally grounded psyche; the importance of integration in drug-free therapy sessions; the roles of expectation, religious education and faith; the role of music; and future research directions.

Abstract

“Presented at a conference titled “Psychedelic Science 2013,” highlighting the resumption of investigations with psychedelic substances (i.e., psilocybin, DMT, LSD, MMDA, etc.) in the United States and Europe after a dormant period of more than two decades, the author presents insights and perspectives gleaned from his 25 years of clinical research experience. After acknowledging the vastness and potential significance of this research frontier, the article focuses on the “cartography of inner space”; the unique therapeutic potential of transcendental states of consciousness; the entelechy of the interpersonally grounded psyche; the importance of integration in drug-free therapy sessions; the roles of expectation, religious education and faith; the role of music; and future research directions.”

Author: William A. Richards

Summary

The author presents insights and perspectives gleaned from his 25 years of clinical research experience on the “cartography of inner space”, the therapeutic potential of transcendental states of consciousness, and future research directions.

Introduction: History and Scope of Observations

In writing this manuscript, I considered what I could contribute to psychedelic science, whether innovative or supportive of content presented by many colleagues.

I entered this field in 1963, when I was a graduate student at the University of Göttingen in Germany. I worked with Hanscarl Leuner on a variety of studies using psilocybin, DPT, LSD, or MDA, and also taught mental health and religious professionals. After the Controlled Substances Act, research with psychedelics and human subjects in Baltimore ceased due to administrative decisions on the state level.

After 22 years of research with psychedelics, I returned to teaching and private practice at the Johns Hopkins School of Medicine, where I am currently working with Roland Griffiths and Robert Jesse. We have reactivated earlier studies with cancer patients and persons suffering from addictions.

I have served as therapist to hundreds of persons, many of whom received multiple psychedelic sessions over time. Most of these persons had no prior experience with psychedelics, and most were in robust physical health, while others were in close proximity to physical death. I have administered psychedelics to individuals, one at a time, with closed eyes and headphones, and have noted how much one can see.

I offer observations from many diverse case histories, and acknowledge that my perceptions and interpretations are colored by my own cognitive structures and linguistic preferences.

The Vastness of the Entheogenic Frontier

Psychedelics are valuable tools in the exploration of consciousness, and they have the potential to advance both scientific and religious knowledge. When sitting silently beside research volunteers, I feel as though I am sitting beside the Buddha, St. Paul, or Isaiah.

Alan Watts (1962) suggested that we avoid this field of enquiry because we fear knowing too much about ourselves. However, volunteers who take psychedelics report experiencing phenomena that call into question our normative, consensual definition of “reality”.

The Cartography of Inner Space

There are many different states of consciousness, which can be experienced depending on dosage, personality structure, the capacity to relinquish ego-control, and the growing edge of a person’s unique personal and spiritual development.

How Little Is Known; How Much Awaits Discovery

Although scientists like to think spatially and speak a language that correlates phenomena encountered in consciousness with neuronal structures and biochemical activity to some extent, the experiential content of a particular foray into the world of alternative states is to be found within the human mind itself.

There is a lot of ignorance and lore surrounding psychedelics, even among those who possess a reasonable personal cache of psychedelic experience. Only patient research will provide the answers we seek.

The Unique Therapeutic Potential of Transcendental States of Consciousness

It is now understood that psychedelic substances may be helpful in accelerating psychotherapy and spiritual growth, but that the unique phenomenology encountered during the period of drug-action determines whether the substance will prove helpful, harmful, or neutral.

The potential therapeutic significance of psychodynamic phenomena, in the context of the Jungian “personal unconscious,” is congruent with many well-established systems of psychotherapy, including transcendental states, which are similar to states of consciousness described in the world’s great religions.

Intuitive insights that remain for many persons after experiencing profound transcendental states include a conviction of the reality of an eternal structure or principle greater than our individual egos, a feeling of interrelatedness to others within the great unity, and an appreciation of love as an ontological power beyond human emotion.

