Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations

This theory-building pre-print article (2022) presents an updated framework for engaging with psychedelic insights and revelations. The model proposes psychedelic apprenticeship as an updated model of ‘set and setting’. It proposes that processes underlying the conferral of meaning and truth in psychedelic experiences may act as a double-edged sword. Namely, these experiences raise important considerations regarding the validation and mediation of knowledge gained during these experiences. Three examples are used to elaborate and illustrate issues of validation. A framework is proposed to address these challenges within historical and cultural contexts, their intersubjective character and the use of practices which is conceptualised here as forms of psychedelic apprenticeship.

Abstract

“A striking feature of psychedelics is their ability to increase attribution of truth and meaningfulness to specific contents and ideas experienced, which may persist long after psychedelic effects have subsided. We propose that processes underlying conferral of meaning and truth in psychedelic experiences may act as a double-edged sword: while these may drive important therapeutic benefits, they also raise important considerations regarding the validation and mediation of knowledge gained during these experiences. Specifically, the ability of psychedelics to induce noetic feelings of revelation may enhance the significance and attribution of the reality of specific beliefs, worldviews, and apparent memories which might exacerbate the risk of iatrogenic complications that other psychotherapeutic approaches have historically faced, such as false memory syndrome. These considerations are timely, as the use of psychedelics is becoming increasingly mainstream, in an environment marked by the emergence of strong commercial interest in psychedelic therapy. We elaborate on these ethical challenges via three examples illustrating issues of validation and mediation in therapeutic, neo-shamanic and research contexts involving psychedelic use. Finally, we propose a pragmatic framework to attend to these challenges based on an ethical approach that considers the embeddedness of psychedelic experiences within larger historical and cultural contexts, their intersubjective character and the use of practices that we conceptualised here as forms of psychedelic apprenticeship. This notion of apprenticeship goes beyond current approaches of preparation and integration by stressing the central importance of validation practices based on empathic resonance by an experienced therapist or guide.”

Authors: Christopher Timmermann, Rosalind Watts & David Dupuis

Summary

Abstract

Psychedelics can increase attribution of truth and meaningfulness to specific contents and ideas experienced, but may also exacerbate the risk of iatrogenic complications, such as false memory syndrome. A pragmatic framework is proposed to address these issues based on an ethical approach that considers the embeddedness of psychedelic experiences within larger historical and cultural contexts.

1. Introduction

Psychedelics induce a multifaceted range of effects in human experience, including visual imagery, high-order phenomena such as ego-dissolution and mystical-type experiences, and profound psychological insights. These insights may be associated with significant modifications in worldviews and beliefs, which has significant ethical implications.

Evidence suggests that mystical-type experiences and psychological insights have a common mechanism that underlies their importance for improving depression, addiction and psychological distress associated with terminal illness, during psychedelic therapy.

This article reflects on ethical considerations associated with psychedelic experiences, including autobiographical insights observed in a clinical trial using psilocybin for the treatment of depression, neo-shamanic practices in the Peruvian amazon, and ‘metaphysical’ insights and revelations occurring in naturalistic and controlled research environments.

Psychedelics are prone to induce insights, and these insights may range from biographical events to metaphysical ‘revelations’. These insights are often imbued with a sense of authority and heightened validation, and their consequences may carry over long after the substances have subsided.

While psychedelic experiences may feel unmediated, recent evidence shows that similar feelings can be artificially induced via experimental manipulation with and without the administration of psychedelics. This provides fertile ground for problematic issues associated with validation of the information attained to arise.

While there is a felt lack of mediation underlying these experiences, forms of mediation are always at play, and are subject to broader contexts occurring in wide-ranging temporal scales.

In the following section we will look at examples of knowledge gained during psychedelic experiences that have led us to consider specific issues around the mediation and validation of these insights.

Psychedelic therapy can involve strange or upsetting revelations, but patients are often guided by a deep inner knowing. The therapist holds a space of gentle agnostic respect for the messages that arise.

A participant in a recent psilocybin trial had a distressing revelation of a biographical event during a session in which a medium-high dose of psilocybin was administered. The participant required extended integration therapy to enable at least partial resolution of the issue.

The participant experienced an intense suffocation event, which was scrutinised by him thoroughly after the effects of psilocybin had subsided. Six months after the session, the depression returned.

This quote illustrates ethical issues that can accompany psychedelic-induced biographical insights in therapeutic contexts, by displaying the participant’s distress concerning the revelation of biographical event, facilitated by psilocybin intake.

The study team referred the participant for 10 sessions of extended ‘Integration’ with a specialist therapist, which allowed him to reframe his experience in a new way. The process of integration may provide support in the process of becoming aware of new information.

Visitors to this centre attend two-week retreats for the purpose of ‘personal development’, during which they work with personal issues and are introduced to the specific cosmovision of the centre, which combines neo-shamanic, psychotherapeutic, biomedical and folk Catholicism elements.

