Why Psychiatry Needs Psychedelics and Psychedelics Need Psychiatry

In this commentary article (2014) Ben Sessa argues why psychedelics can be a great tool for psychiatrists, and that both fields need to integrate more.

Abstract

“Without researching psychedelic drugs for medical therapy, psychiatry is turning its back on a group of compounds that could have great potential. Without the validation of the medical profession, the psychedelic drugs, and those who take them off-license, remain archaic sentiments of the past, with the users maligned as recreational drug abusers and subject to continued negative opinion. These two disparate groups—psychiatrists and recreational psychedelic drug users—are united by their shared recognition of the healing potential of these compounds. A resolution of this conflict is essential for the future of psychiatric medicine and psychedelic culture alike. Progression will come from professionals working in the field adapting to fit a conservative paradigm. In this way, they can provide the public with important treatments and also raise the profile of expanded consciousness in mainstream society.”

Author: Ben Sessa

Notes

This paper is included in our ‘Top 10 Articles Introducing Psychedelic-Assisted Therapy‘

Summary

The Psychiatry Tracks at the Breaking Convention Conferences were organized and chaired by Dr. Sessa in 2011 and 2013 respectively. The medical profession was adequately represented and psychedelic drugs have re-entered the mainstream with impressive force.

The relationship between psychiatry and psychedelia has been part of the necessary developmental trajectory for our culture. Now we need a new way forward.

A BRIEF HISTORY OF PSYCHEDELIC DRUGS IN MEDICINE

Scholars of anthropology have documented the ancient use of hallucinogens for psychotherapy. These early shaman hold the collective characteristics of physicians, psychotherapists, and priests.

The rediscovery of psychedelics in the 1950s was set to revolutionize psychiatry. Ronald Sandison visited Albert Hofmann’s labs and returned to England with 100 vials of Delysid to begin the world’s first large-scale use of psychedelic therapy on psychiatric patients.

After 40 years of repressive actions by successive governments to effectively halt all psychedelic research, the field is now seeing a growth of clinical and neurophysiological studies. These studies are informed hugely by imaging techniques.

THE PROBLEM WITH PSYCHIATRY

Despite advances in research methods, psychiatry remains the Cinderella of the medical profession. One hundred and fifty years ago, doctors had little idea about the pathophysiological nature of common disorders, but just around the corner was a critical advance – antibiotics.

Today, the psychiatric profession enthusiastically tracks the epidemiology of mental disorders, but lacks agreement on effective treatments. Antidepressant drugs may help a person to appear happier, but do not get to the heart of the problem.

The pharmaceutical industry is not adequately challenging the status quo in psychiatric treatment. We need a drug that can be administered for a single session of therapy, have no significant dependency issues, be nontoxic, and reduce depression, raise arousal, increase motivation for therapy, increase relaxation, and reduce hypervigilance.

Psychedelic drugs may be the Holy Grail of psychiatry, reducing the fear of recalling traumatic memories and helping the patient focus intensely on their trauma without being overwhelmed by negative affect.

Using guided psychedelic experiences as medicine, we can tentatively allow ourselves to use a forbidden word: cure. We can help patients re-label their past experiences and become masters or mistresses of their minds, not remain slaves to the random emergence of unwanted memories.

The psychedelic experience is characterized by a mysterious, apparently spiritual element that defies our current medical language. However, the subject of psychedelic spirituality usually sits uncomfortably with medical doctors.

THE PROBLEM WITH THE RECREATIONAL (NON-MEDICAL) USE OF PSYCHEDELICS

LSD was banned in the mid-1960s, which had a paradoxical effect of restricting popular use. This led to the massive 1960s drug culture, which was highly influential in coloring new approaches to multiple disciplines.

Inevitably, the psychedelic revolution irked those in authority, who forced doctors to further distance themselves from using LSD with their patients and instead toe the party line. Most gave up their research with psychedelics and returned to mainstream medicine, embracing the growing arsenal of new symptom-masking psychotropic chemicals flooding the market.

After losing the medical profession as allies, the hippies of the late 1960s became the mouthpiece of the psychedelic revolution, and their message of internal freedom fell on deaf ears for the majority of clean-living people.

The drugs themselves had moved on, and many of the beautiful people of Haight-Ashbury had morphed into a homeless army of amphetamine- and heroin-addled ghosts. The message was lost, and the psychedelic drug trade further restricted any honorable or noble message of the dying hippies.

Doctors, politicians, and other grey-suited “Men of Wisdom” have always struggled with groups of long-haired soothsayers whose sentences end with the word “man”.

Doctors need randomized, double-blind, placebo-controlled clinical studies, not reports of anecdotal drug experiences. They have to be able to appraise individuals’ mental breakdowns in the context of their drug use, and not just assume that one man’s cognitive impairment was another man’s party.

THE PROBLEM WITH THE MEDICAL USE OF PSYCHEDELICS

Medicine does not have all the answers, and psychedelic psychotherapy has never sat comfortably with randomized controlled trials. However, the main challenge lies in convincing a profession funded by the pharmaceutical industry to spend millions on researching.

Pharma companies fund large-scale randomized controlled trials of psychotherapy, but the press is free to propagate whatever message they want without the financial support of pharmaceutical companies.

The medical profession has been slow to develop a consistent, evidence-based approach to the relative harms and safety of recreational drugs with coincidental therapeutic potential. Now, over 45 years after the 1967 Summer of Love, they are starting to get a balanced opinion in the press. Sadly, today’s researchers have got their work underway by watering down the mystico-spiritual elements of psychedelics. This is essential in order to get funding and publication.

Psychiatry is overly restricted and restrictive in describing mental states only in a language of pathology, and by avoiding descriptions of the psychedelic experience in its entirety, the medical profession risks missing the transpersonal and developing substandard therapy paradigms.

Psychedelic psychotherapy must embrace the full healing element of the experience, or else it risks further polarizing these drugs into those that are acceptable and those that are not.

RESOLUTION OF THIS PROBLEM

We need to introduce these drugs gently, and convince the medical profession itself that psychedelic drugs can be used for healing. We must infiltrate their medical journals with case studies, book reviews and well-designed studies.

Psycholytic, entheogen, or entactogen are viable alternatives to the now too-negatively-biased psychedelic. These substances are medical agents, pharmacological compounds designed in the main part in laboratories by and for the medical profession.

Psychedelic drugs need to be brought back into mainstream university teaching as viable medicines to treat a range of mental disorders.

We must overcome the medical model and embrace the mental states of bliss, enlightenment, and spiritual emergence. These mental states have the same empirical validity as depression, anxiety, and agitation, and should be recognized by psychiatrists.

The economics of psychedelic medicine are also convincing, once understood. If psychedelic therapy can eliminate the symptoms of chronic mental disorders for good, then the burden of psychiatric disease can be reduced.

SUMMARY

In the twenty-first century, psychedelics cannot change the world or the course of human history. Professionals working in this field must remain boring and staid.

I do not say all of these dull and conservative things because I lack imagination, but because I believe that a cautious approach will help psychedelics enter mainstream consciousness.