For the cancer patient, the presence of a memory of this magnitude provides a feeling that ultimately somehow all is well, which makes it possible to live the time that remains more fully, with less anxiety, depression, isolation, and pain.

The Entelechy of the Interpersonally Grounded Psyche

In preparation for psychedelic sessions, we emphasize trusting one’s own mind, being open and receptive, and having the courage to confront content that initially may appear frightening. Usually the content of a session proves to be much more skillfully choreographed than any agenda we could have planned.

The day prior to a psychedelic session, I imagine the volunteer’s own creative unconscious has composed a three-act opera and cannot wait to be experienced.

The Interrelatedness of the Personal and the Transpersonal

The term psycholytic is used to describe personal, psychodynamic forms of experience with psychedelics, which may entail abreaction, catharsis, and meaningful suffering that often lead to positive feelings of resolution, forgiveness, and rebirth.

With higher dosages and a supportive setting, profound visionary/archetypal and/or mystical forms of experience may occur, which may have little connection with the everyday historical life of the ego.

Some persons gradually progress through psychodynamic content with psychedelic facilitation, while others encounter profound transcendental content in their first forays into alternative states and subsequently “return to earth” to address issues of traditional psychodynamic import.

For persons who experience transcendental content in an initial session, it would be an error to assume that their psychodynamic work is done. Instead, it is important to explore areas of personal failure without undue loss of self-worth.

The everyday self, or ego, is an important part of each of us that moves through the world from birth until death with our proper names. The ego is best transcended through acceptance, forgiveness, and unconditional love.

Integration: The Importance of Drug-Free Sessions

Huston Smith (2000) first articulated the distinction between religious experiences and religious lives. A revelatory experience may provide an initial impetus toward behavior change, but integrative work is required to make the experience a lifelong habit.

A person who believed herself to be trapped in the womb wanted to take psychedelics until she became free. However, until she addressed her problems in drug-free sessions, no breakthrough would occur during the action of a psychedelic drug.

Most persons require a minimum of 8 hours of shared time with a therapist or guide, usually spread over a period of at least 2 weeks, in preparation for a productive psychedelic session.

After a psychedelic experience, drug-free sessions and disciplined meditative procedures may be of significant assistance in integrating the insights gained and implementing actual changes in attitudes and behavior.

After having glimpsed the top of the mountain, it is easier to maintain the motivation to struggle through the swamps and thickets.

The Roles of Expectation, Religious Education, and Faith

In my experience, faith is an important variable in increasing the probability that transcendental forms of consciousness will occur. A healthy, mature ego must be willing to trust in an unconditional manner.

People who have grown up in a tradition that includes devotion and dialogue with a deity through prayer or meditative disciplines may find it easier to entrust themselves to deeper levels of reality.

Expectation appears to have little import in determining which experiences will occur, as several Roman Catholic priests and an Australian physician experienced the death and resurrection of the Christ, while another narcotic addict experienced strange, partially-naked people dancing with strange hats on their heads.

I suspect that rigid, fundamentalistic belief systems can make it hard to navigate well in the depths of human consciousness, but honest agnosticism can facilitate the constructive exploration of alternative states of consciousness.

The Role of Music

In high-dose psychedelic sessions, carefully selected music increases the probability of potentially constructive outcomes and decreases the probability of unproductive anxiety states.

Music selections during drug onset, the ascent to peak activity, and peak activity appear of maximal importance, and should include some well-chosen classical selections from Bach and Brahms – and more recent composers such as Barber and Gorecki.

Future Research Directions

We now know that many psychedelic substances can facilitate the occurrence of fascinating and meaningful states of human consciousness, and that they can be administered safely when adequate screening of volunteer subjects is conducted.

The promise of these substances extends beyond medical applications, and they have applications in education, philosophy, literature, music, biology, and physics. They also have promise in helping us progress in our understanding of what we are.