Ayahuasca retreat participants may experience anxiety, uncertainty and misunderstanding following their initial ayahuasca sessions. These feelings are expressed in post-session discussions, during which participants reframe psychological or somatic issues by adopting specific cultural motifs of ‘possession’.

A framework for taking psychedelics may be useful for participants, as externalising the source of distress can have significant therapeutic value. However, the tension between pragmatic and ethical considerations is rendered clearly.

Psychedelic use may result in changes in worldviews which persist long after a session is over. These experiences pose challenges to consciousness researchers attempting to determine invariant features of psychedelic phenomenology.

DMT-induced insights may last long after a session has ended and may inform on subsequent experiences. While participants may question the validity of their reports, researchers might question the validity of first-person reports as valid data to understand the effects of these compounds on human consciousness.

Psychedelics may be particularly prone to induce a confusion between experience and representation, due to their ineffable quality and the influence of popular ‘memes’ in the cultural milieu associated with psychedelic drug use.

Preliminary data from ritual settings in Europe reveal that psychedelic experiences may significantly alter beliefs regarding the nature of consciousness and reality. These changes in beliefs were associated with increases in well-being up to 6 months after the retreat took place.

3. Contextual embeddedness of mediation and validation

Psychedelic experiences are not legitimised in the Global North, which renders the instances for mediation and validation highly unstable. Furthermore, different institutions are playing a competing role in the construction, legitimisation and maintenance of new and hybrid practices that are multiplying around the use of ayahuasca.

Once an experience of insight or revelation has taken place within a psychedelic session, the user may be left with the following questions. This text does not attempt to answer these questions, but rather to outline the subtle ways in which these processes may take place.

Insights gained in a psychedelic session are also embedded in complex social networks susceptible to intersubjective mediation and validation. Therefore, it is imperative that methodologies dealing with issues of mediation of psychedelic experiences take this into account.

Acts of becoming aware are pervasive to human experience and promote a certain amount of reflection. Contemplative practices are other examples of situations that undergo similar issues of validation.

The process of becoming aware through psychedelic-induced insights may be exacerbated by the lack of exposure to broader contexts, as illustrated by the controversies surrounding repressed memories of sexual abuse or recovered memory therapy. Psychedelic insights can feel unmediated to users, but the process of validation can be viewed from a mediated and intersubjective perspective. This is important to understand when facilitating psychedelic experiences in diverse contexts.

Expression and validation are processes that occur after becoming aware of insights within a socially situated context. They may take place with a 1st, 2nd or 3rd person position, and occur via intuitive fulfilment or empathic resonance.

The process of becoming aware aided by psychedelic experiences can be rooted within the larger social, historical and cultural context by fostering preparation, setting intentions and expressing expectations before a session, as well as reflecting upon the experience in an open-ended fashion after the experience has taken place.

Within this framework, a second-person position of empathetic resonance may be important for psychedelic therapists and researchers investigating psychedelic phenomenology. This second-person approach may guide the scientific community more widely.

The microphenomenological interview is a technique that allows subjects to re-evoke and reflect upon past experiences through a mediated (i.e. 2nd person) approach. It has been used in different research contexts to determine the micro-structures of meditation, intuition, mind-wandering and mood disorders.

The Accept Connect Embody approach is a clinical model that combines Acceptance and Commitment Therapy (ACT) and the Psychological Flexibility Model (PFM) to address three key mechanisms of psychedelic therapy: acceptance of emotion, connection to meaning, and a level of processing that occurs in the whole body, rather than just cognition.

Some individuals may feel that these explorations are not satisfactory and wish to pursue the truth. If this is not possible, they can listen to two pieces of music to obtain some sense of what feels true.

We would like to mention practices used by therapists, facilitators and mestizo/indigenous shamans, which have formed valuable psychedelic know-how employed to this day in psychedelic use. These practices include the use of structured instances surrounding the psychedelic experience, psychological support during dosing sessions, and detailed attention to users’ experience.

Under the view of apprenticeship, the guide is also involved in the process of becoming aware, and this process results in the development of learning instances that can be used to develop knowledge about psychedelic experiences and therapeutic processes.

Psychedelic experiences can be thought of as acts of becoming aware that depend on intuitive evidence. A framework has been proposed to aid in the process of validation of psychedelic insights after outlining some specific issues which may arise in different contexts.

Under this notion, the psychedelic experience requires a degree of discipline embedded in forms of apprenticeship to manage the risks of transformation. This process is intimately linked to a notion of ethics. Safety aspects associated with ingestion of psychedelics do require a set of principles which have been prescribed a priori, but the experience of psychedelics is where the epistemological challenges occur, and it is in this process that the subject will eventually learn to navigate the subtleties of the psychedelic space.

To conclude, psychedelic apprenticeships require experiential forms of ‘know-how’ that foster the development of devices that allow recursive forms of experiential inquiry.