Psychedelic therapy as a form of mental health treatment has yet to become mainstream, though ongoing research continues to show promising results. This is hopeful news, especially for people who have hit a wall in their efforts to treat chronic and debilitating mental health conditions.
Here are insights from four psychologists, with experience in psychedelic therapy, on why it could be the next frontier in mental health treatment.
Psychedelics Provide an Experience People Learn From
Matthew Johnson, PhD is a professor in the department of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. He says psychedelic therapy is the new frontier in mental health therapy based on the results researchers have produced over the last few decades, in combination with the findings from when these compounds were researched in the 1950s and 1970s.
“The drugs biologically facilitate psychotherapeutic processes,” he explains. “They prompt an experience that people learn from and that learning has long term, behavioural impact. That’s fundamentally different from the treatment of surface level symptoms that you see with virtually all other psychiatric medications. Most psychiatric medications treat the symptoms, they don’t treat the core of the illness.”
The core of the illness is typically psychological in nature, Johnson says.
For example, the medications that treat addiction, which are approved by the FDA, by and large work by interacting with the receptor system in the brain that mediates the rewarding properties, the craving, and the withdrawal you get from that drug. This is treating symptoms but the nature of addiction is not simply the withdrawal state. It’s far more than that.
“You name the drug, there's a lot of people who’ve gotten past the withdrawal and relapsed,” Johnson says. “It’s a deeper seeded psychological issue. With psychedelics, they prompt experiences which people learn from, which is the goal of psychotherapy. But it’s often not that powerful. Psychedelics biologically enhance what’s possible with psychotherapy.”
Johnson admits there’s still a lot of groundwork to do when it comes to regulating psychedelic therapy. A big component of that is the Risk Evaluation Mitigation Strategies (REMS) program required by the FDA.
“You need people trained in treatment,” he says. “There’s a whole number of factors that are going to need to be worked on...There’d need to be new clinics. What needs to be figured out is how to keep clinicians on the rails without delving into or adopting the role of priest or shaman, which is a danger in this area. There’s a whole field of professional development that needs to come along.”
While psychedelic therapy might not be for everyone, Johnson says the data holds up that it could help a lot of people. But it’s crucial that they be used in the right way that mitigates the risks.
Psychedelics Provide Another Access Point for Behavioral Change
Norman Farb, PhD of Psychology is an associate professor at the University of Toronto and the director of the school’s psychedelics studies research program. He explains that psychedelic therapy accesses another door into human behavior, revealing the deeply automated patterns of the mind.
“There’s lots of schools of thoughts on how you can give people insight or access to noticing those habits and potentially to work with what they notice,” he says. “From my perspective, psychedelics provide another one of those access points. You can have diary entries, meditation, you can talk it out with people, you can do dream analysis. Psychedelics is potentially another tool in that toolkit to help reveal the deeply automated patterns of the mind.”
This type of treatment isn’t anything new, Farb explains, as cultures have been using psychedelics for thousands of years. Now that there’s interest in its potential to treat mental illnesses, there’s commercial interest in what the next big antidepressant or antianxiety drug will be, especially since there hasn’t been much movement in that area for years.
Farb believes there can be a lot of benefits from psychedelic therapy if used in the right way, especially for people who aren’t particularly introspective on their own.
“It’s a way to fast track into having some insights,” he says. “There’s probably a lot of reason why people either automate or condition themselves to avoid having access to some of these experiences and there’s a lot of learning that will have to be done on the therapist’s side to live up to the promise of providing safe, introspective experiences that lead to some sort of positive transformation or insight or growth.”
Farb says his optimism around the use of psychedelics as psychotherapy is “guarded.”
“Once you get someone to be open to new ideas and new perspectives on things and you work on testing some of those ideas and looking at the functional outcomes of relating to other people...that is the therapeutic arch. [Psychotherapists] can definitely empower that arch. But the drugs aren’t going to do that work.”
Mental Discomfort is Rising, Psychedelic Therapy Could Help
Dr. Gabor Maté is an internationally renowned expert on addiction and mental illness. In an interview with YouTube channel Rebel Wisdom, Maté explained why psychedelic therapy could have potential, based on the prevalence of mental illness in society and the lack of treatment options that makes a lasting difference.
“Why are we even looking at psychedelics? For two reasons. Mental illness is burgeoning in society, anxiety is the fastest growing diagnosis on both sides of the Atlantic and more and more people are depressed...for social reasons, mental discomfort is rising,” he says.
“Number two, there’s the largely complete failure of the Western medical system, of which I was trained and practiced, to deal with the crisis of mental health. We don’t understand it. Fundamentally we’re in denial about the unity of the human soul and the mind and the body. We’re in denial about the social nature of human beings, we look upon mental illness as [solely] biological problems. So people are looking for solutions beyond the mainstream as they have to, because even within the mainstream the responses and the preventions are so inadequate.”
Psychedelic Therapy Goes After the Root Causes of Problems
Rick Doblin, PhD is the founder and executive director of the Multidisciplinary Association for Psychedelic Studies (MAPS). In a 2019 TED Talk, he speaks on how we’re experiencing a global renaissance of psychedelic research.
“Psychedelic psychotherapy is showing great promise for the treatment of post-traumatic stress disorder, or PTSD, depression, social anxiety, substance abuse and alcoholism and suicide,” he says.
“Psychedelic psychotherapy is an attempt to go after the root causes of the problems, with just relatively few administrations, as contrasted to most of the psychiatric drugs used today that are mostly just reducing symptoms and are meant to be taken on a daily basis. Psychedelics are now also being used as tools for neuroscience to study brain function and to study the enduring mystery of human consciousness. And psychedelics and the mystical experiences they produce are being explored for their connections between meditation and mindfulness.”
This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.
Important FDA Safety Information
Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.
Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).
Do not proceed with ketamine treatment if any of the following apply to you:
- Allergic to ketamine
- Symptoms of psychosis or mania
- Uncontrolled high blood pressure
- CHF or other serious heart problem
- Severe breathing problem
- History of elevated intraocular or intracranial pressure
- History of hyperthyroidism
- Other serious medical illness
- Pregnant, nursing, or trying to become pregnant
Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.
While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.
- In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
- Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
- Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom clinician before proceeding with treatment.
- The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.
To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:
- Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
- Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
- Continue to take antihypertensive medication as prescribed
- Avoid hangovers or alcohol intake
- Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
- Ketamine treatment should never be conducted without a monitor present to ensure your safety