Must Psilocybin Always “Assist Psychotherapy”?

This commentary (2023) critically re-evaluates the role of psychedelics in psychotherapy, focusing on psilocybin’s use and challenging its current understanding in mental health treatment. Concluding that “psychedelic-assisted psychotherapy” is a misnomer, it proposes “psilocybin treatment” as a more accurate term, foreseeing a future where psychedelics could precede various psychotherapies, antidepressants, or neurostimulation for specific conditions.

Abstract of Psilocybin Always “Assist Psychotherapy”?

Abstract generated by Blossom as the commentary has no abstract.

This article critically re-evaluates the use of psychedelics, particularly psilocybin, in modern psychotherapy, challenging the prevailing notion of ‘psychedelic-assisted psychotherapy.’ It argues for viewing psilocybin as a catalyst for therapeutic change, not a treatment modality per se, in light of historical and contemporary practices. Tracing the shift from LSD use in psychodynamic psychotherapy in the 1950s to recent psilocybin trials for conditions like cancer and treatment-resistant depression, the paper underscores the safety-oriented nature of psychological support in these studies, diverging from traditional evidence-based psychotherapies. The article delves into the neurobiological mechanisms of psychedelics, emphasizing their serotonergic properties and enduring brain connectivity changes, and considers the ethical complexities of using MDMA for PTSD treatment. Concluding that ‘psychedelic-assisted psychotherapy’ is a misnomer, it suggests the more accurate term ‘psilocybin treatment’ to reflect the unique mechanisms of psychedelic-induced change, foreseeing a potential future where psychedelics precede a variety of focused psychotherapies, antidepressants, or neurostimulation for specific clinical conditions.

Authors: Guy M. Goodwin, Ekaterina Malievskaia, Gregory A. Fonzo & Charles B. Nemeroff

Summary of Psilocybin Always “Assist Psychotherapy”?

Psychedelic drugs can produce a powerful psychedelic experience. Psychedelic-assisted psychotherapy is now commonplace.

The statement that psilocybin is a catalyst for treatment, not a treatment in itself, is grounded in an odd dualism. The psychological support provided in recent studies of psilocybin is primarily directed to safety, and does not typically receive evidence-based psychotherapy as it is usually understood.

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